Three years ago my wife and I attended a wedding in France. When our French friends would ask me what I do in my practice, I would describe Prolotherapy, which they had never heard of. Shortly into the description, they would interrupt with “Ah, c’est comme le mesotherapie, n’est pas?” (Oh, you do mesotherapy, right?), and my response was “Qu’est-ce c’est, le mesotherapie?” (What on earth is mesotherapy?).
There was a French doctor in the wedding party who briefly explained that mesotherapy is an injection therapy which is considered front line, conventional treatment for sports injuries and pain management. When I got home I did some internet searches to learn what I could about this French injection therapy. All I could find were websites describing mesotherapy for the treatment of cellulite at very high-end cosmetic clinics as well as physician trainings in mesotherapy for the treatment of cellulite at unbelievably high prices. The only information I could find in the English language on mesotherapy for sports and pain was written by Dr. Hauser and posted on the Caring Medical website. I then did a mesotherapy search in the French spelling, and found the French Society of Mesotherapy site as well as the site of Dr. LeCoz. These sites explained what my training options were in France (luckily I speak French). So I went to Paris to learn mesotherapy.
Mesotherapy, also called “meso” has been in existence for over 50 years and is considered part of mainstream medicine in France with over 16,000 doctors in France alone using it and many more around the world. Invented in 1952 by Dr Michel Pistor, mesotherapy has, in the past 20 years, exploded as far as the number of docs practicing it around the globe, research being conducted, and interest by the public. In 1987 the French Academy of Medicine (France’s equivalent of the American College of Physicians) recognized mesotherapy as an inherent part of conventional medicine. Mesotherapy has been incorporated as an integral treatment in the specialty of sports medicine in France as well as in many other countries around the world (most of Europe, North Africa, Canada, Mexico, and much of Asia). While the US is always at the cutting edge of expensive surgical procedures, anything that is inexpensive and ineligible for patenting always arrives here late and then is subject to tremendous scrutiny.
Meso has recently received a great deal of press here in the US in relation to its cosmetic medicine applications namely the treatments for cellulite, female hair loss, and the effects of aging on the skin of the face and neck. However, meso’s sports and pain applications are virtually unheard of here in the US. Upon returning from France, the only person in the US I knew who had heard of meso for sports medicine applications was one of my patients who is a professional climber who lived for years in France and had been successfully treated with meso.
Mesotherapy is elegant in its simplicity, safety, and efficacy. It is essentially a novel route of administration of conventional medications and natural substances. It involves extremely superficial and near-painless injections of various cocktails. The hypothesis is that by infusing medications intra-cutaneously (between 1mm and 4mm deep), the substances remain in the area and diffuse into the deeper tissue for up to a week whereas deeper injections or topical applications disperse much more quickly. Research has been conducted which has shown that medications injected by these very specific techniques using extremely short needles remain in the tissue for much longer periods of time and travel down into the deeper tissues, as opposed to intravenous or intramuscular administrations, which are cleared away within an hour. This allows one to resume normal activity and discontinue anti-inflammatory medication taken by mouth.
Mesotherapy dovetails beautifully into a prolotherapy practice. There are times when I use it with prolotherapy and times when I use it on its own. What makes meso of great interest to competitive athletes over prolotherapy is that with prolo, usually a minimum of one week of rest (“rest” meaning not training at 100%) is required for it to be most effective, and many athletes cannot, try as they may, comply with this. It is for this reason that meso is hugely popular around the world with elite athletes. During my time in Paris, I did a number of shifts at huge sports universities where I saw Olympian’s and professional athletes of all shapes and sizes who sought treatment with Meso. With Meso, there is no “down-time”, one can resume training right away (while I do not advocate this as rest and time are the greatest healers, the reality is- athletes are nuts).
The other time I use meso on its own is when I have new patients who have been in severe chronic pain for years. Often these people have sustained motor vehicle accidents and have extremely lax ligaments which need prolotherapy. However, my experience has been that if you jump right in with prolotherapy, sometimes (not always) these people are in so much pain to begin with that the irritation that comes from prolotherapy is too much for them. With these folks, I do a series of meso treatments along with intravenous injections of magnesium, vitamin C and B vitamins. This combination of treatments “takes the edge off” and helps them to sleep better. Once we have calmed the pain down, now we can do prolo without fear of exacerbating the condition.
Most frequently, however, I combine prolo with meso. This makes a great deal of sense. With the prolo, we are triggering the body’s natural healing response. And with the meso, we are increasing local microcirculation and introducing a multi-vitamin. This can only help the healing process. I no longer do prolo on its own; the “icing on the cake” is always finishing a session with meso and I have been very pleased with the results.