PROLOTHERAPY Eliminates Long-standing Pain...
Simply... Quickly.... And Without Side Effects.

Does the following describe you?

• You need surgery or surgery has failed
• Take anti-inflammatory drugs, but no lasting relief
• You have had years of pain and told there is no treatment
• Manipulations / adjustments help but don't last
• The more you do, the more you hurt
• You need to change positions all the time
• You have deep pulling, achy spinal pain
• You lack endurance
  
• Pain interferes with your normal sleep pattern

Prolotherapy involves a short series of injections containing a variety of substances into weakened ligaments, tendons and structural tissues that are overlooked as the source of pain for many common pain conditions. The injected material irritates the tissue. The body reacts by constructing new tissue growth at the site of the injections. This non-surgical, non-drug treatment mobilizes the body's very own natural healing agents, a response that strengthens and stabilizes damaged or weakened tissues and joints, resulting in amazing relief - usually permanent.

The technique was first reported in a 1937 issue of The Journal of the American Medical Association by Louis W. Schultz, M.D., an oral surgeon who found he could provide full relief for patients with temporomandibular joint (TMJ) pain with injections of fatty acids. ·

Over the next twenty years, George S. Hackett, M.D., an Ohio physician, applied the technique to patients with a variety of pain problems. He monitored many patients for years to determine the effect of the treatment and reported his findings in leading publications such as Journal of the American Medical Association, American Journal of Surgery, and the British Journal of Physical Medicine.

• One of his studies involved 665 patients, ages 15 to 88, who suffered with pain from 3 months to 65 years (average: 4 ½ years). Twelve years after treatment 82 percent of the patients considered themselves long "cured."
• Hackett's foremost disciple was Gustav A. Hemwall, M.D., an Illinois physician. Between 1955 and 1996, when he retired, he was the leading Prolotherapy instructor and clinician in the United States. He treated more 10,000 patients. In 1974, he reported the results of a clinical survey of 2,007 patients and revealed that 75.5% of the patient considered themselves recovered and cured of chronic pain, 24.3% as generally improved, and only 0.2% as not improved.
• One of Dr. Hemwall's patients was C. Everett Koop, M.D., who later became the Surgeon General of the United States. Koop went to Hemwall for treatment of persistent back and leg pain and was healed after a few treatments. Koop, a pediatric surgeon, was so impressed that he learned the technique himself and offered it to the parents of his patients who he saw suffered from pain.
  
  

  Why does it work?

  In laboratory experiments, Dr. Hackett found that his technique stimulated the growth of ligament and tendon tissue and was especially effective at reinforcing the "weld" of these structures to the bone. prolotherapy injections are made at the site of so-called fibro-osseous junctions, that is, points in the body where ligaments and tendons adhere to bones.
• Ligaments and tendons are bands of tough, fibrous connective tissue that link structures in your musculoskeletal system and basically enable you to move. Ligaments connect bones, providing stability to joints and prevent and preventing overextension. Tendons attach muscles to bones, and thus transmit "muscles power" to bones.
• Strains and sprains, overuse injuries, and microtrauma from repeated stress and damage ligaments and tendons. Often they do not heal completely because of poor blood supply in ligament and tendon tissue that prevents immune cells and other healing agents from reaching the area. Incomplete repair leads to a loss of tissue strength.
• A slow deterioration of ligaments and other structural tissues can also result from underfunctioning or degeneration of internal organs and glands, poor circulation, nerve impingement due to joint misalignments, and blocked channels (meridians) of energy.
• Any of these scenarios can undermine the normally tough, taut ligaments and tendons. They become relaxed and weak, allowing too much movement of joints, and thus become potential generators for prolonged pain.
• Nerves become irritated, resulting in both local pain and so-called referred pain, that is, pain felt elsewhere in the body. Joints that are too loose may pinch nerves or blood vessels and create additional damage. Muscles in the vicinity of weakened ligament and tendons tighten to help stabilize suddenly destabilized joints. Moreover, the fibro-osseous junctions have high concentrations of nerves and if there is damage in the area, you will feel it. In fact, the periosteum (outer layer of bones), ligaments and tendons are regarded as the most pain-sensitive areas of the body.
• Prolotherapy injections permanently strengthen these vulnerable and sensitive tissues, and in the process, reduces and often eliminates the pain right at the source.
• Prolotherapy cause growth of new, normal tissue. The method stimulates ligament and tendon growth.
• Initially, Dr. Hackett injected animals and found that one to three injections caused a 40% increase in the diameter of tendons - a near doubling of tendon strength. Later studies by other researchers supported his findings. They included these results:
• Within six weeks, the inside knee ligament of injected rabbits increased by 44% in mass and 27% in thickness compared to non-injected animals. The fibro-osseous junction increased in strength by 28%. (YK Liu, Connective Tissue Research, 1983).
• Tendon girth increased an average of 20 to 25 percent in injected rabbit knee and Achilles tissue after six weeks. Injections appear to mimic the early stages of the body's normal injury repair mechanisms by promoting the activity of certain immune cells involved in the healing process. (JA Maynard, Journal of Orthopedic Research, 1985).
• Prolotherapy causes a regrowth of tissue, an increase in the number of fibroblasts (connective tissue cells), and an increase in collagen, the structural protein that forms tendons, ligaments, and cartilage, and is responsible for the strength of these tissues. (T Dorman, Journal of Orthopedic Medicine, 1994).
  
  

  Can Prolotherapy Help Your Pain?

  Many kinds of chronic pain are triggered by weakened and damaged structural tissue involving ligaments, tendons, muscles, and joints. Prolotherapy specifically addresses these problems.
  
  

  Back Pain

  This is the single most expensive health care problem and the most common cause of disability for people under 45.
  
  Very frequently, back pain occurs as a result of injury or degeneration of the ligaments in the back, such as the sacroiliac ligament or the ring of ligaments holding vertebral disc in place. Low back problems, resulting from weakened ligaments, can cause debilitating local pain as well as sciatic pain in the legs and other lower extremity discomfort.
  
  In a 1956 medical journal article, Dr. Hackett reported on a series of 124 patients with low back pain disability, half of whom had previously undergone unsuccessful back surgery. Prolotherapy for these patients produced an 80 percent cure rate.
  
  In a 1991 study on chronic low back pain among individuals unresponsive to other treatments, Robert Schwartz, M.D., reported that 40 out of 43 patients experienced pain relief after six weeks of Prolotherapy treatment. Already after two weeks of treatment, he said, 35 patients reported two-thirds less pain than before, and 20 of them said the pain was 95 percent improved (Journal of Neurology, Orthopedic Medicine, and Surgery, 1991).
  
  Harold Wilkinson, M.D., a neurosurgeon at the University of Massachusetts Medical Center, found that just a single Prolotherapy injection was enough to give significant relief to patients with chronic low back pain referred to him after failed back surgery. He reported that one injection have significant relief to 76 percent of 349 patients, including 29 percent with total relief.
  
  

  HEADACHES, TMJ AND NECK PAIN

  Undiagnosed ligament abnormalities in the head and neck cause many chronic headaches, neck aches, and oral pains. If the primary cause of the migraine is ligament or tendon injury in the neck, total elimination of pain can be expected in a high percentage of cases.
  
  In a 1963 issue of the medical journal Headache, Daniel Kayfetz, M.D., reported that Prolotherapy gave relief to 86 percent of 189 patients who developed chronic head and body pains after whiplash injury. 60 percent of the patients had full relief of pain.
  
  Headaches and neck pain may also stem from temporomandibular joint problem, the junction just in front of the lower part of the your ear where the temporal bone of your skull attaches to your jaw, or mandible. Poorly fitting braces, poor dental work, and trauma can cause a problem in the TMJ - and lots of pain. When you open and close your mouth, a popping or clicking sound in the joint indicates a TMJ problem. Injecting the affected ligament effectively relieves pain.
  
  

  KNEE PAIN

  Ligament and tendon injury and weakness are primary causes of pain that develop in the knee and often lead to crippling arthritis. Four ligaments are critical to the stability of the knee joint. They are the anterior (ACL) and posterior cruciate ligaments (PCL), and the medial (MCL) and lateral collateral ligaments (LCL). The ACL is the most frequently injured ligament of the knee, and a cause of considerable instability, pain, further damage, and eventual arthritis. Most ligament injuries involve partial tears of the ligament tissue, which can be substantially helped by Prolotherapy. A complete tear of a ligament requires surgery.
  
  Kenneth D. Reeves, M.D., a physical medicine and rehabilitation specialist at the Kansas City Bethany Medical Center, found that Prolotherapy treatments for patients with painful arthritis of the knee produced significant improvement. Injections were given periodically over a three-year period. At the end of the experiment period, the researchers found that pain at rest, with walking, and with stair use have improved by 45, 43 and 35 percent respectively (Alternative Therapies in Health and Medicine, 2003).
  
  

  "REFERRED PAIN "

  This is a tricky problem that is unfamiliar to most health practitioners. A "referred pain" means that an injury to a ligament in one part of the body transmits pain to another part of the body. For instance, weakened hip ligaments can refer pain to the big toe. A sacroiliac ligament problem in the low back can send pain down the leg to the side of the foot, resulting often in misdiagnosis of "sciatica." This phenomenon was first described many years ago by Dr. Hackett, who mapped out referral patterns of ligaments in the hip, pelvis, lower back, and neck.
  
  

  Prolotherapy Helps Many Conditions

OSTEOARTHRITIS This is the common wear-and-tear-arthritis, and it often occurs because weak ligaments cause joints to operate in an uneven fashion that leads to cartilage damage.

SHOULDER PROBLEMS Shoulder dislocations, rotator cuff tears, and age-related degeneration.

 

REPETITIVE STRAIN INJURIES (RSIs) Pain in hands, wrists, and elbows is commonly caused by repeatedly performing the same manual tasks each day, Golfer's or tennis elbow, and even Carpal Tunnel pain, may often be misdiagnosed damage to the annular ligament that attaches the radius bone to the ulnar bone adjacent to the elbow, and facilitates the rotational movement of the hand.

 

HIP , KNEE , ANKLE SPRAINS AND FOOT PAIN including Achilles tendonitis, plantar fasciitis, and even bunions caused by ligament laxity.

 

FRIBROMYALGIA Interestingly, many of the 18 so-called "tender points" associated with fibromyalgia are located at the site of tendon and ligament insertions, and thus respond superbly to Prolotherapy treatment.

 

SPORTS INJURIES involving tendons, ligaments, and muscles. Prolotherapy promotes healing and earlier return to activity.

FAQs About Prolotherapy

IF PROLOTHERAPY IS SO GOOD, WHY HAVEN'T I HEARD ABOUT IT? Prolotherapy has long been practiced, studied, reported on, and taught in medical workshops, yet it is largely unknown. More than any other reason, lack of public familiarity is due to the influence of the pharmaceutical, surgical, and medical device industries that dominate the medical system. Former U.S. Surgeon General C. Everett Koop, M.D., an advocate of Prolotherapy, points out that the very simplicity of the treatment itself for such a wide variety of musculoskeletal problems makes skeptics of many physicians who do not understand the method. To skeptics it sounds too good to be true. Prolotherapy is recognized and taught by the American Association of Orthopedic Medicine. However, it is not taught in Medical schools. Physicians must take time, as I did, to learn through intensive hands-on training. There are only a few hundred physicians in North America with the proper specialized training qualified to perform Prolotherapy.

Is Prolotherapy Safe?

It is very safe when administered correctly by trained physicians. Gustav Hemwall, M.D., one of the pioneers for Prolotherapy, treated more than ten thousand patients with more than four million injections without incident. "Not even a pimple" formed at injection sites, he once said. However, any medical treatment, including injections, bears a risk of adverse reactions and complications. In the case of Prolotherapy, the risk is very small. Injections are done near nerves and vessels. The injections are done directly to touch bone, which minimizes the potential damage to nerves and vessels but damage can occur. As will all medical procedures, side effects and risks can occur but rare: these include increase pain, numbness, and infection, allergic reaction to medication, weakness, headache, pneumothorax, dizziness, nausea and death.

Will Prolotherapy Work For Me?

Individuals who have unresolved chronic pain or who have suffered a recent painful injury should consider Prolotherapy treatment. The technique received an endorsement from the Mayo Clinic in its April, 2005 health letter, the clinic stated that when chronic ligament or tendon pain fails to respond to more conservative measures, like physical therapy and prescribed exercises, prolotherapy may be helpful. And when surgery is the only remaining option to relieve chronic pain, prolotherapy is a much less invasive and expensive technique that may be worth a try. Prolotherapists are trained to follow a diagnostic routine that uncovers the presence of damaged ligaments. Many times CAT or MRI scans cannot detect ligament abnormalities that cause chronic pain, and particularly so for the common, yet typical undiagnosed problem of damaged ligaments referring pain elsewhere in the body. The most important diagnostic tool available, believe it or not, is the thumb. I apply pressure to a particular site of chronic pain or a point I suspect as the source of "referred pain." If the patient "jumps" because of the tenderness of the particular ligament, this indicates that the pain-producing structure has been identified. There are other indicators of ligament weakness: pain aggravated by movement, a cracking sensation in the joint with movement, a chronic misalignment of a joint, and temporary relief from physical therapy, massage, or chiropractic adjustments. Prolotherapy often gives relief where other techniques may fail, or it enhances the benefits of other techniques such as chiropractic and physical therapy. If you are under the care of a chiropractor, acupuncturist, or other allied health professional, suggest using the thumb palpation test on a suspect ligament. If the pressure produces a good deal of pain, a ligament problem is likely present that will benefit from Prolotherapy treatment. Hormonal and nutritional deficiencies are factors that can interfere with efficiency of Prolotherapy treatment. These deficiencies undermine immune function. A strong immune system is necessary to ensure a good healing response from the treatment. In my clinic, hormonal and nutritional problems are routinely addressed as part of a holistic approach to better health. Ligament weakness can be cause by poor circulation, blocked meridians, and joint misalignments. These abnormalities need to be corrected for maximum Prolotherapy results.

How Many Treatments Do I Need For Relief?

The number of injections to obtain relief varies considerably from patient to patient and injury to injury. For healthy patients, one injection can relieve their pain totally, but usually a series of three to four treatments are sufficient. At the most, patients need ten treatments. If there is no improvement in pain, prolotherapy will usually not be continued. If progress is being made, treatments are usually performed every four to six weeks. Most ligaments heal within this time. If multiple sources of pain are involved - for instance, neck and back pain - I will usually inject one site first and then the other several weeks later. Subsequent injections are administered about four to six weeks after the previous injections at a given site.

Will The Treatment Relieve My Pain Right Away?

The injected solution contains an anesthetic (Lidocaine) that often generates immediate pain relief. After the effects of the anesthetic subside, patients tend to experience various degrees of soreness and swelling around the injection site for several days. This is the result of healing and inflammatory substances rushed to the area by the body. Applying ice or taking anti-inflammatories are not recommended. You want the inflammatory process to run its course, which results in strengthened tissue. Relief of the original pain usually continues for a few weeks after the first treatment. However, after initial stabilization, some pain may return. This occurs because full regrowth of ligament tissue is not complete. Follow-up evaluations and /or treatment are recommended every four to six weeks. Sometimes pain is entirely relieved after a single treatment. Residual pain generally diminishes with each treatment. In the case of an acute injury, healing can occur within a few weeks of injection.

Do the Injections Hurt?

Prolotherapy involves precise injection on the site of the torn or stretched LIGAMENT OR TENDON. Depending on the site and size of the area involved, this may necessitate many injections during one office visit. These injections are uncomfortable because they involve multiple needle sticks. Many patients tolerate this well but some patients, prior to procedure, may require oral sedative, like valium. Local anesthetic to produce skine wheels is also used over the area to be injected, making it more comfortable .

How Much Does Prolotherapy Cost?

Procedure fees vary depending on body part, which can range from $150- $300 per session.  A second body part on same day session is discounted 50%.

We will not bill insurance companies for prolotherapy. Fees are paid at the time of service and we will supply you with a superbill upon request, to turn to your insurance company for any reimbursement

If you expect to receive the procedure on the same day of the consultation, please do not take any anti-inflammatory medicines at least one week before your appointment. If you have any questions, please feel free to call the office or email me at lizasmigel@gmail.co

AREAS                        COST

Low Back                    $250-300
Neck                           $250-300
Thoracic                      $250
Shoulder                     $200
Elbow                         $150
Wrist/Hand                 $150
Hip                              $200
Knee                           $200
Ankle/foot                  $150

Is Anyone Too Young or Too Old for Prolotherapy?

I treat patients ranging in age from teenagers to nonagenarians. Occasionally I treat younger children who have been injured in accidents. Youngsters usually require fewer treatments than older individuals, and often can be totally relieved in one or two sessions. Older people tend to heal more slowly and thus may require more treatments. However, the use of nutritional medicine, including oral supplements or even intravenous nutrients, can significantly shorten healing time and improve overall health. It is amazing - and very gratifying - to witness the relief on the face of older patients who have suffered chronic pain · For more information on prolotherapy, check out: www.aaomed.org and www.getprolo.com