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Find A
Prolotherapy Doctor
Physicians Add Your
Listing
● 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.
|
 The NSAIDs Crisis
(January 13, 2005)
Rick Marinelli, N.D., M.Ac.O.M.
News reports the last few
months on the increased cardiovascular risks associated with taking
NSAIDs
(research) is
hardly a news flash for those progressive doctors doing
Prolotherapy and other
cutting edge pain therapies. Ever since Merck took rofecoxib (Vioxx) off the
market in September, it seems one carboxylic derived NSAID after another has
fallen as evidence of or suggestion of injury has been associated with their use
including voldecoxib (Bexstra), celecoxib (Celebrex), and now naproxen (Naprosyn,
Aleve). The public and uninformed doctors are now scrambling for alternatives to
taking these drugs when the answers have been before us for a long time.
The primary reason knowledgeable doctors have not wanted their patients taking
these NSAIDs is the inhibiting effect of these drugs on healing
ligaments,
tendons,
cartilage. While not all NSAIDs are created equal there is significant
animal data to indicate a general inhibition in wound repair and
collagen
synthesis in the presence of these drugs. Ligaments have been shown to have less
tensile strength, articular cartilage is less robust, and tendon strength is
inhibited when chronically exposed to NSAIDs in these classes or when these
NSAIDs are taken after an acute injury. Collagen synthesis and remodeling of
wounded areas is how our bodies have such remarkable self-healing capabilities.
If this becomes unbalanced, as with the inhibition of collagen synthesis in the
presence of carboxylic derived NSAIDs, then this lack of healing quickly gives
way to accelerated tissue breakdown of the collagen matrix, leading to
degeneration of the tendons (tendinopathy), of the cartilage (Osteoarthritis),
and of the surrounding ligaments (joint instability). In part this occurs
because there is now an imbalance of the collagen remodeling with a definite
trend toward collagen breakdown instead of repair and regeneration. To be sure
this may be associated with injury, age, osteoarthritis, or an immune-mediated
type of collagen vascular disease like rheumatoid arthritis as well as nutrient
deficiencies and other metabolic disturbances.
So what are we to do?
There are an increasing number of studies on the efficacy and safety of
Prolotherapy
or regenerative injection therapy in soft tissue pain, joint instability,
tendinopathies,
chronic low back pain, and osteoarthritis. Many of
you have had direct experience of the benefits of this approach and as we are
able to use specific
growth factors the effects of
Prolotherapy
will improve to
an even greater degree. There is also an increasing body of evidence to support
the long known effects of diet, nutritional supplements, herbal medicine, and
exercise on the healing of collagen and specifically on osteoarthritis. Let’s
just briefly mention the best studied of these.
Glucosamine sulfate:
Ever since the Lancet study in 1999 on oral
glucosamine for knee osteoarthritis,
it has been clear that our observations were correct. Many doctors have been
using glucosamine for years prior to this study showing that not only are
functional symptoms greatly improved (e.g. pain-free walking time) but in some
cases cartilage regrowth and an increase in thickness of the cartilage was able
to be seen on xray. Similar results have been associated with the oral ingestion
of other GAGs (glycosaminoglycans) such as chondroitin (more chondroprotective
than regenerative), bovine trachea cartilage, green-lipped muscle, etc. Dr.
Reeves knee prolotherapy studies have shown similarly impressive results with
only the use of local anesthetic and glucose! Many of us have used glucosamine
for years as an addition to our
Prolotherapy solutions in the hope of even
better results. I believe future studies will show there is an increased benefit
with this approach for most patients.
Fish oil: Type
in fish oil on the query line of the National Library of Medicine (Pub
Med) and you get almost 10,000 hits. To say there are many articles on the
benefits of taking fish oil as a supplement is a gross understatement. In
addition to its well-recognized effects on cardiovascular risks (decreases in
strokes, blood pressure, blood viscosity, triglycerides, vascular inflammation),
you will find studies suggesting benefits in osteoarthritis, soft tissue pain
and inflammation, and reduction of the breakdown of the collagen matrix we have
been talking about.
Antioxidants:
Despite recent flawed studies on the negative effects of antioxidants, the
majority of studies show an overall reduction in cancer, degenerative diseases,
and cardiovascular mortality from the use of antioxidant supplements.
Clinically, this is especially apparent in osteoarthritis. Whole food
antioxidants such as fish, green tea, berries, chocolate, garlic, and nuts are
especially easy additions to one’s diet.
Herbal medicine:
Historically, in traditional herbal medicine many formulae have been
successfully used. Prominent among these are those containing the herbs ginger,
boswellia, angelica dahurica, salvia, atractylodes, lycium, bupleurum, poria,
etc. The complexity of these herbal medicines and the lack of research funding
(like prolotherapy) has hampered understanding from a scientific perspective.
These herbal medicines will gain prominence in use as they are better
understood. Many important discoveries in pharmacology have been associated with
the study of traditional herbal medicine prescriptions.
Exercise: The
lack of exercise in our culture is certainly a huge problem with soaring rates
of
obesity, cardiovascular mortality, and diabetes as a result. This is hardly
news to prolotherapy doctors who along with others have been advocating and
prescribing exercise to their patients from the beginning. In older athletic
patient, or with “weekend warriors” there are greater challenges with optimizing
the amount of exercise. Many of these folks also have excessive collagen
breakdown due to exceeding their bodies’ repair abilities. This repair function
is often improved with the addition of glucosamine, fish oil, antioxidants, and
herbal medicine and a more reasonable and varied exercise approach. Often, there
are deficiencies of anabolic repair (hormones such as
Testosterone,
Growth Hormone, thyroid) inhibition by metabolic factors (excess sugar intake, insulin
resistance, cytokine imbalance) or a combination of these factors. An
experienced practitioner can help to sort these out. Overall though, more
exercise is better!
Conclusion:
From the preceding discussion, I think it is clear there are many good natural
alternatives to the use of NSAIDs. If you are a patient, seek out those
practitioners (like most that are listed here) who have experience in these
areas. If you are a doctor that would like to use these approaches but have
little experience, please seek out some of the excellent continuing education
courses offered. Your patients will be glad you did.
|
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
Videos Online
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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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