Curing Pain with Prolotherapy/Sclerotherapy

Prolotherapy (proliferative therapy), also known as ligament reconstructive therapy or sclerotherapy, is a recognized orthopedic procedure that stimulates the body's natural healing processes to strengthen joints weakened by trauma or arthritis.

Joints weakened when ligaments and tendons are stretched, torn, or fragmented, become hypermobile and painful.  Traditional approaches with anti-inflammatory drugs and surgery often fail to stabilize the joint and relieve pain permanently.  Prolotherapy has the unique ability to directly address the cause of instability and repair the weakened sites, resulting in permanent stabilization of the joint.

Both Dr. Magaziner and Dr. Greenberg are experienced and skilled in prolotherapy treatments. Dr. Greenberg has performed over 9,000 such treatments, with two of his notable patients being Mark Simoneau, former starting linebacker for the Philadelphia Eagles and Mike Carey, linebacker for the Oakland Raiders.

Dr. Magaziner with Manuel, one of the translators during his 2007 prolotherapy medical mission in Honduras.	Dr. Magaziner and colleagues at the Red Cross Center in La Ceiba, Honduras where they treated hundreds of patients suffering from chronic pain and arthritis with prolotherapy. Dr. Magaziner was one of 50 physicians selected to provide medical care and treatment for individuals who otherwise would not receive it.
Dr. Greenberg with Mark Simoneau, former starting linebacker for the Philadelphia Eagles, who underwent successful prolotherapy treatments. "The prolotherapy I received from Dr. Greenberg has made my ankle and hip the strongest and most stable they have been in years," Mark said about the results of his treatments.	Dr. Greenberg with Mike Carey, former Linebacker for the Oakland Raiders. The treatments given to Mark Simoneau and Mike Carey were among over 9,000 prolotherapy procedures that have been performed by Dr. Greenberg.

Dr. Greenberg with Angelo Cataldi from station WIP in Philadelphia.  After years of complaining on the radio about his back, Angelo gives Dr. Greenberg a "thumbs up" for curing his pain with prolotherapy.

What is Prolotherapy?

BACK TO TOP

Prolotherapy (proliferative therapy), also known as ligament reconstructive therapy or sclerotherapy, is a recognized orthopedic procedure that stimulates the body's natural healing processes to strengthen joints weakened by trauma or arthritis. 

Joints weakened when ligaments and tendons are stretched, torn, or fragmented, become hypermobile and painful.  Traditional approaches with anti-inflammatory drugs and surgery often fail to stabilize the joint and relieve pain permanently.  Prolotherapy has the unique ability to directly address the cause of instability and repair the weakened sites, resulting in permanent stabilization of the joint.  When precisely injected into the site of pain or injury, prolotherapy creates a mild, controlled inflammation which stimulates the body to lay down new tendon or ligament fibers, resulting in a strengthening of the weakened structure.  When the joint becomes strong, pain will be relieved.

Prolotherapy's Range of Applications

Prolotherapy can be used to relieve a broad spectrum of conditions, including:

arthritis backaches carpal tunnel syndrome compression fractures knee conditions herniated discs

chronic headaches tennis elbow shoulder pain varicose veins temporal mandibular joint dysfunction work-related injuries

Prolotherapy's Role in Chronic Pain Relief

At the Magaziner Center for Wellness and Anti-Aging Medicine, prolotherapy is part of the comprehensive approach we take to curing chronic pain.  We evaluate each patient thoroughly with a personal history and physical exam and specialized laboratory analysis.  We may ask patients to have X-rays performed before receiving prolotherapy.  In all cases involving chronic pain, our physicians will use their expertise in dietary and nutritional medicine and recommend specific supplements to maximize your health and ability to heal. 

How Effective is Prolotherapy?

The success of prolotherapy depends on a number of variables, including the patient's history and ability to heal.  Some 85-95% of patients suffering from low back pain with hypermobility, for instance, experienced remission when treated with prolotherapy.  In comparison, the Journal of Bone and Joint Therapy reports only a 52% improvement in patients treated with disc surgery. 

Are Prolotherapy Treatments Painful?

Patients can have prolotherapy without the need for anesthesia. The pain of an injection will vary depending on the structure to be treated and the choice of solution involved.  Because prolotherapy uses inflammation to heal the body, it may result in mild swelling and stiffness, which can be treated with pain relievers such as Tylenol.  If  necessary, we can perform conscious sedation for patients undergoing extensive treatment. 

How Often Are Treatments Administered?

At the Magaziner Center, prolotherapy treatments are administered as determined on an individual basis, usually every one, two, or three weeks.  The length of the treatments is variable and depends on several factors, including nutritional status, ability to heal, and the degree and site of the injury involved. Some patients may experience complete relief from pain along with restoration of full function after only one or two treatments. Generally speaking, however, back and neck problems require from six to 12 sessions and less extensive injuries from one to six sessions.  We ask patients to avoid any heavy-duty exertion during the treatments, but they are otherwise usually able to pursue their normal life and work schedules in between sessions.

BACK TO TOP       Curing Chronic Pain with Prolotherapy

by Scott R. Greenberg, M.D.

 Have you ever suffered from chronic musculoskeletal pain?  If you have, you are not alone. Statistically speaking, 75% of Americans will experience chronic back pain in their lifetime. Unfortunately, a stressful and active lifestyle may not give our body the chance it deserves to heal. Instead we are prescribed medicines such as ibuprofen (i.e., Motrin, Advil) and naproxen (i.e., Aleve) that relieve pain and decrease the inflammatory process. 

However, natural healing is predicated upon inflammation. Your body releases naturally occurring chemicals known as cytokines, chemotactic substances and vasoactive factors in response to injury to help repair the body.  Drugs such as ibuprofen block these healing factors resulting in unrepaired microscopic damage to the tendons, ligaments and joints.  When these structures haven't completely healed, the body compensates and signals the surrounding muscles to spasm.  Chronic pain results from a combination of these factors. 

Therefore, without correcting the underlying problem, your pain will persist. Fortunately, there is a way to correct the underlying defect by stimulating the body to repair itself using a technique known as prolotherapy. 

Definition and History

Prolotherapy (also called sclerotherapy) is named for its proliferative effect on tendons and ligaments.  Although the term was coined by an industrial surgeon in the 1950s, prolotherapy was first used in ancient times.  Hippocrates treated injured rotator cuffs of javelin throwers back around 400 B.C. with hot lances to create small amounts of scar tissue around the shoulder joint. The technique evolved in the 1930s and was used to repair hernias before modern surgical techniques became available.  Dr. George Hackett refined the procedure and described the use of localized injections into the junction  between a bone and tendon, causing a controlled rate of inflammation and healing.  Hackett also described the sclerotogenous origin of pain, that is, pain referred from an injured tendon, ligament or bone.  He had success in relieving headaches and arm and shoulder pain by treating injuries in the neck.  Similar points have been described in treatment of the legs and hips. 

Healing Mechanisms of Prolotherapy:

The healing process is a multifactorial event.  Healing pathways are multiple and are initiated by tissue injury.  Injury provokes the release of chemotactic factors and complement, and stimulates processes known as fibrinolysis and coagulation.  Specialized white blood cells, called neutrophils and macrophages, enter the site to eliminate cellular debris and to release growth factors.  These growth factors tell your body to deposit a new collagen matrix, initiating the rebuilding and strengthening of the damaged structure. 

Several solutions may be used for prolotherapy treatment. A standard solution will consist of an anesthetic (numbing agent) combined with an inflammatory agent such as phenol, dextrose, or sodium morrhuate.  This inflammation triggers biochemicals that signal the beginning of the natural healing process. 

Case Histories:

G.A. is a fifty-two-year-old female who experienced severe pain in her right ankle.  Even the simple task of walking became a painful chore.  She was diagnosed with chronic ankle tendonitis and reflex sympathetic dystrophy.  Ankle surgery and physical therapy did not relieve her symptoms.  The severity of pain led her to become disabled for a period of four months. When she was examined, pain was noted on palpation of the supporting ankle ligaments, and the ankle joint was hypermobile.  There were no abnormalities appreciated in the knees, hips or back.  After a series of prolotherapy treatments, G.A.'s pain completely resolved.  She was no longer disabled and resumed full time employment. 

A.S. is a sixty-two-year-old female with chronic neck and back pain.  She owns a health food store and is active in all aspects of its operation, including the lifting of cartons.  A.S. had failed to cure her pain with numerous supplements such as MSM, boswellia, glucosamine, chondroitin, tumeric and SAMe.  She was unable to get relief from acupuncture or chiropractic treatments. Radiographs and MRIs of her spine taken by her primary physician did not reveal any abnormalities.  On examination, she had full range of motion of her lumbar spine, cervical spine, hips, and knees.  She was tender upon palpation of  the sacroiliac joints and had tension in the muscles that support the spine.  Prolotherapy injections were given to the joints and ligaments of the neck, low back, and sacral area.  After three sessions, her pain had decreased 70-80%.  She began to sleep better and no longer awoke at night from back or neck pain.

Conclusion:

Prolotherapy is a safe and effective treatment for pain.  It presents a superior treatment option for relieving chronic pain when compared to drugs which interfere with the inflammatory pathways of healing.   Proper and complete healing can only occur when the natural pathways are left uninterrupted. As a result, prolotherapy should be considered a tool in treating chronic pain. 

BACK TO TOP

Additional Therapies to Help Pain

Mesotherapy

Mesotherapy is the painless injection of vitamins, minerals, and medications under the surface of the skin. Mesotherapy treatments can benefit those patients suffering from muscle spasms, carpal tunnel syndrome, fibromyalgia, RSD, and osteoarthritis, among other conditions.  Mesotherapy safely delivers effective treatment only into the area of pain, thus avoiding the side-effects of taking oral medications. Additionally, medication doses used in mesotherapy are a fraction of that taken orally. Nutritional Therapy Drs. Magaziner and Greenberg are extensively trained in the use of vitamins, nutritional supplements, and diet modifications that may affect pain levels.  Methods we employ include enzymes, glucosamine/chondroitin, herbs, essential fatty acids, and food allergy testing.

Far-Infrared Therapy

Far-Infrared therapy is a safe and effective treatment for pain, arthritis, neuropathy, stiffness, and rheumatic conditions.  Infrared treatments deliver heat deep into the body, easing discomfort and reducing stiffness. Additionally, infrared treatments stimulate the detoxification of heavy metals and chemicals from the body.

Alpha-wave Stimulation

Alpha-wave stimulation is the use of an electrical signal sent across painful regions to reduce levels of acute pain. Cranio-electrical stimulation (CES), used in conjunction with Alpha-wave stimulation, is also an effective technique to safely change the brain's response to pain.  CES is also useful to induce relaxation and reduce anxiety. 

PCR Testing

Many patients who suffer from diffuse aches, fatigue, and fibromyalgia may have undiagnosed infections such as Mycoplasma and Candida. PCR testing is the most advanced technique to diagnose these infections, looking for the DNA of various infections, often not discovered on other tests. Such infections may be treated by a combination of nutrient supplements and medications on a case-by-case basis.

Intravenous Therapy

At the Magaziner Center for Wellness, we have used the intravenous administration of vitamins, minerals, and medications for over 15 years to optimize health, reduce pain and stress, and renew vitality.

BACK TO TOP