Among sports-related injuries, post-concussion syndrome is one of the most elusive and challenging problems to treat. While many patients will recover from their concussion, just as many will not. To make matters worse, as an athlete sustains repeat concussions, the chance of recovery becomes less likely. Symptoms of post-concussion syndrome vary from patient to patient but can include headache, difficulty in tracking objects, slower reaction times, anger, lightheadedness, anxiety, depression, blurred vision, difficulty in concentration, photophobia (intolerance to bright light), and phonophobia (intolerance to loud sounds). These symptoms can range in severity from being slightly annoying to becoming an overwhelming disability.

Most patients who suffer from post-concussion syndrome will have normal blood work, normal MRI examinations, and normal vital signs. Since we cannot “see” an apparent cause of their symptoms by these traditional tests, a conventional treatment for post-concussion syndrome does not exist. Those that suffer from this disorder are asked to rest and possibly undergo physical and occupational therapy until symptoms resolve.

While my personal quest to solve my own head injury began with an automobile accident rather than a sports injury, my symptoms were quite similar to those who suffer from post-concussion syndrome. After exhausting the realm of traditional medical treatment including examination by neurologists, therapists, and surgeons – my headaches, inability to concentrate, and lack of energy continued for over 10 years. Out of desperation, I began to take matters into my own hands. I determined that most of my issues were likely caused not by damage to my brain, but by something entirely different.

Through research into how the body fights pain, naturally, I discovered prolotherapy, a holistic procedure that involves a series of injections into damaged ligaments, tendons, and joints that produces a healing response within the damaged tissue, ultimately leading to repair of the damage. The mechanism for this non-surgical repair is mediated through immune system modulators which cause the concentration of cells known as macrophages and monocytes along with chemicals known as chemokines, to remove microscopic debris and fix damaged tissues.

Agents used for Prolotherapy restoration include lidocaine, dextrose, phenol, glycerin, and more recently growth factors derived from the patient’s own body known as platelet rich plasma (PRP). The exact mixture or substance used in prolotherapy is not nearly as important as the precise diagnosis and treatment into the area of damage that is causing the symptoms of post-concussion syndrome.

I began to treat administer injections into the base of my skull and localized areas of my neck and head. While performing this procedure on myself was somewhat risky, it was my last and only hope. Simply put, suffering in chronic pain for a decade needed to end.. Fortunately within a few treatments, my pain was drastically reduced and I’m pleased to say it has been gone now for more than 12 years!

Since my initial use of prolotherapy, , many patients suffering from post-concussion syndrome entered my office – like me, with nowhere to turn. These patients ranged from professional athletes, to recreational athletes to peoplewho sustained head injuries due to trauma, but our symptoms and examination results were all markedly similar. We all suffered soft-tissue damage in areas that connect the head and the neck, and repair of these areas by regenerative medical techniques like Prolotherapy was curative.

One may ask, how could injections into the neck and head possibly cure the problems of concussion and head injury? The answer has to do with a complete understanding of what happens during a head injury. I have studied films of the hits that have caused devastating concussions and observed that trauma to the skull does not just damage the brain, it also creates a significant whiplash injury to the neck and the base of the skull. Within these areas lies the brainstem, an area of the brain that controls our balance and coordination, and supplies nerves to the muscles that control the eyes, ears, face, and portions of our autonomic nervous system (ANS). Injury to the cervical and skull base changes the relationship between the brainstem, base of the skull, and cervical canal, causing increased pressure on the nerve control that I have described above. This leads to many of the symptoms of post-concussion syndrome. Fortunately, Prolotherapy and PRP injections (injections of a patient’s own platelet rich plasma) into these damaged areas can normalize the relationship between the skull base and cervical canal, and relieve excessive pressure on the nerve. Once this happens, symptoms of post-concussion syndrome resolve!

Prolotherapy and PRP injections are certainly the silver lining around a dark cloud, but must be used with caution. Having performed well over 45,000 procedures in my career, I know it takes an extreme amount of skill and dexterity to treat damage from concussion. However, successful treatment leads to regaining the patient’s life, allowing them to function again without pain, headache, blurred vision, and all of the other lingering symptoms of concussion. While there has never been a controlled clinical trial on Prolotherapy for treatment of post-concussion syndrome, the results speak for themselves.

Scott Greenberg, M.D.

USA TODAY ARTICLE JANUARY 16, 2009
Gagne returns to pre-concussion form
PHILADELPHIA — Simon Gagne hated the mornings he would wake up with that familiar pounding headache.

He couldn’t even blame a night of revelry.

The throbbing would surface, and no pain reliever would cure it. His neck ached, and there were days when he felt woozy or had blurred vision.

All Gagne wanted was to grab a stick and play hockey again for the Philadelphia Flyers. But even when he did skate, well, good luck keeping track of the whizzing puck.

Missing the playoffs, losing in the playoffs, none of it pained Gagne like the agony of living with a concussion.

“Last year,” Gagne said, “was a tough situation. Tough. I wouldn’t wish it on anyone.”

The head injuries limited Gagne to 25 games and he missed Philadelphia’s run to the Eastern Conference final. Gagne had nagging fears about his future, about what another traumatic hit to the head might mean for his career. He wondered if he could resume the high-scoring pace that made him an All-Star and an Olympian.

Those doubts all seem behind Gagne, for now at least. While Gagne has cooled a bit from one of the fastest starts of his career, the quick forward has 18 goals and 42 points in 41 games this season. And the Flyers are in the thick of a tight race in the Atlantic Division, one point behind the New York Rangers headed into Friday night’s game at the Florida Panthers.

For Gagne, the miserable side effects and cobwebs in his nerves have vanished.

“The way I feel now is back to where it used to be,” Gagne said.

Gagne, who turns 29 next month, considers himself lucky. He might not even be playing this season had he not caught a local TV report about a doctor who eschews traditional anti-inflammatory medications, cortisone injections, and surgery in favor of an approach that stimulates natural healing processes to strengthen joints, tendons and ligaments.

Gagne hoped the treatment would cure his chronic neck pain and headaches and, after checking with the Flyers trainer, met with Dr. Scott Greenberg last April. Greenberg, a Cherry Hill, N.J., physician, didn’t like what he saw.

“The damage that Gagne had was very significant,” he said.

The nerves running from Gagne’s neck and head, neck and shoulder blades and other joints, ligaments and tendons were all damaged. That was the cause of the dizzy spells, the loss of balance and blurred vision. Greenberg’s approach is to repair the joints and nerves with pinpoint injections into selected areas of the spine and the symptoms clear.

The treatment is called Prolotherapy. The shots, a concoction that sparks the body’s immune system, regenerate the damaged tissue and strengthen joints. Greenberg said Gagne’s neck is now as strong as it was before he was hurt. The player needed 20 to 30 injections in his neck his first few visits, but he hasn’t visited Greenberg since November. Gagne might go again around the All-Star break for a checkup.

His neck and spine stable, Gagne proclaimed himself “good to go” the rest of the season.

All he has to do is look at recent Flyers history to know his day-to-day life could be much worse. Former Flyers captains Eric Lindros and Keith Primeau both had their promising careers curtailed because of concussions and still suffer from post-concussion trauma.

Gagne has had two minor setbacks this season – a bout with the flu and dehydration in December, and he was the victim of a blindside hit against Vancouver that caused a shoulder injury and kept him out of two games.

A scary moment came in November when Montreal’s Alexei Kovalev plowed his shoulder into Gagne’s head. Gagne was able to shake off the hit, but any shot near his neck or head is an immediate cause for concern.

Gagne believed Kovalev deliberately targeted his head and shared his view with NHL disciplinarian Colin Campbell.

If Gagne had his way, shoulder-to-head hits would be banned from the game.

“If you get hit shoulder-to-head, you’re going to have a concussion no matter what,” Gagne said. “You see it too much. Almost every night you look at highlights on TV and you see someone get knocked out.”

He also talked with Glenn Healy, the player affairs director for the NHL players’ association, about what could be done to better protect the players. Hockey will never become a non-violent sport, but Gagne and others feel it could be a safer one.

Healy said the NHLPA is working on adding soft caps, which are already on elbow pads, to shoulder pads to reduce the impact of hits. Last season, of the 65 diagnosed concussions, Healy said 39 were from a shoulder-to-head blow.

On the NHLPA’s fall tour of all the teams, videos were shown of players deciding not to finish their body checks in a situation where an opposing player was vulnerable or the outcome had already been decided. Healy also does not want to see players launching themselves at someone’s head.

“That’s going to take a lot longer to change that cultural view of how we play the game,” Healy said.

The NHLPA hopes to sit down with the league this summer and discuss possible solutions or punishments.

Gagne was diagnosed with three concussions (two in juniors, one early in his career with the Flyers) before last season. He suffered a fourth concussion after his jaw crashed into the shoulder of Panthers defenceman Jay Bouwmeester early last season. Gagne returned after only four games, then was hurt again and missed the next 26 games. He was reinjured in February and didn’t play again.

Gagne eventually learned that he didn’t suffer three more concussions, but that the first one in October never healed and was aggravated with each additional blow.

Gagne says he might have returned too quickly from the initial hit and wonders whether last season would have been different had he been more patient.

“Until you go through a tough time like that, you know nothing about concussions,” Gagne said. “Now I know the brain takes a lot of time to heal.”

But this pre-season, Flyers coach John Stevens was so encouraged by Gagne’s play that he had no reservations about playing him his regular minutes.

“We didn’t expect him to get back to where he was so quickly,” Stevens said.

Gagne totalled 31 points in his first 22 games and was on pace to at least match his career high of 47 goals set in 2005-06. Gagne’s numbers have tailed off lately and the winger has gone eight straight games without a goal entering Friday’s game.

Some of the scoreless slump can be blamed on the shoulder injury. Another factor is just simple fatigue. Gagne, the Flyers’ first-round pick in the 1998 draft, is still working his way back to his physical peak after a seven-month layoff.

“People forgot, I didn’t play for a while last year,” he said. “For me to play at that level again, it takes time to get back.”

When he’s playing, Gagne can’t think about absorbing a hard hit, he just has to attack the net and play as hard as he did in an Olympic or playoff game.

He does admit to a different approach this season. Gagne comes to the rink to have fun, be able to play all his shifts and feel good when the game is over. He’s not concerned with goals, points and other personal achievements. So far, that style has worked out fine.

“It’s just fun being back to normal and being able to play the game that I love to play,” Gagne said.

Dr. Greenberg is located at the Magaziner Center Prolotherapy New Jersey

The Magaziner Center for Wellness in Cherry Hill, NJ. specializes in regenerative sports medicine and non-surgical approaches including the use of Autologous Stem Cell, Prolotherapy and PRP injections for both professional and high level athletes and those who suffer with chronic pain. For more information 1.856.424.8222.

“The number of total knee replacements is growing drastically,” said Elena Losina, PhD, lead investigator and co-director of Orthopedic and Arthritis Center for Outcomes Research at Brigham and Women’s Hospital in Boston, Mass. “We now have a lot of people living with TKR,” which may lead to substantial increases in the likelihood of revisions and complications, especially in younger patients. (1)

1. AAOS Press release 02/10/2012

The age of regenerative medicine is here. We have utilized prolotherapy for decades, PRP is starting to gain traction in the medical community, and we are also now able to unleash the power of the stem cell. While we have these technologies available to help the body help itself heal to prevent surgery, eliminate pain, and restore joint function, it is up to the skill and knowledge of the physician to best utilize these treatments to achieve optimal results.

We will use a case illustration of knee pain in a 61 year old patient to demonstrate where stem cell, PRP and prolotherapy all have a place in treatment of knee pain. This patient has had chronic pain in her knee, and has been limping for as long as she can remember. She had undergone traditional injections of cortisone, which had limited benefit. An MRI of the knee showed complex tearing of the posterior horn of the medial meniscus along with arthritis of the knee, and the patient underwent arthroscopic surgery. After a month or so, the patient’s pain or function had not changed, and a dose of Euflexa (similar to Hyalgan, Supartz, Synvisc, and other forms of viscosupplementation) was injected into the knee, again with limited results.

When I examined the patient, her gait (walking cycle) was clearly off, and she was listing to the left with a severe limp. Excessive pronation was also found in the left foot, further exacerbating her knee condition. Her limp was caused by a functional leg length discrepancy (pelvic tilt). Her knee was slightly swolen, with some limitation in range of motion, and was significantly tender around the coronary ligament (supports the meniscus and joint), and laxity and pain was discovered in the medial collateral ligament (MCL). I did review her MRI, showing arthritis and a torn meniscus. While it may make sense to shave a torn meniscus on the surface, large medical studies have shown that arthroscopic surgery on an arthritic knee actually accelerates arthritis, and patients that have this surgery are more likely to need knee replacement than those that have not had the surgery.

We needed to decide on a treatment plan for this patient, of how to not only eliminate her pain, but also reduce the chances of needing a knee replacement in the coming years.

I used prolotherapy to correct the leg length discrepancy (pelvic tilt), which immediately corrected and her gait improved and limp was eliminated. We will use prolotherapy to rebuild the arch of her foot to reduce the excess pronation, and also treat the damage to the medial collateral ligament (which by the way did not show on MRI but was clearly found on examination). PRP will be used to treat the outside of the meniscus and the coronary ligament, as in my opinion works better in this area, as meniscal tissue has very little blood flow whatsoever. This patient will also be best served by a stem cell procedure, using the patient’s own fat to derive stem cells, which will be injected into the knee with PRP. I believe this will enhance the ability to regrow cartilage, and also reverse some of the arthritic changes in the knee, and reducing the risk of needing knee replacement in the future.

I hope this illustrates how we use a combination of therapies to treat an ailing joint problem that has failed traditional options. It is up to both an educated patient and a skilled physician to obtain the best results for the patient, and also prevent a surgery that may do harm.

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Magaziner Wellness Center, New Jersey Knee Replacement Alternatives and Options

I was fortunate to follow Dr. Greenberg as a student these past few weeks.  The experience was incredibly inspiring.  The frustration I have felt as a nurse about medicine was lifted as I watched patients rapidly recover from conditions and injuries that I was conventionally taught were irreversible and only treated with surgical interventions and palliative measures.

As a student whose head is constantly in medical journals, I can vouch that Dr. Greenberg and his partner, Dr. Magaziner, stay leaps and bounds ahead of standard clinical practice, employing cutting- edge science, proven safe and effective; although yielding much less financial profit.  They clearly measure their gains based on achieving optimal health for their patients, which is humbling and inspiring to me as a student, and it visibly brings security and relief to their patients.   There is no better way to convey the gravity of these treatment modalities than to briefly tell some of the stories of my family.

Carpal Tunnel
My younger sister and best friend, Angie, devoted her childhood to gymnastics.  Diagnosed with ADHD and unable to focus academically, she discovered that she had a raw talent for gymnastics.  She was home schooled, and gymnastics fueled her love of life, giving her strength and confidence.  At 14, she developed severe carpal tunnel syndrome, and physicians refused to operate due to her young age.  As my sister’s pain persisted and mental health began to deteriorate, my mom desperately searched for alternatives.  She discovered Dr. Greenberg and the Magaziner Center for Wellness.  Angie’s carpal tunnel was fully healed in less than a month after beginning Mesotherapy treatments.  Dr. Greenberg continued to treat her after countless other injuries, making it possible for her to stay successful in competition. She continued to excel in gymnastics into her adult life.  Today, she is the healthiest, most grounded and active person I know.

Devastating Knee Injury
Again at around the age of 14, my brother, Joe, tore his MCL, ACL, and LCL during football practice.  An Orthopedic surgeon insisted he undergo two separate surgeries (six months apart) in order to repair/reattach his torn ligaments.   The doctor was convinced that there was no alternative and that without surgery, Joe would never return to football.  Concerned about the risk of errors, unpredictable outcomes of invasive surgical procedures, and the immobility factors, my mom took Joe to Dr. Greenberg.   Within a couple months of Prolotherapy treatments, Joe’s ACL and MCL were completely healed, with the LCL not far behind.  The results were verified through a follow-up MRI, and a team of Radiologists was impressed with the progress.  They were amazed that the completely detached LCL was well on its way to being healed.  Joe not only played competitive baseball on a travel team that Spring, he received All-County/State awards for both defensive and offensive positions in football throughout high school.  At almost 23, he continues to be active in a variety of sports, with his knee remaining strong.

Sciatica
Last, and most incredible, is a story about my grandfather, who was around 76 at the time.  He was hit by a car, leaving him with a crushed pelvis, resulting in compressed nerves and severe sciatic pain.  Months later, after several surgeries, he was still unable to walk, bound to a walker, and married to narcotics.  His doctors advised against further surgeries, convinced that they would not result in significant pain relief.   My dad drove to Alabama and brought him home for Dr. Greenberg to begin treatment.  I had remembered him so full of life, and it was unbearable to see him suffer with such an empty spirit.  After a summer of hyperbaric oxygen treatments, Prolotherapy, supplements, and nutritional modifications, he was walking, smiling, and full of love.  He planted a garden the following Spring and was remarried over a year ago.  To this day he credits Dr. Greenberg for “saving his life”.
I feel fortunate to have witnessed moments like these in the lives of my family over the years and in others these last few weeks. I am eager to devote my life to regenerative medicine, inspired by Dr. Greenberg and his colleagues.

If you would like a representative to discuss how we can help you, please  call us at 856-424-8222.

The study involved 1,233 people between the ages of 70 and 89 and free of dementia residing in Olmsted County, Minn. Of those, 163 had MCI. Participants reported the amount of calories they ate or drank in a food questionnaire and were divided into three equal groups based on their daily caloric consumption. One-third of the participants consumed between 600 and 1,526 calories per day, one-third between 1,526 and 2,143 and one-third consumed between 2,143 and 6,000 calories per day.

The odds of having MCI more than doubled for those in the highest calorie-consuming group compared to those in the lowest calorie-consuming group. The results were the same after adjusting for history of stroke, diabetes, amount of education, and other factors that can affect risk of memory loss. There was no significant difference in risk for the middle group.

“Cutting calories and eating foods that make up a healthy diet may be a simpler way to prevent memory loss as we age,” said study co-author Yonas E. Geda, MD. (1,2)

The link between obesity and weight loss is well documented as we age. “Midlife hypertension, diabetes, smoking, and obesity were associated with an increased rate of progression of vascular brain injury, global and hippocampal atrophy, and decline in executive function a decade later.” (3)

At the Magaziner center we offer many programs for the aging patient to deal with the tough issues of weight loss some of these programs we have covered in our recent articles.

Belly fat and waist size
The battle to rid yourself of “belly fat” may have become a little easier. Researchers writing in the American Journal of Clinical Nutrition say that their findings suggest that calcium and/or vitamin D supplementation contributes to a beneficial reduction of VAT (visceral adipose tissue) or “belly fat.” (1) The researchers

More reasons fish oils should be part of your nutritional goals
More research is out suggesting the many benefits of fish oils in your diet. Fish oils function as anti-inflammatories and have been useful in reducing symptoms of arthritis, lowering cholesterol and triglyceride levels, reducing platelet stickiness, and reducing the symptoms of ulcerative colitis. In some cases, fish oils have been

Super foods and eating well
How to eat well

Obesity
Obesity What is Obesity? Obesity refers to body weight that is much greater than what is healthy. People who are obese also have a much higher BMI (Body Mass Index) than those at an ideal weight. BMI is a measure of body fat based on height and weight that applies.

Why not call us with your questions? Phone: 856-424-8222

1 . Overeating May Double Risk of Memory Loss AAN Press Release

http://www.aan.com/press/index.cfm?fuseaction=release.view&release=1023

2. Yonas Geda, MD, MSc, Marion Ragossnig, Lewis K. Roberts, Rosebud Roberts, MD, Vernon Pankratz, Teresa Christianson, Michelle Mielke, Bradley Boeve, MD, Eric Tangalos and Ronald Petersen, PhD, MD. Caloric Intake, Aging, and Mild Cognitive Impairment: A Population-Based Study.  Advanced release – April 2012 Annual meeting of the American Academy of Neurology

3. Debette S, Seshadri S, Beiser A, Au R, Himali JJ, Palumbo C, Wolf PA, DeCarli C. Midlife vascular risk factor exposure accelerates structural brain aging and cognitive decline.Neurology. 2011 Aug 2;77(5):461-8.

Ruiz AD. Effectiveness of Compounded Bioidentical Hormone Replacement Therapy: An Observational Cohort Study. BMC Womens Health. 2011; 11: 27. Published online 2011 June 8. doi:  10.1186/1472-6874-11-27

Mood swings and irritability are often considered one and the same by many doctors. Going from a happy euphoric feeling to a sad and depressed state seemingly at the snap of the fingers is a well documented menopause symptom that is directly related to hormone imbalance.

Estrogen levels influences seroton levels. Serotonin is a neurotransmitter that regulates mood. The rising or falling estrogen levels causes an increased production of serotonin which causes emotional swings.

See our article on
Women, Estrogen, Serotonin, Depression

The Magaziner Center for Wellness treats five to 10 women per day for menopausal syndrome. Until the year 2002, most women were placed on (synthetic) Hormone Replacement Therapy by their gynecologists. HRT, as it is known, was highly controversial because of the link between synthetic hormones and increased risk of breast cancer, heart disease, stroke and blood clots. Since that time, use of synthetic hormones has become virtually obsolete.

At the Magaziner Center for Wellness, we use bio-identical hormones (BHRT). Bio-identical hormones are different than synthetic hormones because they are structurally and chemically the same as the three estrogens naturally produced by the body – Estriol, Estradiol and Estrone and natural progesterone, testosterone and others, depending on the needs of the patient. Synthetic hormones – namely conjugated estrogens feature a manipulated form of the three estrogens while Medroxyprogesterone Acetate (MPA), which is found in Provera, is a synthetic form of progesterone.

The body responds to and metabolizes synthetic hormones differently than bio-identical hormones. Bio-identical hormones are far safer and more effective than synthetics and, therefore, have grown in use. At the Magaziner Center for Wellness, we have been treating patients for more than 25 years with BHRT.  Each is compounded by pharmacists – meaning they are handmade using a mortar and pestle – so that they are customized for each patient based on the strength needed by each individual according to her needs and wants.

Before formulating a treatment plan, the doctors at the Magaziner Center for Wellness analyze each patient individually using 24 hour urine specimens and comprehensive blood work. We look at the metabolites of estrogen in a woman’s body, as certain metabolites can increase the risk of breast or gynecological cancers. We also look at both thyroid and adrenal function. We rarely use saliva tests as they are not comprehensive enough to give information about hormone metabolites and to ascertain the best course of treatment for a patient.

We use a self-scoring system each time a patient comes in so that we can further customize and assess the success of her treatment as it progresses. This allows us to tweak the dosages so that we can optimize the patient’s results.mong our patients at the Center.

Call our office for more information
Phone: 856-424-8222

Use of alternative treatments was as follows: chiropractor, Osteoarthritis 11%, chronic low back pain 34%; physical therapy, 20% in both groups; transcutaneous electrical nerve stimulations (TENS), Osteoarthritis 14%, chronic low back pain 22%; acupuncture, hydrotherapy, massage therapy, and biofeedback, less than 3% in both groups.

A case history from a patient:
“I had been experiencing pain in my lower back across my buttock and down my left leg. The pain was so bad at times I would lose my balance. I fell as though I have a high tolerance for pain and I am not a big believer in medicines especially painkillers. I asked my Doctor to send me for an MRI. I hoped the answer would be there and it wasn’t. I was told it was not bad enough to operate on and I was glad because that was my last choice and was told it would go away as fast as it came on. The pain that is. I had been going through this for eight months and that was a little much for any pain, especially this type which was my back, my buttocks, my leg and my mental being.

It was at this point I was recommended to see Dr. Greenberg, whom made me feel very comfortable at our first meeting. I felt confident with his confidence in what he was going to do to solve my problem. For the rest of the month the pain subsided and after three great treatments all pain was gone and some preventive measure was put in place. I feel great and thank you again Dr. Greenberg. I am now pain free.” RVH

Prolotherapy is a treatment where a cure for pain is sought, not a means to suppress symptoms. If you have tried the medical treatments including opioids, nonselective nonsteroidal anti-inflammatory drugs, antidepressants, benzodiazepines, sedative hypnotics, or chiropractor, physical therapy, transcutaneous electrical nerve stimulations (TENS), osteoarthritis acupuncture, hydrotherapy, and/or massage therapy, with less than hoped for results, then please consider and appoint for a Prolotherapy evaluation with us here in Cherry Hill, NJ.

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Study presenter Raymond Rocco Monto, MD, explained that “chronic plantar fasciitis is a common, yet occasionally difficult, condition to treat successfully. Improved outcomes using PRP as a treatment in a study of patients with severe, chronic, Achilles tendinitis led him to consider using PRP with his plantar fasciitis patients.” This was due to failure in these patients of traditional treatments that included: nonsurgical treatments (rest, physical therapy, silicone heel lifts, CAM (controlled ankle motion) walker bracing, cast immobilization, night splinting, and nonsteroidal medication) and block randomized them into two study groups.

Study recap
Control group participants (8 men, 12 women) were an average of 59 years old (range: 24 to 74 years) and had previously had, on average, 5.4 months (range: 4 to 24 months) of standard nonsurgical management. Prior to treatment, control group patients had an average American Orthopaedic Foot & Ankle Society (AOFAS) score of 52 (range: 24 to 60).

Patients in the experimental group (9 men, 11 women) were an average of 51 years old (range: 21 to 67 years) and had had 5.7 months (range: 4 to 26 months) of standard nonsurgical management, with average pretreatment AOFAS scores of 37 (range: 30 to 56).

The control group received a single ultrasound-guided injection of 40 mg methylprednisolone at the injury site. Patients in the experimental group received a single ultrasound-guided injection (3 cc) of unbuffered autologous PRP at the injury site.

All patients were fitted with an inflatable walking Aircast fracture boot, worn for 2 weeks. They were started on eccentric home exercises and allowed to return to normal activities as tolerated and without support. Patients were given a home eccentric exercise and stretching program and were not permitted to use nonsteroidal medications during the first 2 weeks after treatment.

At 3-month follow-up, AOFAS scores had improved for all patients. The mean score for patients in the control group was 81 (range: 60 to 90), while for patients in the experimental group it was 95 (range: 84 to 90).

However, the average score for patients in the control group fell to 74 (range: 56 to 85) at the 6-month follow-up and to 58 (range: 45 to 77) at 12 months. In contrast, the average score for patients in the experimental PRP group remained high, at 94 (range: 87 to 100) at both 6 months and 12 months. (1)

In other words the PRP group had better pain relief, long-term.

To create PRP therapy, a small sample of your blood is drawn (similar to a lab test sample) and placed in a centrifuge that spins the blood at high speeds, separating the platelets from the other components. The concentrated platelet rich plasma (PRP) is then injected into and around the point of injury, jump-starting and significantly strengthening the body’s natural healing signal. Because your own blood is used, there is no risk of a transmissible infection and a very low risk of allergic reaction.

The body’s first response to soft tissue injury is to deliver platelets. Packed with growth and healing factors, platelets initiate repair and attract the critical assistance of stem cells. PRP therapy’s natural healing process intensifies the body’s efforts by delivering a higher concentration of platelets.

Because the goal of PRP therapy is to resolve pain through healing, it could prove to have lasting results. Initial improvement may be seen within a few weeks, gradually increasing as the healing progresses.

Research studies and clinical practice have shown PRP therapy to be very effective at relieving pain and returning patients to their normal lives. Both ultrasound and MRI images have shown definitive tissue repair after PRP therapy, confirming the healing process. The need for surgery can also be greatly reduced by treating injured tissues before the damage progresses and the condition is irreversible.

Magaziner Center for Wellness performs over 1,500 PRP procedures each year. So you know at Magaziner, your wellness is in very good hands.

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1. http://www.aaos.org/news/acadnews/2012/AAOS15_2_8.asp

In this study, researchers conducted a population cohort study consisting of 45,509 adults undergoing bone mineral density testing for the first time and followed them for up to ten years. Of the 45,509 adults included in the study, 1,841 had recent-onset heart failure. After adjusting for traditional osteoporosis risk factors, researchers found that heart failure was associated with a 30 percent increase in major fractures.

The article, “Heart Failure is a Clinically and Densitometrically Independent Risk Factor for Osteoporotic Fractures,” appears in the April 2012 issue of JCEM. (1)

Since family history is a risk factor for osteoporosis and heart disease, at the Magaziner Center for Wellness, we use genomic testing to gauge a genetic predisposition to bone loss and, where one is identified, treat the predisposition using nutritional supplements customized for a patient’s individual needs.

We look closely at each patient’s diet and lifestyle and work with her/him to make any necessary modifications for both heart disease and osteoporosis. For instance, if we see that a patient is consuming too much red meat and or sugar, we help her/him move toward a plant-based eating plan; if we see excessive smoking and alcohol use, we work to identify healthy strategies for stress relief.

We have found that many with osteoporosis have insulin resistance.  As a result, we do a thorough evaluation regarding lipid balance, and insulin and glucose metabolism and treat these areas accordingly.

Additionally, we assess for appropriate digestion and assimilation to be sure that a patient can properly break down and utilize the nutrients in their food as well as other testing based on the individual needs of the patient.

1. Journal of Clinical Endocrinology & Metabolism, news release, Feb. 2, 2012

Stem Cell Therapy Philadelphia Fox News

From Fat To Feeling Good: MyFoxPHILLY.com