Prolotherapy: Relieve Pain, Restore Motion
by Dr. Scott Greenberg
TThis interview originally appeared at Letsliveonline.com

 

Originally used by Hippocrates to help javelin throwers with dislocated shoulders, prolotherapy is a natural solution for chronic pain -- and the only treatment that helped to relieve the former surgeon general’s persistent back pain. Scott Greenberg, M.D., a physician at the Magaziner Center for Wellness & Anti-Aging Medicine in Cherry Hill, N.J., talks about why he uses prolotherapy almost exclusively for chronic pain caused by ligament and tendon injuries.

How did you get interested in holistic medicine, particularly prolotherapy?
I was very disappointed when I entered my clinical years. Medicine seemed to be a revolving door of patients coming in and going out, all getting the same treatments. Things weren’t individualized in any way. I had always wanted to be a doctor, but traditional medicine seemed impersonal, cold and very much like, “Here, take this -- it will fix you. There’s no other way.” When I started my family residency, I began reading more about nutrition and testing it out on my patients, with amazing results.

One thing that I thought was particularly tragic was people in pain. Many times, however, something hurts for a very good, mechanical reason. Through my investigation, I found that prolotherapy was the way to fix this damage. When I learned that prolotherapy was the only treatment that helped the former surgeon general, C. Everett Koop, M.D., I began to incorporate it into my practice.

What is prolotherapy?
Prolotherapy is a reconstructive ligament treatment administered through a series of injections, which signal the body to repair a damaged area. The ligaments and tendons are the supporting structures of our bodies. I’ve found that a lot of people’s chronic pain comes from these areas. For example, in the case of arthritis, it is often the soft tissue and the supporting structure around the joint that cause symptoms, not necessarily bone grinding on bone. Prolotherapy works because it restrengthens an area, which eliminates the pain and restores function.

Which conditions respond best to prolotherapy?
Any kind of chronic pain in the hands, fingers, ankles, knees, neck and back. Prolotherapy is also useful for tennis elbow, TMJ, herniated discs and even migraines and sciatica.

How does prolotherapy work?
First off, I do a complete medical examination and a full musculoskeletal examination, placing extra emphasis on pain that originates from the ligaments or tendons. If I find that a patient’s pain is coming from one of these areas (because I’m able to reproduce the symptoms during my examination), then I will be able to treat it with prolotherapy.

For the injections, I use a solution generally made up of two anesthetics and an irritating (or inflammatory) agent (dextrose or cod-liver extract). The purpose of the irritant is to signal the body that there is an area that needs repair. It’s the same as when you sprain your ankle -- your body creates inflammation to repair the damage. Prolotherapy does the same thing: It tells the body that there is an injury that needs to be healed. The body sends specialized white-blood cells, fibroblasts and growth hormones, which help to remove debris and, ultimately, repair tissue and lay down new collagen. Collagen is the supporting structure for our tendons and ligaments.

Is pain involved?
The injections aren’t painful when done by a skilled practitioner. Initially, because there is some local anesthetic in the injection, patients are relieved of pain when they leave the office. If I inject the ligaments of the knee, and a patient’s pain goes away, then I know that the arthritis isn’t from bone grinding on bone. I know that the arthritis is from ligament pain in the knee. Unfortunately, the local anesthetic only lasts for a few hours. I use that more for a diagnostic purpose. After a few days, patients will experience an increase in pain and soreness. (Some patients have described it like a toothache.)

How many sessions do people need?
It’s very individualized. The small joints may take from one to four series of injections. Knees and ankles may take anywhere from three to six series of injections, and necks and backs may take on average of six to 12 series of injections, depending on the person. Usually, I inject people every two to three weeks. It can take up to six weeks to have maximum healing from one injection. The body is repairing itself over a six-week period of time.

What are the signs that the ligaments and tendons are healing?
I can tell a couple of ways: patients’ strength, their range of motion, and, most importantly, their symptoms. Are they pain-free? Some people may need follow-up sessions. Because it’s a restorative technique, however, the person should be “cured” of pain forever. The technique is really something that rebuilds structure, and unless there is another injury, there may not be a need for additional treatments.

If prolotherapy replicates a natural process in the body, why do some people need extra help healing?
The most common reason is that when most people get hurt, they reach for drugs like Advil, Motrin and Aleve, all of which inhibit inflammation. In the long term, this detracts from the body’s ability to heal. Ironically, I haven’t really found inflammation in my chronic-pain patients, outside of those with rheumatoid arthritis, which is more of a degenerative disease. The second most common reason is that a person’s ligament and tendon strength deteriorates and weakens over time for a variety of reasons. This contributes to tissue breakdown, rather than tissue building. That is why I need to stimulate the tissues to rebuild themselves.

The “technical” side of prolotherapy is interesting, but how does it work for your patients?
A 72-year-old man came to me after having diagnostic arthroscopic surgery for chronic knee pain. His orthopedic surgeon told him he would need knee-replacement surgery. His knee pain was so bad that when he came to our office, he had to use our handrail to hoist himself up the stairs. I found out that he had some tenderness in certain ligaments of his knees. I gave him three series of prolotherapy injections. After the third treatment, he had 100% relief of his pain. He no longer limped (which he did initially); he was able to walk upstairs with no knee pain -- and without holding onto the railing. He canceled his knee surgery.

What supplements/therapies do you use in addition to prolotherapy?
I usually put my patients on an individualized stretching and strengthening program. I also like heat therapy, ultrasound and massage a lot. Some supplements that are good for tissue regrowth are vitamin C, MSM, glucosamine sulfate and zinc.

Scott Greenberg, M.D., specializes in prolotherapy, nutrition, cancer therapies, preventive medicine and anti-aging strategies. For more information, call (856) 424-8222, or visit www.drmagaziner.com. Greenberg answers patient questions on Tuesday and Wednesday nights from 5 to 6 p.m. (EST) at (856) 424-0707.

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