Holistic Medicine - Prolotherapy
Holistic Podiatric Medicine at the Family Foot and Leg Center by Dr. Kevin Lam
Why holistic medicine?
The Family Foot and Leg Center strives to be on the cutting edge of technology and medical knowledge. There are times that surgery is warranted such as for dislocations, fractures, or tendon ruptures. But there are other complaints that can be treated by holistic means such as chronic ankle pain, chronic plantar fasciosis (fascitis for acute inflammation), chronic achilles tendonosis (tendonitis for acute inflammation). The basic principle is allowing your own body's amazing healing properties repair itself.
Conservative therapies are stressed and our holistic center now has the ability to offer more choices to our patients in Naples, FL.
Should conservative / holistic methods fail, there are always conventional medical and surgical options available. Three main forms of holistic treatment available at our center are:
Is Prolotherapy painful?
The injection is considered mild to moderately painful, and there is typically a "flare" of soreness for 3-7 days afterwards. A mild pain medication, such as Tylenol, is usually sufficient to control the discomfort. Rarely a stronger medication is necessary.
Are there any medication interactions?
Because the effect of Prolotherapy initiate a "healing cascade" which requires inflammation you are advised to avoid anti-inflammatory medications such as ibuprofen or naprosyn. Aspirin may also interfere with the process to some degree, but if an individual is taking Aspirin to reduce risk of stroke or heart attack, a small amount of Aspirin, such as a "Baby Aspirin" (80 mg) is acceptable.
Is Prolotherapy safe?
Using the current solutions and techniques, there have not been any reported side effects. There is occasionally some bruising, and very rarely, a nerve may be injured, usually temporarily. The procedure has been used for over 60 years.
How does "sugar water" have a chance of solving the painful condition?
The Dextrose is actually quite irritating in the standard 50% concentration. This is then diluted with saline water, anesthetic such as Lidocaine, to a concentration of 12-15%. This is thought to "dehydrate" the injected tissues, causing an injury signal for the body, and initiating the healing process. Dextrose has been shown to be a growth stimulant on it's own as well.
What tissues of the body are treated by Prolotherapy?
The ligaments, which connect bones together, may be stretched and torn. Tendons attach muscles to bone and may also be torn. The capsule surrounding joints may become lax (loose) and also contribute to pain. All of these may be strengthened and "tightened" with Prolotherapy, reducing the "play" in the joints, reducing arthritis, and bonding the clicking or popping structures in a way that is much more functional and normal. Cartilage has been shown to be repaired and thickened after a series of planned prolotherapy injections.
Does Prolotherapy involve steroid injections?
Not usually. Occasionally, the physician may try a steroid injection first, as this is a mainstream, accepted approach for these types of injuries. If this is not curative with 1-2 efforts, then repeat steroid injections are unlikely to resolve the problem and Prolotherapy is a safer, more permanent solution. Steroid injections are well known to have complications, usually mild but occasionally significant, and repeating them unnecessarily increases the risk. Each steroid injection weakens the underlying connective tissue, and may result in a need for additional Prolotherapy injections to regain any lost ground from steroid injections. Even if a steroid injection provides temporary benefit, which is usual for 3 days to 2-3 weeks, the typical recurrence of pain when the steroid "wears off" often occurs.
Does Prolotherapy treat foot and ankle pain?
Many foot and ankle problems are treated and resolved with Prolotherapy. The most common and notable are plantar fascitis, Morton's Neuroma, bunions, and chronic ankle sprains. Each of these involves stretching of ligaments and joint capsules, which respond quite well to Prolotherapy. If steroid injections do not provide long-term relief for these, you should strongly consider Prolotherapy. You certainly can bypass steroid injections and surgery; treatment with Prolotherapy can and usually does achieve a great deal of success without the risks of surgery.
How can I test myself to see if Prolotherapy could help me?
The signature finding is pain that you can put a finger on. If you can precisely point to your source of pain, there is an excellent chance that Prolotherapy will resolve or at least greatly improve it.
Shouldn't I be skeptical of such a weird idea that few doctors know about?
Of course, I certainly was! I knew about this technique for over 8 years, read about it carefully for 4 years, learned how to perform it, and still didn't use it except on my worst patients who had tried all options for their pain. I certainly didn't tell my referring doctors at first that I was using Prolotherapy, for fear that I would be "too alternative." I remained skeptical for the first 6 months of using this technique, until my patients' success became difficult to ignore. I now use Prolotherapy as one of my many tools that I have available to treat my patients, and over time it has become one of my primary tools because of the vast array of problems solvable with this technique. Be skeptical, but be open-minded; you have almost nothing to lose and a great deal to gain.
So Prolotherapy is a cure for everything?
Of course not. Many diseases and illnesses are not resolvable with Prolotherapy. Pain can originate in many tissues, and a complete, thorough examination is absolutely essential. The physician who practices Prolotherapy is usually one who has a great deal of experience with the treatment of musculoskeletal disorders, and should also examine and test the patient for other causes of pain using appropriate studies, lab tests and other manner of testing to ensure that your condition is correctly managed. At times, consultation with a surgical specialist, a gynecology specialist, a gastrointestinal specialist, etc. may be necessary to ensure that your evaluation is complete.
Will Prolotherapy improve my loose joints?
Prolotherapy has been shown to increase the ligaments around joints by approximately 30-40% in strength and mass. This can remarkably improve torn ankle, knee, and other ligaments. Even if there is minimal pain with some of these injuries, the weakness can ultimately tear further and create greater dysfunction. Many athletes utilize Prolotherapy to strengthen their weak ligamentous tissues to reduce future risk of tears and injury. Prolotherapy is the only clinically proven method of regenerating and repairing torn cartilage inside joints.
How many visits are necessary, and how frequent are they scheduled?
Most conditions are treated with 4-8 visits, but may take more. The timing of visits varies from weekly to every 4-6 weeks or more. Rarely, 10-15 visits may be required as long as progress is being made.
How long does it take to know if I will be improved or cured with Prolotherapy?
Patients occasionally experience a great deal of relief after their first injection; most, however, note improvement after 3-4 injections, with the duration of treatment then determined by the rate of progress. Studies suggest a success rate ("greater than 50% improvement in pain level") of 80-90%.
Is Prolotherapy expensive?
Compared to many treatments that are much less permanent and carry greater risk, it is very cost-effective. A treatment will cost $150 per location, typically you will require 4-6 treatments 1 week apart. Sometimes 10 - 15 treatments are needed, but you should start to feel relief after the second or third treatment. The total cost of a course of treatment may easily be less than the cost of an MRI scan and a series of x-rays. Insurance companies, in general, including Medicare, are slow to realize the tremendous gain in cost-effectiveness that Prolotherapy offers them. This is a cash service for insurance companies including medicare does not cover for such treatment.
Are there any activity restrictions following the injection?
We recommend careful resumption of activity as tolerated. This can include normal exercise routines, walking, sports, and other activities. Physical therapy, massage, chiropractic and other treatment does not usually need to be stopped and may in fact assist with the overall process.
The Thinking Person's Guide to Perfect Health
© 1996 Ron Kennedy, MD
Nonsurgical reconstructive therapy also referred to as "prolotherapy" or "proliferative therapy" evolved out of a treatment pioneered by H.I. Biegeleisen called "Sclerotherapy," which was originally used to treat varicose veins. Prolotherapy involved the injection of an "irritant" solution into the area where ligaments are weak and/or damaged. Over the next few days, called "macrophages," literally big eaters, are attracted into the area by the presence of the irritant solution. Once they arrive, these macrophages pick up the irritant solution and carry it away for disposal (they are the garbage men of the body). As the macrophages are finishing their job, the body sends in "fibroblasts," literally connective tissue builders, to lay down fibrous tissue wherever they detect damage to connective tissue such as ligaments.
Microlight ML830 Cold Laser
Microlight ML830 Cold Laser to treat:
- Foot and ankle tendonitis
- Plantar fascitis
- Ankle arthritis
- Heel spur syndrome
- Wound care
The Microlight ML830 is a handheld, battery-operated, noninvasive, light-emitting, medical device. Approved by the FDA in the treatment of a variety of soft and connective tissue disorders as well as certain neurological disorders, this device is a low energy laser also known as a "cold laser."
Read more about the Microlight ML830 Cold Laser.