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Prolotherapy Doctors
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.
FOLSOM
Michele Raithel ND
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
EAST
LANSING
David Pawsat,
D.O.
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
GOSHEN
Irwin
Abraham, M.D.
HICKSVILLE
David Borenstein, M.D.
MANHATTAN
Irwin Abraham, M.D.
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.
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From the Journal of Prolotherapy
Prolotherapy for 20 Year Old Ankle Injury
Clive Sinoff, MD
Mr. AS was a 58 year-old man when he consulted me in July 2005 for a
work-related injury of his ankles. The injury occurred some 22 years earlier
when he fell off a roof, landing on his feet and causing substantial damage to
his
ankles and feet. He had
physical
therapy for seven years following the
accident, and eventually underwent arthodesis of both ankles and right foot.
This helped his stability, but he continued to have significant pain.
Therapeutic ultrasound, a TENS unit, and hot foot soaks only provided transient,
mild relief.
At the time of his initial consultation AS reported pain between 5 and 7 out of
10 (with 10 being extreme). Using a cane, he was able to walk with difficulty,
but was no longer able to participate in physical leisure activities or go
shopping. In addition, he had developed some shoulder discomfort which he
attributed to the use of a cane.
Examination showed a stilted gait with a moderate limp on the right. Ankle
movement was 0 to 40 degrees on the left, and 5 to 30 degrees on the right.
There was minimal inversion or eversion on each side and minimal movement of the
toes. There was rigidity of the hind and mid-foot bilaterally. He had moderate
tenderness around the malleoli, anteriorly and on the dorsum and arches of each
foot. (See Figures 1 & 2.) X-rays of the right foot showed irregular sclerosis
and lysis of the
tarsal bones with various areas of joint fusion with
irregularity and some narrowing of multiple joints. X-rays of the left foot
revealed fusion of most of the hind foot and mid-foot joints, including the tarso-metatarsal joints. (See Figures 3 & 4.)
Treatment
To control pain, the patient initially required significant doses of
narcotics.
Prolotherapy was started in May 2006. On the right ankle he had two treatments,
and then refused more treatment, because of pain, until June 2007. At that time,
he had another three treatments at monthly intervals. Later, in April 2008, he
received an
injection, and a final focal injection in August 2008 (a total of
seven sessions over two years).
He had only two injections in the left ankle,
one in November 2007 and the final in May 2008. The solution consisted of 3.5ml
P25G (phenol 2.5%, glucose 25% and glycerin 25%), 3.5ml of Sarapin (an extract
from Sarracenia purpurea (pitcher plant) in alkaline solution High Chemical
Company, Levittown, PA), and 3 ml of 2% lidocaine with epinephrine per 10ml.
Injections were given into all tender ligaments and, on two or three occasions,
into the right tibio-talar joint from an anterior approach. The early sessions
used between 6 and 10ml of solution per foot. But at the end, when the tender
areas were much more focal, only 1-4ml was used per foot.
Figure 1. Medial view of the right ankle and dorsum of the foot with tender
points marked at his first visit in July 2005.
Figure 2. Lateral view of the right ankle and dorsum of the foot with tender
points marked in July 2005.
Figure 3. X-ray of tarsal bones of the right foot. Extensive lytic and
sclerotic changes are noted in the tarsal bones with extensive joint narrowing.
Figure 4. X-ray of tarsal bones of the left foot. Extensive arthritis and
arthrodesis is demonstrated.
AS also received 10 low level laser treatments to the right ankle, some during
the time he had suspended Prolotherapy, and some a day or two after injection to
reduce pain.
Outcome
Although there was significant injection and post injection pain for several
days after each injection, AS began to notice a progressive reduction in pain.
The narcotics were steadily reduced and by July 2009, he reported minimal pain
and no longer needed analgesics. He had a fairly normal gait without a cane, and
no tenderness. AS described his ankles and feet as the best ever.
Discussion
Prolotherapy of the ankles and feet resulted in substantial improvement in pain
and function after more than 20 years of severe pain and disability. Arthrodesis
had reduced mobility but had failed to improve his pain or function. In
retrospect, I would not use the same intensive solution, since P25G, especially
in the concentration administered, was significantly painful, especially in the
early sessions. I would recommend using alternative, less painful solutions such
as dextrose, Sarapin (a plant alkaloid) and/or sodium morrhuate, but without
P25G, unless healing was unsatisfactory. This case illustrates the power of
Prolotherapy. One can only imagine how much suffering could have been avoided
and how much function could have been preserved if AS had sought Prolotherapy
soon after his injury.
This case also illustrates the power of clinical examination, since no further
X-ray or MRI scan was performed. The total cost of all these injections is about
the same as a single MRI scan.
Low level or cold laser therapy is also a useful modality with pain reducing
and healing properties. I have seen no studies comparing laser therapy and
Prolotherapy, nor the combined use. Although some authors have claimed laser
therapy to be anti-inflammatory, the described effects (increased blood flow,
increased ATP, release of cytokines and infiltration of inflammatory cells)
suggest that the mechanism of action is by low level inflammation and,
consequently, this may prove a useful modality to combine with Prolotherapy.1-3
References
1. Marovino T. Cold lasers in pain management. Practical Pain Mgt. Sep/Oct 2004.
2. Bjordal JM, et al. Low-level laser therapy in acute pain: A systematic review
of possible mechanisms of action and clinical effects in randomized
placebo-controlled trials. Photomed Laser Surg. 2006;24:158168.
3. Fulop AM, et al. A meta-analysis of the efficacy of phototherapy in tissue
repair. Photomed Laser Surg. 2009;27:695702.
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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
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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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