Prolotherapy is a non-surgical, reparative 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 (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. "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. 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.
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.
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.
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 and PRP to be experimental and do not currently pay for these treatments. I ask for payment at time of service.
* 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 (My Regional 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.