Treatments

Prolotherapy

Prolotherapy is a non-surgical, regenerative injection technique. Prolotherapy stimulates the body to heal damaged tendons, ligaments, and joints. With local anesthesia, a thin needle is used to inject a dextrose (glucose) solution. The injection stimulates growth factors and creates a proliferation of white blood cells and fibroblasts that rebuild heathy tissues.  Prolotherapy is inexpensive because it is so simple. Pharmaceutical companies cannot market "sugar water" (dextrose) injections.

 

Early on after an injury, 1-2 treatments may be needed. For long standing problems, 4-6 treatments may be necessary at 4 week intervals. You might have to take it easy for a few days after prolotherapy because of soreness. Prolotherapy creates a temporary inflammation that tricks the body into healing. For this reason, anti-inflammatory medications should be avoided during prolotherapy treatment.

 

Consider prolotherapy if your doctor says:

"Take this medication for your pain"

"Just don't do that sport anymore"

"You're too old. It is never going to heal"

"You need to learn to live with it"

"There is nothing more we can do about it"

"We could try a cortisone shot"

" The next step is to get an MRI scan"

" Maybe you need to have surgery"

Platelet-rich plasma (Emcyte Brand Pure PRP)

I take advantage of a natural pharmacy in your bloodstream, called the "platelets".  Platelets are a fantastic medicine circulating in your blood, which are full of growth factors that stimulate healing.   A small sample of your own blood is removed and spun in a centrifuge for 15 minutes. This process purifies the platelets and growth growth factors from the blood. Emcyte brand "Pure PRP" is a rich yellow color because the red blood cells have been removed.  The Pure PRP is injected into damaged joints, torn ligaments, or injured tendons. Emcyte PRP devices are safe and 510(k) FDA-cleared. Pure PRP can be considered when dextrose prolotherapy does not completely fix the problem. Pure PRP may be the first choice for muscle tears, or severe tendon problems. Although Pure PRP injections are more expensive than dextrose prolotherapy, the body heals faster and less injections are needed.

 
Cellular Regenerative Injections
Sometimes prolotherapy with dextrose or using PRP does not give adequate healing.  The problem may be the lack of locally available repair cells. Cellular treatment borrows your own body’s repair cells from either bone marrow or fat (adipose tissue), and put these cells into action where they are needed. Preliminary research shows promising results. Critics of cellular treatments call it the “Wild, Wild West” of 21st century medicine and surgery, because the benefits are not yet sufficiently proven.  With cellular treatments, repair cells are not manipulated, and no additives are used.  The cells are taken from, and put back into, the same patient on the same day.  The results of these injections are not immediate. It can take 3-6 months to see the full benefits
 
Bone Marrow Concentrate (Emcyte Brand Pure BMC)
Bone marrow is an important reservoir of repair cells. These cells repair joints, cartilage, tendons and ligaments. Your repair cells can be isolated using a centrifuge and on the same day, these cells can be strategically placed into arthritic joints, damaged articular cartilage, injured meniscus, or torn ligaments to promote healing.
 

The aspiration procedure typically takes less than 10 minutes and begins with having you lie face down on your stomach. The top back part of the hip bone, called the iliac crest, is the harvest site. Local anesthesia is used to minimize pain.  A needle is then advanced into the iliac crest, and between 50mL and 100mL of bone marrow is aspirated from the region. The bone marrow aspirate is then placed in a special Emcyte centrifuge to concentrate the repair cells from the rest of the marrow. The bone marrow concentrate (BMC) is then placed into a syringe in order to be injected into the desired area. BMC injections can be combined with PRP, and this may give better results. 

 
LipoGems
Fat (adipose tissue) is another rich source of repair cells. It is widely used in cosmetic surgery.  Why not put your fat to good use?
LipoGems is the latest technology which harnesses the innate healing capabilities of adipose tissue. It is 510(k) FDA-cleared for orthopedic use in the office. A mini-liposuction procedure is used to obtain a fat sample (lipoaspirate), under local anesthetia (tumescent anesthesia).  The lipoaspirate is minimally processed (i.e rinsed clean of blood and oil in a closed system), which maintains the fat's vascular stromal niche. The final product is used to fill defects inside joints, ligaments or tendons. Fat grafts can be a successful “stand-alone” treatment, but some specialists combine fat with PRP and BMAC.  Watch the following video to learn more:

 

 

 

 

Perineural Injections (PNI)

PNI is a new and promising treatment for nerve pain.   A dextrose solution is injected subcutaneously in multiple areas around peripheral nerves to dissipate pain. The result is an immediate relief of pain.  Treatments are repeated at weekly intervals until the pain permanently resolves.  A new variation of PNI is a slightly deeper injection, called "hydrodissection" of a peripheral nerve using dextrose. Ultrasound is used to precisely hydrodissect and heal a sick peripheral nerve.

 

PNI complements prolotherapy by dealing with the nerve pain component of the pain cycle. Whereas traditional prolotherapy and PRP address bone, ligament, tendon, muscle and joint pain generators, PNI addresses  pain generated from inflammation in the nerves themselves. 

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PNI is useful for headaches, postherpetic neuralgia, complex regional pain syndrome, carpal tunnel, and other types of nerve pain syndromes. PNI was initially called Neural Prolotherapy (NPT) by its discoverer, Dr. John Lyftogt.

Musculoskeletal Ultrasound (MSKUS)

MSKUS gives high resolution real time images of joints, ligaments, tendons and cartilage. MSKUS can help diagnose tendon tears, tendinosis, or excess joint fluid. Ultrasound guidance is helpful in some cases for needle injections. 

Prolotherapy:

* Repairs the underlying cause of your pain

* Is a long-term solution, not a short-term fix

* Unlike cortisone injections, heals tissues.

* Gets you back doing things you want to do

* Is a safe, effective non-surgical treatment

* Works as long as the tendon or ligament is 

   not completely torn or shredded.

* Is simple,  inexpensive and  "low tech"

* Uses a different kind of MRI.  The doctor's 

   hand is an MRI (MRegional Investigator). 

   A good examination may be more 

   important than an MRI scan.

* Avoids surgery. Do prolotherapy 1st and 

   surgery last. Surgery can always be done,

   but never undone.

 

 

 

 

Bio-identical hormones

Sometimes healing is impaired because of insufficient hormone levels, including DHEA and testosterone.  Bio-identical hormones can be safely taken to replace the deficiencies. 

 

Insurance and Regenerative Injections

Insurance companies consider dextrose prolotherapy, PRP, and stem cells experimental and do not currently pay for these treatments. We ask for payment at time of service.

 

 

 
 
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