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Find A
Prolotherapy Doctor
Physicians Add Your
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● ARIZONA
PHOENIX
Fred Arnold, DC, NMD
Kent L.
Pomeroy, M.D.
SCOTTSDALE
Michael Cronin, N.D.
David Tallman, DC, NMD.
TEMPE
Robb D.
Bird, NMD
TUCSON
Jorge B. Cochran, ND.NMD
● ARKANSAS
Merl
B. Cox, D.O.
●
BRITISH COLUMBIA
Christoph Kind, N.D.
●
CALIFORNIA
ANAHEIM
AREA
Hanson
Wong, M.D.
Howard Rosen,
M.D.
AUBURN
Rodney Van Pelt, M.D.
BAKERSFIELD
Payam Kerendian, D.O.
BEVERLY HILLS
Behzad Emad, M.D.
Payam Kerendian, D.O.
CLOVIS
Kevin Wingert, M.D.
GARDEN GROVE
Howard Rosen,
M.D.
GLENDALE
G. Megan Shields, M.D
IRVINE
Allan
Sosin, M.D.
Los Angeles
Donna Alderman,
D.O.
Marc Darrow, M.D
Hanson
Wong, M.D.
Los
GATOS
Joshua M, Donaldson, N.D.
Marin County
Paul
Handleman, D.O.
John Monagle, NMD
Monterey
Howard Rosen,
M.D.
SAN
DIEGO
Andrew
Kulik, D.O.
Gary Matson, D.O.
SAN FRANCISCO EAST BAY
Donna Alderman,
D.O.
SAN FRANCISCO NORTH BAY
Paul
Handleman, D.O.
John Monagle, NMD
San
Ramon
Richard I.
Gracer, M.D.
SANTA
BARBARA
Allen
Thomashefsky, M.D.
SANTA
CRUZ
Joshua M, Donaldson, N.D.
SANTa monica
Peter Fields, M.D.,D.C.
SANTa
ROSA
Justin Hoffman, NMD
Temecula
Edward A.
Venn-Watson, M.D.
UKIAH
AREA
Rodney Van Pelt, M.D.
● COLORADO
BOULDER
Gary Clark, M.D.
BROOMFIELD
Christopher J. Centeno, M.D.
John
R. Schultz, M.D.
COLORADO SPRINGS
Mary Harrow, D.O,
DENVER
Joel A. Berenbeim, D.O.
Thomas Ravin, M.D.
FORT COLLINS
Mark Kelley, N.D. LAc
LITTLETON
Jo
Ann Douglas, M.S.,D.O
PARKER
John
A. Littleford, D.O.
STEAMBOAT SPRINGS
Jon Freckleton, D.O.
● CONNECTICUT
AVON
Valley Sports Physicians & Orthopedic
Medicine
Paul Tortland, D.O.
Albert Kozar
WEST
REDDING
Perry M.
Perretz, D.O.
● DELAWARE
SOUTHERN NJ
Scott R. Greenberg, M.D.
SOUTHERN PA
Brian J.
Shiple, D.O.
● FLORIDA
ORLANDO AREA
Nelson Kraucak, M.D.
ORMAND BEACH
Hana Chaim, DO
Clearwater
Felix Linetsky, M.D.
PLANTATION
Alvin Stein,M.D.
SARASOTA/TAMPA BAY
Mark Walter, M.D.
Wellington Chen, M.D.
Matthew Burks, M.D.
TAMPA BAY AREA
Felix Linetsky, M.D.
Robinson Family Clinic
● GEORGIA
WARNER ROBINS
E.
Glynn Taunton, D.O.
MARIETTA
Robert C. Shuman, M.D.
● HAWAII
HAIKU
Kevin Davison, N.D.
HILO
Liza Maniquis-Smigel, MD
Honolulu, Hawaii
Liza Maniquis-Smigel, MD
● ILLINOIS
CHICAGOLAND
Ross Hauser, M.D
PEORIA
Yibing
Li, M.D.
Jay Harms,
M.D.
WESTERN ILLINOIS
Anwer Rasheed, M.D.
● INDIANA
CLARKSVILLE
Steven
M. Johnson, D.O.
LAFAYETTE
Carolyn
G. Kochert, M.D.
Mishawaka
Mark S. Cantieri, D.O.,
● IOWA
CLINTON
Anwer Rasheed, M.D.
IOWA CITY
John
Macatee, DO.
WEST DES MOINES
Jacqueline M Stoken, D.O
● KANSAS
KANSAS
CITY AREA
K. Dean Reeves, M.D.
TOPEKA
Doug Frye, M.D.
● KENTUCKY
LOUISVILLE
Steven
M. Johnson, D.O.
● LOUISIANA
NEW ORLEANS AREA
Thomas K. Bond, M.D.
● MARYLAND
Rockville
Ingrid Gheen, M.D.
● MASSACHUSETTS
MALDEN
Albert V. Franchi, M.D.
WORCESTER
Jon Trister, M.D.
● MICHIGAN
Howell
Jerald Gach, DO
SHELBY TWP
Robert Krasnick,
M.D.
Southfield
Jerald Gach, DO
WARREN
Robert Krasnick,
M.D.
● MINNESOTA
EXCELSIOR/Menahga
Mark T. Wheaton, M.D.
MINNETONKA
George H. Kramer, M.D.
● MISSOURI
KANSAS CITY
Edward McDonagh, D.O
ST. Peters
Michael J.
Adams
● MONTANA
HAMILTON
Mark Kelley, N.D. LAc
● NEVADA
CARSON CITY
Alfred N.
Grimes, M.D.
RENO
Andrew C.
Wesely, M.D.
● NEW JERSEY
BLAIRSTOWN
Walter R. Grote, D.O
CENTRAL NJ
Edward Magaziner, M.D.
WAYNE/NORTH NJ
Robert
Kramberg, M.D.
SOUTH NJ/PHILADELPHIA
Scott R. Greenberg, M.D.
(Cherry Hill)
Joseph P. Mullane, M.D.
(Hamilton)
Brian J.
Shiple, D.O.
(Springfield PA)
●
NEW MEXICO
Albuquerque
R. Dean Bair, D.O.
James
E. Baum,
D.O.
SANTA FE
James
E. Baum,
D.O.
Jonas R. Skardis, DOM
● NEW YORK
BALDWIN
Pandu Tadoori, M.D.
BUFFALO AREA
Timothy L. Speciale, D.O.
BROOKLYN
Neil Raff, MD, CNS
David Zirkitev,
P.A.
EAST MEADOW
Christopher Calapai, D.O.
FLUSHING
Neil Raff, MD, CNS
HICKSVILLE
David Borenstein, M.D.
MANHATTAN
Richard Ash, M.D.
David Borenstein, M.D.
John H. Juhl, D.O.
Robert Kramberg, M.D.
NEW YORK METRO AREA
Perry M. Perretz, D.O.
Edward Magaziner, M.D.
Scott R. Greenberg, M.D.
ORANGE
Neil Raff, MD, CNS
ROCKLAND
Neil Raff, MD, CNS
WESTMINSTER
Neil Raff, MD, CNS
● NORTH CAROLINA
ASHEVILLE AREA
Stephen
Blievernicht, M.D.
CARY
Catherine Duncan, D.O.
Huntersville
Dr. Mark Hines
● OHIO
AKRON/CANTON
Vladimir Djuric, M.D.
BLUFFTON
L. Terry Chappell, M.D.
CENTERVILLE
Rick
Buenaventura, M.D.
CINCINNATI
Michael J. Bertram, MD
TOLEDO
AREA
Jay W. Nielsen, M.D.
● OKLAHOMA
BROKEN ARROW
Shirley J.
Welden, M.D.
● OREGON
ASHLAND
Allen
Thomashefsky,M.D.
EUGENE
Thomas
Peterson, M.D.
HILLSBORO
Kevin C. Wilson, N.D.
LAKE OSWEGO
Noel S. Peterson, N.D.
MEDFORD
Carl Osborn, D.O.
OREGON CITY
Joanne Gordon, ND,MS,PT
PORTLAND
Rick Marinelli, N.D.
Chiaoli
Lu, ND. LAc. DAOM.
Patrick Chapman, N.D.
Joshua David,
N.D.
REDMOND
E. Payson Flattery, D.C.,N.D.
SALEM
Donald McBride, Jr, ND
● PENNSYLVANIA
BALA CYNWYD
Harvey Kleinberg, D.O.
BETHLEHEM
James F. Frommer, M.D.
ELKINS PARK
Kab S. Hong, M.D.
JEANNETTE
Martin
P. Gallagher, M.D., D.C.
MEADVILLE
Paul Peirsel,
M.D.
PITTSBURG
Paul S. Lieber, MD
SOUTHERN NJ - PA
Scott R. Greenberg, M.D.
Allan Magaziner, D.O
Edward Magaziner, M.D.
SPRINGFIELD
Brian J.
Shiple, D.O.
WOMELSDORF
Peter J Blakemore, D.O,
● SOUTH CAROLINA
GREENVILLE/SPARTANSBURG
Robert Schwartz, M.D.
CHARLESTON
Marc N.
Dubick, M.D.
MOUNT PLEASANT
Patrick
Lovegrove, D.O.
● TENNESSEE
BRENTWOOD
Mark L.
Johnson, M.D.
CLARKSVILLE
Rafael Prieto, M.D.
JACKSON
Marcus
E. Meekins, M.D.
MEMPHIS
Marcus
E. Meekins, M.D.
NASHVILLE
Mark L.
Johnson, M.D.
● TEXAS
AUSTIN
Mihnea Dumitrescu, M.D.
David
K. Harris, M.D.
Brad Fullerton, M.D.
DALLAS
Michael Ellman, M.D.
DENTON
Carlos
J. Garcia, M.D.
FORT
WORTH
Gerald Harris, DO
Dennis E. Minotti II, D.O
David E. Teitelbaum, D.O.
HOUSTON
Robert Battle, M.D.
Adam Weglein,
D.O
HOUSTON AREA
Joseph
G. Valdez, M.D
John P. Trowbridge
MESQUITE
Michael Ellman, M.D.
PARIS
Gregg
Diamond, M.D.
Norberto Vargas, M.D.
PLANO
Michael Ellman, M.D.
RICHARDSON
Gregg
Diamond, M.D.
Norberto Vargas, M.D.
SAN ANTONIO
Annette M. Zaharoff,
M.D.
SHERMAN
Gregg
Diamond, M.D.
Norberto Vargas, M.D.
SUNNYVALE
Gregg
Diamond, M.D.
Norberto Vargas, M.D.
TOMBALL
Shaun Lehmann, M.D.
Curtis Fandrich, D.O.
● UTAH
PARK CITY
Harry Adelson, N.D.
Kenneth Hurwitz, M.D.
SALT LAKE CITY
Harry Adelson, N.D.
E. Alan Jeppsen
SPANISH FORK
David Taylor Roberts, M.D
● VERMONT
WINOOSKI
Jonathan
E. Fenton, D.O
● VIRGINIA
ALEXANDRIA
Robert H. Wagner,
M.D.
BLUEFIELD
Lenny
Horwitz, DPM
FAIRFAX
Mayo
Friedlis, M.D.
McLEAN
David Wang, D.O.
VIRGINIA BEACH
Lisa
Barr, M.D.
● WASHINGTON
ISSAQUAH
Jena
Schliiter., M.D.
SEATTLE
AREA
Richard
A. Sandler, M.D.
JoAnna Forwell, N.D.
Adam R.
Geiger, N.D.
● WEST VIRGINIA
MORGANTOWN
Nori Onishi, D.O.
● WISCONSIN
EAU CLAIRE
Deborah Raehl, DO
WAUWATOSA
Neal Pollack, D.O.
MILWAUKEE
William
J. Faber, D.O.
|
 Inflammation
Marc
Darrow, M.D.
What is Collagen?
Our bones and muscles are held together by the aptly named
connective tissue.
Connective tissues are
ligaments,
which connect bone to bone, and
tendons, which connect the bones to muscles. It
is also the fascia covering muscles and the joint capsule tissue.
Ligaments and tendons are made of
collagen. When the ligaments and tendons are
injured, the body produces collagen to heal them. The problem with ligaments and
tendons is that the body offers them a poor blood supply and, because of it, a
poor chance to completely heal.
The poor supply of blood to the ligaments and tendons is very apparent from
their white color. Muscles on the other hand are red because they have a very
good blood supply. Ligaments and tendons therefore are prone to not heal
completely from injury, because their limited blood supply does not offer, among
other things, the supplies necessary to rebuild collagen.
Collagen and Degenerative Disc Disease, Collagen and
Degenerative Joint Disease
Most are familiar with collagen because of its cosmetic benefits. Skin is held
together by collagen and young skin has plenty of it, making it smooth and
wrinkle-free. As we age, the quality and quantity of collagen diminishes and
breaks down. Years of sun exposure, facial movement, and gravity aggravate the
signs of age. Wrinkles and creases appear; the cheeks are not as full; and the
upper lip usually thins out.
Just as the collagen in our face deteriorates, so does the collagen in other
parts of our body. This includes the ligaments and tendons in, and around, our
joints. Where loss of collagen in our face is signified by wrinkles, in our
joints it is signified by pain and a diagnosis of degenerative joint disease or
degenerative disc disease.
The key to
Prolotherapy is its ability to
stimulate the growth of collagen and therefore, the growth of new
ligament and
tendon tissue. Grow stronger ligaments and tendons and you repair the injury and
reverse the degenerative cycle of
arthritis and wear and tear disorders.
A Profile of Collagen
Collagen makes up 70-90% of the stuff that holds our bones and joints together
and in their proper place. Some older readers may remember that old horses were
often sent to the "glue factory." The reason is that boiled collagen is used as
glue.
In degenerative disease and aging, collagen, like glue, dries out and loses its
ability to stretch. Why this happens more in some individuals than others is
speculation at this time. There are many theories including, but not limited to,
poor genetic makeup, blood type with its specific
dietary requirements, viral or
bacterial load, pathological conditions, acidity in the body, and food
allergies, to name a few.
But just as collagen can rejuvenate damaged skin to make you look better,
collagen can rejuvenate your soft tissues to help eliminate your pain.
Collagen and Joint Injuries
In non-injured ligaments or tendons, collagen fibers are flexible and have some
elasticity. Elastic as they are, they are not supposed to stretch very far.
Injuries occur when we stretch these fibers beyond their designed lengths.
Injuries also occur when wear and tear through repetitive motion fray and tear
at these fibers.
When these tissues are
stretched beyond their normal limits, wear out, or tear,
pain is perceived.
Inflammation produces pain, which is a sign the body's healing process is
occurring. So initially,
inflammation
occurs as the body tries to heal the damage. Since the tendons and
ligaments have a poor and limited blood supply, it is important not to
shut down the initial inflammatory response. Shutting down the inflammation is
equivalent to shutting down the healing cycle and YOU prevent yourself from
healing correctly. In all cases that require
Prolotherapy, the ligaments and tendons, whether through the
use of anti-inflammatories, or because of a weakened immune system, or because
of the severity of the injury, did not heal sufficiently.
When things do not heal correctly, not only is there chronic pain, but now
inflammation, initially our friend, also becomes chronic and bothersome.
Injured, loose, or stretched out ligaments are often referred to as ligament
relaxation, or
Ligament
laxity. This is what produces the pain and discomfort,
especially with movement. Because of the laxity, the joint may move beyond its
normal range of motion.
Referred Pain
Pain will not only occur at the site of the injury and loose ligaments, but may
also be
referred to other parts of the body.
Referred pain is created by ligament laxity around a joint, but is felt at some
distance from the injury. These painful points that refer pain elsewhere are
called
trigger points, and will be dealt
with later. Abnormal joint movement also creates many "protective actions" by
adjacent tissues. Muscles will contract in spasm in an attempt to pull the joint
back to the correct location or stabilize it to protect it from further damage.
When this occurs in the back,
orthopedic surgeons will often try to reduce
vertebral instability by fusing the vertebrae with bone and/or metal fixation.
But there is often an easier and more conservative way to achieve the same
stabilization. And this is the outcome of
Prolotherapy.
Unfortunately, this is where chronic problems begin, because the conventional
medical practice with its emphasis on pain relief, treats the symptom—pain, and
not the problem—laxity. A patient will likely be told to take anti-inflammatory
drugs, which is often precisely the wrong thing to do because inflammation is
the first part in the body's healing process.
Nonsteroidal anti-inflammatories (NSAIDS)
and
cortisone (an anti-inflammatory steroid) can give immediate relief, but with
a risk of creating a long-term injury with chronic pain.
By blocking inflammation, anti-inflammatories never allow complete healing, and
instead, aggravate the situation.
Inflammation and the Healing Process
If we allow the inflammation process to run its cycle without interference, we
see that inflammation leads to granular tissue formation that results in new
collagen tissue being created. The new collagen forms new threads, which attach
themselves to the damaged tissue.
New collagen fibers are short, they lose water and shrink, and as they attach
themselves to the old ligament, muscle, joint capsule, or tendon, these tissues
become more dense. Denser tissue is stronger tissue. This process is much like
the scab on a wound or scar that tightens up and shrinks once healing occurs.
The difference is that with
Prolotherapy, biopsies have shown brand new, beautiful tissue
without evidence of scarring. In essence, the tissue is healed, rejuvenated and
made stronger than before.
The Science Behind the Regrowth of Collagen with
Prolotherapy
As we have noted, the collagen in our bodies, especially in the tissue around
and near our joints, is prone to breakdown. We subject our joints to wear and
tear through repetitive movement, injury, accident or any other number of
reasons. Because the connective tissue around our joints and
cartilage
have poor blood circulation, conventional treatment maintained that any injury
to connective tissue was often irreparable. This was before a study conducted by
Y. King Liu.
In a 1983 study of
Prolotherapy's effectiveness, Y. King Liu injected five percent
sodium morrhuate
solution into the
medial collateral ligament
of rabbits. He
found that after five
injections,
the ligament mass increased by 44 percent, the thickness by 27 percent, and the
strength of the ligament bone junction increased by 28 percent(1).
Liu's study (1)confirmed the results of an earlier study done by George Hackett
(2), M.D. In 1955, Dr. Hackett and his colleague Dr. D.G. Henderson, reported on
two years experimentation on the effects of the proliferant Sylnasol when
injected into rabbit tendons.
In 48 hours, histological tissue examinations revealed an early inflammatory
reaction surrounding the nerves and blood vessels with lymphocytic (immune
system cells that remove damaged tissue) infiltration throughout the area
between the two tendons and between the tendons and its sheath.
Two weeks after the
injection,
fibrous tissue was present; lymphocytic infiltration had diminished, although
some was still present, which showed that the proliferation of new white fibrous
tissue was still being stimulated.
One month after injection, fibrous tissue was present, and lymphocytic and
fibroblastic (immune system rebuilding cells) activity was greatly diminished.
In other words, they finished their jobs and moved on.
One year after three injections of the proliferant solution, the diameter of the
tendons increased dramatically, which was estimated to double the strength of
the tendon.
References
1.
Liu Y, Tipton C, Matthes R, Bedford T, Maynard J, Walmer H.
An in situ study of the influence of a sclerosing solution
in rabbit medial collateral ligaments and its junction strength. Connect Tissue Res 1983;11:95-102.
2. Hackett GS, Henderson DG. Joint Stabilization: An experimental, histologic
study with comments on the clinical application in ligament proliferation. Amer
J Surg 1955;89:968-1973.
|
Prolotherapy
Information and Research
Prolotherapy
●
Prolotherapy
●
How
Does Prolotherapy Work?
●
Why
Does Prolotherapy Work?
●
How
Prolotherapy Helps?
●
Indications - Contraindications
●
Introduction to Prolotherapy
● Why Get Prolotherapy?
● What is Prolotherapy?
●
How Does Prolotherapy Work?
● Are You A Prolo Candidate?
● Ligament Reconstruction
●
How Safe Is Prolotherapy?
●
Finding a Prolotherapy doctor
●
When Prolo May Not
Work
●
20 Questions - Prolotherapy
●
The History of Prolotherapy
●
Curing Chronic Pain
●
Sclerotherapy?
●
Turning to Prolotherapy
●
Prolotherapy and Chronic
Pain
● Proof Prolotherapy is Working
●
Creating Collagen
●
How To
Support Treatment
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Platelet Rich Plasma PRP
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Prolotherapy
and Inflammation
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Prolotherapy
In The News
Prolotherapy
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Prolotherapy to the knee
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Back and Spine treatments
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Shoulder treatments
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Prolotherapy Information sites
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