What Is Prolotherapy?

Prolotherapy, or proliferation therapy, is an injection-based treatment used for chronic musculoskeletal conditions. It is a non-surgical, regenerative, alternative treatment option that stimulates the body’s natural healing process to strengthen and repair injured and painful joints and connective tissue.

How Does It Work?

The prolotherapy injection consists of a natural irritant, such as a dextrose solution, which is injected into the affected joint. Once activated, the body’s healing response kicks in and begins to strengthen and repair the damaged ligaments. Essentially, it tells the body to give more support to the affected joint. Without proper support, joints can be painful and easily injured. Once the joint is better supported, the pain will start to fade.

The affected joint requires several shots of prolotherapy in order for the treatment to be effective. This can consist of 4 to 15 shots per session, with several sessions occurring over 3 to 6 months. Once completed, the pain relief that this treatment provides is permanent, relying on the body’s self-healing process. In addition, the increased stability of the joint improves the overall movement and function of the back and other joints.

What Can It Treat?

Prolotherapy can be used to treat a wide variety of musculoskeletal conditions, including:

  • Foot & ankle problems
  • Knee pain (including MCL, LCL, and ACL sprains)
  • Baker’s Cysts
  • Pelvic tilt & Functional Leg Discrepancy
  • Chronic pelvic pain
  • Sciatica and Pyriformis Syndrome
  • Sacroiliac joint disorders
  • Herniated discs
  • Back pain
  • Tennis/Golfer’s elbow
  • Shoulder pain
  • Rotator Cuff Tendonitis
  • Biceps Tendonitis
  • Headaches
  • Post-Concussion Syndrome
  • Compression fractures
  • Arthritis
  • Carpal tunnel syndrome
  • TMJ / Temporomandibular Joint Dysfunction
  • Ehlers-Danlos Syndrome (EDS)

How Does Prolotherapy Compare To Other Treatments?

Pain killers and anti-inflammatory medications provide only temporary relief. On the other hand, surgery does not always work to stabilize a joint fully and poses the risk of causing more damage. There are several studies that describe the outcomes of prolotherapy, showing its success in treating osteoarthritic thumbs and fingers as well as osteoarthritic knees.

The success rates for prolotherapy are high and consistent, according to a meta-analysis. About 85% to 95% of patients with low back pain experienced a significant reduction in pain and improvement in range of motion and quality of life following the treatment. These results last a lifetime and future treatments are almost never needed. This compares poorly to patients who underwent invasive back surgery, about 52% of which saw improvement.

What To Expect

If you considering Prolotherapy for your musculoskeletal pain, bring it up with your doctor. They will discuss with you whether or not you are a good candidate for this treatment option. If you have a chronic condition, you may not be suitable for this treatment; your doctor may recommend an alternative that would be more likely to relieve your pain in the long-term. Before considering if this treatment is right for you, your doctor will take scans of your joint or back to determine the location and severity of the injury.

Once you and your doctor have decided on this treatment, they will instruct you to stop anti-inflammatory medications at least 2-3 days before treatment. Continuing to take these types of medications can prevent the therapy from working. On the day of your treatment, you should eat a large protein-filled meal. The treatment begins like any other shot – the doctor sterilizes the area with rubbing alcohol. They will then apply a numbing cream to the area; the needle used for Prolotherapy goes deeper into the body than that of a vaccine and may cause some pain. If you are extremely sensitive to pain and discomfort, sedation may be used. The doctor will administer several shots of the irritant to several different points around the joint or back, depending on the area or joint affected.

Risks & Side Effects

Out of all documented cases of Prolotherapy, the worst side effect is an infection at the site of injection. This generally presents with fever and pain but can be easily treated with antibiotics. Directly after the injection, the area may feel worse than it did in the first place, but this is normal. Over time, the pain and swelling will fade.

If you have a subacute musculoskeletal condition or injury and are considering Prolotherapy, call Greenberg Regenerative Medicine today at (833) 440-4325 or schedule a consultation online!

What Is Platelet-Rich Plasma (PRP) Therapy?

Typically, chronic joint pain and other injuries have been treated with medications, physical therapy, or surgery. However, over the past several years, there has been a dramatic increase in the use of PRP therapy, and it has been found to be very effective in treating many different types of joint injuries.

Blood is made up of several components: plasma (the liquid), red and white blood cells, and platelets, which are known for their clotting properties. These platelets contain hundreds of growth factor proteins, which are a known mechanism in the healing of joint injuries. To make PRP therapy very reliable and effective, the platelet concentration is significantly increased. The treatment contains 5 to 10 times more growth factor proteins than the natural levels present in your body.

Injection for Spine Osteoarthritis

What Should I Expect?

In the first step of the treatment, the doctor will draw your blood. In the lab, they will separate all the blood components from the platelets, where they use centrifugation to increase the platelet concentration. The platelet cocktail is then mixed with some of the patient’s own blood; the injured area is locally numbed prior to re-injection. The procedure takes about one hour, including platelet preparation and recovery time. It does not require bed rest or hospital stays, and most people return to their jobs and activities in the same day. In many cases, PRP therapy is an effective alternative to invasive surgery. However, many athletes receive platelet injections after having joint surgery (or during surgery) to speed up the healing process and improve outcomes.

Conditions Successfully Treated with PRP Therapy:

  • Back and neck injuries
  • Tendonitis
  • Sports injuries
  • Ligament Sprains
  • Tennis elbow
  • Frozen shoulder
  • Pelvic pain and instability
  • Post-concussion syndrome
  • Cervicocranial syndrome
  • Ehlers-Danlos Syndrome (EDS)
  • Labral tears of the hip and shoulder
  • ACL, MCL, and meniscus tears
  • Rotator cuff tears
  • Osteoarthritis (knee, shoulder, hip, elbow, thumbs, and spine)
  • Achilles tendonitis, plantar fasciitis, & foot and ankle pain

Recovery & Results

Improvement may be seen within a few weeks and gradually increases as the joint heals. Studies have confirmed definitive tissue repair in PRP therapy patients, proving effective in relieving pain returning injured patients to their normal lives. The speed of your recovery will vary depending on nutritional status, ability to heal, overall health, and the severity of the injury. PRP injections are administered on an individual basis; depending on your injury, you may require more than one session. Although small joints take one to four treatments, chronic back and neck injuries may require six to twelve sessions.

Upon your initial visit, Dr. Greenberg will do a complete medical and musculoskeletal examination. He will check for referred pain and determine if PRP is the best course of treatment for you. In addition, he will check for pelvic tilt or functional leg length discrepancy, an acquired condition in which one leg becomes slightly shorter than the other. This may not be evident in many cases but can lead to joint dysfunction in the spine, sacroiliac joint, hips, pyriformis, knees, and ankles. Dr. Greenberg pioneered a highly successful treatment for pelvic tilt in 1999 that is still widely used today.

What Is Stem Cell Therapy?

Stem Cell Therapy is an alternative regenerative treatment for musculoskeletal pain in which the body’s own stem cells are injected into the affected area. Stem cells are incredibly adept and can regenerate any organ, muscle, vascular system, and nerve pathway in the body. When this treatment is combined with Platelet Rich Plasma (PRP), it is turbocharged with more growth factors and cells that have a greater ability to recruit the immune system to heal. Stem cells, PRP, and Prolotherapy are all considered Kinetic Regenerative Therapies. Based on the location, severity, and chronicity of your condition, Dr. Greenberg may recommend one or a combination of these three treatments.

What Exactly Are Stem Cells?

‘Stem cell’ is an overarching term used to describe several types of regenerative cells. Often referred to as Mesenchymal stem cells, they are extracted from the patient’s blood, along with biological growth factors. Mesenchymal stem cells are created in bone marrow but are stored in the highest concentrations in fat cells (which makes them easy to harvest). Mesenchymal stem cells are multipotent stromal cells that can include osteoblasts (bone cells), chondrocytes (cartilage cells), adipocytes (fat cells), myocytes (muscle cells) pericytes (vascular system cells), endothelial cells, neural progenitor cells, and other components.

How Can They Help Me?

Once the stem cell concoction is injected into the affected joint, the body’s natural healing process is activated. While the stem cells are hard at work rebuilding your tissues, White Blood Cells, Macrophages, and growth factors help to reduce inflammation, promote the proliferation of collagen, and enhance cell growth. Stem cell injections are used for a wide variety of musculoskeletal conditions affecting the head, neck, shoulders, elbows, wrists, fingers, back, hips, pelvis, knees, ankles, and feet.

What Does The Procedure Entail?

There are many factors that can affect a patient’s treatment plan, including age, severity of the injury, immune response, and the rate of healing. For some patients, positive results may be felt within a week. Other patients may require several months to heal fully. Unlike synthetic treatments, stem cell therapy simply stimulates your body to heal faster. It is very important to remain patient and give the cell structures time to grow back.

To determine if this is the best treatment for you, Dr. Greenberg and his team will review your condition, medical history, radiographic studies (scans), and perform a Comprehensive Kinetic Diagnosis. A Comprehensive Kinetic Diagnosis seeks to identify the root cause of your pain and create a roadmap for joint regeneration that resolves the core problem and eliminates many of your symptoms.

During the procedure, a local anesthetic is applied to numb both the harvest and treatment region. The harvest area is the site where your cells are drawn from your adipose tissue using two very small incisions. They are then prepared according to FDA guidelines by your Stem Cell Therapy team. Dr. Greenberg will then perform a comprehensive treatment to the damaged region and related areas that are contributing to the source of pain and joint dysfunction. Often times, adipose is used as a fat graft in patients who have joint damage in knees, ankles, hips, shoulders, elbows, and thumbs; patients with neck and back pain will receive direct treatment to areas of the spine and sacrum.

Since the Mesenchymal cells are autologous, meaning they were taken from the patient, there is an extremely small risk of rejection. The only documented complication is an infection at the injection site, which can be treated with antibiotics. You may experience pain and discomfort in the joint for a few days after the injection, until the healing process kick-starts.

If you or a loved one are considering Stem Cell Therapy, call Greenberg Regenerative Medicine today at (833) 440-4325 or schedule an appointment online!