Integrative Medicine By Damon Miller Prolotherapy? Is that a real treatment? Definitely. In fact it’s a promising, minimally invasive procedure that assists in the healing of joint problems. I first heard of Prolotherapy in the 1990’s. Simply, it involves the injection of a solution into a joint or around a tendon that is having problems. It is not a steroid injection. I repeat, it is not the injection of steroids. I looked into it when I first heard of it, but could find no set protocol, no research to prove its effectiveness, and no one local to teach me how to do it. Over the years I’ve kept my ears and eyes open to the development of this procedure, and I think it is ready for Prime Time. Let’s use the knee as an example. The technique can be used on any joint, any muscle and any tendon, but there is some data published about the knee, so we’ll use that for our discussion. People with pain in their knees know that it can be very debilitating. Often they are given a diagnosis of arthritis, but that is just a label. Being told that you have arthritis is never followed with a discussion of all of the amazing things that modern medicine has to offer. You are told to take some ibuprofen if your stomach will tolerate it. There was an interesting review article published in the New England Journal of Medicine in July of 2002. The article, A Controlled Trial of Arthroscopic Surgery for Osteoarthritis of the Knee (NEJM, Vol.347, No.2, July 11, 2002, p.81-87) (Click HERE for a link to the article) described a study that compared the results of doing arthroscopic lavage of the knee, arthroscopic debridement or just a “placebo procedure”. It turns out that the “placebo procedure” was as effective as the $30,000 surgery. Prolotherapy may be considered a placebo by many physicians, but it is a placebo with results that rival those of a very pricey and risky surgery. What is injected? Dextrose, which blocks the capsaicin receptor, inhibits substance P, blocks cyclic inflammation, and tightens bonds between collagen-rich tissue i.e. tendons , ligaments, cartilage & joint capsules Homeopathic anti-inflammatories that block pain and assist with rebuilding cartilage. Procaine, which blocks pain and stabilizes and restores damaged neurological membrane potentials. Vitamin B-12, which is utilized in protein metabolism, promotes healthy collagen formation, and is utilized in inflammation reduction within cells. And occasionally vitamin B-6, which helps with the utilization of proteins, and is important for collagen formation. Finally, thanks to the work of Dr. Frank Shallenberger, some practitioners finish the procedure with the injection of ozone. Ozone contributes to the healing of the tissue, and the doctors who do many of these procedures feel the ozone has taken Prolotherapy to a whole new level. Some practitioners use a substance called Platelet Rich Plasma (PRP) for their injections. In some sense, injections of PRP are a variation of Prolotherapy. Radiologists who have seen cases of actual cartilage regrowth with these therapies have been so excited by the results that there have been articles published in the radiology literature. See the American Journal of Radiology (AJR) for their review article from March, 2011, Volume 196, p. 628. (Click HERE for a link). We are considering doing Prolotherapy in our own office. Ask the next time you are in if you have a chronically troublesome joint. Or if you want ways to present this to your physician, let us know. Just try it, especially before you embark on a complex and expensive surgery. To your health.