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Prolotherapy Treatment Options
What is the best Prolotherapy treatment route for chronic pain and/or injury. Is it Prolotherapy with dextrose, sodium morrhuate, minerals, hormones, PRP, and even stem cell therapy using bone marrow?
PRP Prolotherapy versus dextrose Prolotherapy:
A side-by-side comparison study has yet to be published, Ross Hauser, M.D. utilizes PRP Prolotherapy his office as well as dextrose Prolotherapy, and both certainly work well. Dr. Hauser has published a paper on the use of PRP Prolotherapy in knee patients with meniscus tears told they needed surgery who were able to resolve their injuries with PRP Prolotherapy instead of surgery.
Dr. Hauser says in his opinion that it is not necessary to use PRP Prolotherapy on all patients for all conditions. It has its place, but it is not needed for all patients. That would only add undue cost and time when dextrose Prolotherapy will work great for a wide array of conditions.
Dr. Hauser has a new video out on the subject that you can view below
Platelet Rich Plasma Therapy Basic Information
Basic Information on Prolotherapy and Platelet Rich Plasma Therapy. Free access article from the Journal of Prolotherapy by Ross Hauser, M.D.
In this article Dr. Hauser discusses the basic preparation of the blood platelets into growth factor solution before the treatment is admistered to the patient.
Dr. Hauser is recognized as a leading physician in the practice of Platelet Rich Plasma Treatments (PRP) and Prolotherapy.
New Prolotherapy Video – Prolotherapy injections
Ross Hauser, M.D. explains the different types of Prolotherapy injections.
Ross Hauser, M.D., is recognized as one of the leading experts in Prolotherapy. His Chicago area chronic pain clinic is located in Oak Park, Illinois
Bone marrow injections for cartilage repair
Direct uncultured bone marrow cells regenerate articular cartilage in animal study
The question still remains, “Is Bone Marrow Prolotherapy the very best type of stem cell therapy?” Let’s put it another way, “Is direct bone marrow injection the best way to introduce stem cell therapy into a joint?” Let’s take a look at why these researchers give a resounding “yes” answer to that question.
Researchers from the Graduate School of Human Comprehensive Sciences, at the University of Tsukuba Japan have successfully regenerated articular hyaline cartilage by using uncultured bone-marrow-derived cells.1 The researchers wanted to determine if autologous (cells from the same animals) bone marrow cells could regenerate articular cartilage. To determine this they generated large full-thickness articular cartilage defects in the knees of 48 Japanese white rabbits. The animals were divided into four groups: the uncultured bone marrow cell group; the peripheral blood cell group; a fibrin group (gel used in the study); or a control group, where nothing was done. The knees of the rabbits were studied 3 months after the treatments were given. The articular cartilage underwent histological and histochemical investigation (under the microscope). So what did placing bone marrow cells do to the articular cartilage in this study?
According to the authors, “In the bone marrow cell group, regeneration of cartilage could be detected in almost all of the sections…the percentages of Safranin-O-stained areas (stains for cartilage granules) with respect to the regenerated soft tissue area were significantly higher in the bone marrow cell group than in the other groups.’1 They also noted “…our group has reported that autologous bone marrow-derived culture-expanded cartilage repair. Comparing these latter results with those of the bone marrow cell group (direct bone marrow injection) there was no significant difference in any criteria….In conclusion, the transplantation of autologous uncultured bone marrow-derived mononuclear cells contributes to articular cartilage repair. The easy and safe method used in this study is potentially viable for clinical application.”
The question still remains does bone marrow have to be cultured to get more stem cells to make it effective? Our experience at Caring Medical is no, just like these researchers found. They found, as we surmise, that the stem cells in human bone marrow are smart enough to find the injured area and start proliferating, differentiating and proliferating the necessary cells to make the tissue that is degenerated or torn. In other words, the body knows best. Direct bone marrow injection for the regeneration of tissue such as articular cartilage and meniscus works in humans and there is no reason it won’t work in people. We hope to be one of the centers to prove it!
1Chang F, Ishii T, Yania T. Repair of large full-thickness articular cartilage defects by transplantation of autologous uncultured bone-marrow-derived mononuclear cells. Journal of Orthopaedic Research. 2008;26:18-26.
Ross A. Hauser, M.D.
Dr. Hauser the Medical Director of the comprehensive Prolotherapy, PRP, and Bone Marrow Prolotherapy clinic, Caring Medical & Rehabilitation Services in Oak Park, Illinois. Dr. Hauser is one of the leading experts in the treatment of chronic pain and sports injuries with Prolotherapy.
PRP (platelet rich plasma) and bone marrow to grow cartilage
PRP (platelet rich plasma) and bone marrow to grow cartilage
What is the role of platelet rich plasma in bone marrow prolotherapy for articular cartilage regeneration?
It is already well established that bone marrow contains mesenchymal stem cells, also called connective tissue progenitor cells. The question is “How can we get these stem or progenitor cells to repopulate an area the quickest?” How can we get stem cells to proliferate and differentiate the way we want them?
Recently researchers at Stanford University Medical Center asked these questions.1 Specifically they tested, whether platelet rich plasma (PRP) may be useful for cartilage regeneration by seeing mesenchymal stem cells grew more quickly when grown in a medium with PRP.1
PRP can be defined as plasma with enriched levels of platelets relative to whole blood. Within platelets are alpha granules that contain powerful growth factors that are proposed to substantially aid the healing of soft tissue structures such as tendons. PRP is one of the available proliferants used at Caring Medical for Prolotherapy, thus we call it appropriately PRPP or Platelet Rich Plasma Prolotherapy.
The Stanford researchers found a 10% PRP solution caused a fivefold increase in mesenchymal stem cell proliferation after 7 days. The PRP treatment also caused an increase in expression of markers of both chondrogenic and osteogenic differentiation by human mesenchymal stem cells. They noted, “Adding PRP to mesenchymal stem cells and then using the combination to treat bone, ligament, tendon, or cartilage may be valuable….this suggests that PRP may selectively encourage mesenchymal stem cell differentiation along a chondrogenic line.”
This article provides some of the scientific research that supports the use of PRP in Bone Marrow Prolotherapy. While direct bone marrow aspiration injection (direct Bone Marrow Prolotherapy) involves the injection of only bone marrow into the injured tissues and joints; concentrated bone marrow aspiration can include just bone marrow or bone marrow combined with PRP. Either of these solutions is then concentrated to make whatever volume is needed. An example of would be someone coming for advanced osteoarthritis and a total of 12cc of solution is desired (6cc for each knee). If PRP is used, 20cc of PRP could be combined with 30 cc of bone marrow and then the solution concentrated down (to concentrate the cells and growth factors) to 12cc.
The reason to use the PRP would be the same as the article shows, to enhance the growth of the mesenchymal stem cells, only the stimulation would occur in situ or in its natural environment. Where would that be? The injections are given at the site of the knee arthritis. The mesenchymal stem cells (bone marrow concentrate) and PRP (concentrate) would be injected right into the person’s arthritic knees!
In our office, this is typically done every six to eight weeks and normally takes four to six visits to achieve pain resolution. Before and after x-rays or MRIs are encouraged to better quantify the articular cartilage and/or meniscus regeneration. The most important result, however, is the decrease in the pain level, improved joint range of motion, and increased walking and exercise ability.
Ross A. Hauser, M.D.
Dr. Hauser the Medical Director of the comprehensive Prolotherapy, PRP, and Bone Marrow Prolotherapy clinic, Caring Medical & Rehabilitation Services in Oak Park, Illinois. Dr. Hauser is one of the leading experts in the treatment of chronic pain and sports injuries with Prolotherapy.
An alternative treatment for shin splints
An alternative treatment for shin splints
Shin splints or medial tibial stress syndrome (MTSS) is caused by injury to muscle attachments onto the medial tibia which can include the soleus, posterior tibialis, among others. While traditional medicine treats shin splints with rest, ice, compression and elevation (RICE) and NSAIDs, these can often make the structures weaker and is one of the reasons shin splints often come back. Many athletes look to alternative treatments like Prolotherapy as a long-term solution to dealing with shin splint pain. In our practice in Oak Park Illinois, we use Prolotherapy to stimulate the body to repair the painful injured area(s) when the body’s natural healing process is not able to do the job on its own. As an avid runner myself, I know how it feels to be sidelined with a running injury!
In a study published in the February 2011 issue by the British Journal of Sports Medicine, the effectiveness of Prolotherapy was documented. Prolotherapy has long proven to be a great option for treating shin splints compared to traditional remedies because Prolotherapy strengthens the weakened areas, which is good news for runners who can’t seem to get over the pain. In our experience, typically 3-6 visits of Prolotherapy are needed to resolve chronic shin splints. This study proves what we have known for years! Prolotherapy gets runners back on the road much more quickly than the traditional treatments of icing, wrapping, and rest – which may linger on for months and months.
Do I Need to Modify My Training?
We recommends that you continue your training and activities while receiving Prolotherapy. Runners however may want to decrease mileage and avoid doing too much too soon. Using the ellipitcal or power walking on the treadmill set at an incline to keep the heart rate up can help you continue to exercise during treatments. Stretching the Achilles and calf muscles is very important as is strengthening the lower leg muscles. Listen to your body. While some muscle aches or discomforts are to be expected when you push yourself, pain is not. Pain is your body’s way of telling you that something is wrong. If you continue exercising through pain, you risk injury. And if you have an injury, seek help. You risk more damage and your recovery will take longer if you don’t!
In other words, traditional treatments for running injuries often miss the root problem, causing the runner to cease training and risk dropping out of the race completely. Prolotherapy addresses the real problem, leading to safe and effective healing, allowing runners to get back to what they love. Many of our runner patients’ races have been saved using Prolotherapy to get them safely back to running. If you are plagued by injury or you are starting to feel an injury coming on, don’t rest until you give us a call. Prolotherapy can get you back in the race.
Dr. Hauser received his M.D. from the University of Illinois, Chicago; completed his residency at Loyola-Hines VA-Marianjoy Hospitals in Physical Medicine and Rehabilitation; and received his Bachelor of Science degree from the University of Illinois, Urbana-Champaign. Dr. Hauser is the Medical Director and co-founder of the physician-run, comprehensive Prolotherapy, PRP, and Bone Marrow Prolotherapy clinic, Caring Medical & Rehabilitation Services in Oak Park, Illinois. Dr. Hauser is one of the leading experts in the treatment of chronic pain and sports injuries with Prolotherapy. He, along with his wife Marion, have written seven books on the topic of Prolotherapy, a comprehensive book on the natural medicine approach to cancer, as well as a myriad of articles and newsletters for the general public.
Prolotherapy Newsletter 11/03/2010
Prolotherapy Articles
● Loose bodies on Arthroscopy Loose bodies are fragments of bone, cartilage, or collagen that are located in the joint cavities. The most common location is the knee. Sometimes these loose bodies, truly are loose, they move freely within the joint and can be entrapped between the articular surfaces of say the knee bones (like the femur and tibia). This can cause symptoms such as intermittent joint locking, limitation of motion, pain and sometimes swelling. There are other types of loose bodies that are not so loose. The fragments attach into a bursa (a fluid filled sac that prevents friction between bone and soft tissue structure such as a tendon) or stabilize onto some structure such as the synovium. Most loose bodies do not produce symptoms and are found incidentally on X-ray.
● My MRI is Terrible Does Caring Medical order MRIs? Almost never. In my opinion, most MRI findings have nothing to do with why the person has pain and is thus the reason for most ‘failed surgery syndromes.’ Almost all people even after surgery are not pain free. Surgery for pain in the best case scenario should be done only after all of the conservative treatments have been tried and failed. This includes Prolotherapy! Degenerated joints, including degenerated or herniated discs, signify ligament laxity. Ligament laxity or vertebral instabilities are the reason that discs become degenerated. A herniated disc by definition means the nucleus pulposis (gelatin part of the disc) has herniated through the annulus fibrosis, which is ligamentous tissue. Caring Medical has helped many people with acute and chronic disc herniations and degenerated discs resolve their pain and disability without surgery. For a person in relatively good shape and immune function (good healing ability) the likelihood of success is even higher. Prolotherapy by stimulating the ligaments to heal, helps the vertebral segment become stabilized and thus eliminates the reason for the degenerated disc.
● Prolotherapy for the Achilles Tendon 5 treatments – 5 months Mark was an avid runner and softball player who was struggling with painful Achilles tendonitis. The pain was present for over a year and after no relief from cortisone shots or electrical stimulation.
Back Pain Links
● Degenerative Disc Disease Articles
● Low back pain
● Low Back Pain and Prolotherapy
● Low and mid back pain
● Low back and sitz bone
● Arachnoiditis
● Ankylosing Spondylitis
● BACK PAIN-WHAT’S THE DIAGNOSIS?
● Loose Ligaments and Back Pain
● Prolotherapy-Back Surgery-Spinal Fusion
● Compression Fracture
● Facet Syndrome
● Sacroiliac Pain
● Tarlov Cysts
● The problem with getting properly diagnosed: SI strain
● Prolotherapy Spondylolisthesis
● SPINAL DISC PROBLEMS
● Diffuse idiopathic skeletal hyperostosis
● Scoliosis and Prolotherapy
● Spinal Stenosis and Prolotherapy
● Spinal Cord Stimulators
● Spinal Stenosis and Prolotherapy
● MRIs, Herniated Discs, Prolotherapy
● Radiofrequency denervation
● Women, Back Pain and Hormones
● Sacroiliac Blog
● BACK PAIN BLOG
For the Athlete
● Ross Hauser, MD on Shoulder Injuries in swimmers in USMS
● Rugby knee injury in high school athlete
● Post fracture pain treated with Prolotherapy
● Platelet Rich Plasma (PRP) Prolotherapy for Athletes
● The shoes you wear can affect knees and joints in arthritic patients
Enhancing Healing Through Diet
● The Hauser Diet For Lower Cholesterol
● Are you exercising, but still overweight?
Ross A. Hauser, M.D.
Dr. Hauser is the Medical Director and co-founder of the Chicago area based chronic pain clinic Caring Medical & Rehabilitation Services in Oak Park, Illinois. CMRS is nationally recognized as a leading center specializing in Prolotherapy and PRP Prolotherapy (Platelet Rich Plasma Therapy),
Dr. Hauser is one of the leading experts in the treatment of chronic pain and sports injuries with Prolotherapy and PRP Prolotherapy. He, along with his wife Marion, have many books and Prolotherapy research papers on the topic of Prolotherapy.
CMRS 715 Lake Street Suite 600, Oak Park Il, 60301 708-848-7789
Prolotherapy Newsletter 10/28/2010
● Is there an age limit to getting Prolotherapy?
Losing the ability to be mobile and active is possibly the worst thing that can happen to people as they age. Activity truly keeps the blood flowing. Joints like the hips and knees depend on walking and weight-bearing activities to provide nourishment to the joint cartilage. No walking, no nourishment. No nourishment, no cartilage. No cartilage, no movement. Walking keeps people alive and keeps the body functioning It stiffness sets in, the grave may follow.
Why not treat all patients with Platelet Rich Plasma? Here is my bottom line related to joint instability and PRP. If you have joint instability, you can receive PRP Prolotherapy to the joint a hundred times and you will continue to have instability if ligament laxity (weakness) is involved.
● When should I get pain relief from Prolotherapy, how many visits?
For the Athlete
● Hip Osteoarthritis Prolotherapy is a great option for the athlete who wishes to quickly heal an injury and return to the sport that they love. Larry was one such athlete who we treated last summer from a far north suburb of Chicago. He had been practicing martial arts and bodybuilding for years until he hit age 54. It was then that he experienced a hip injury that took him out of martial arts. Now, two years later he was desperate to get back to his active lifestyle. Not only did chronic pain keep him from martial arts, it also interfered with his daily activities and his sleep. Despite a few years of PUSH therapy his pain remained. When he visited an orthopedist he was diagnosed with osteoporosis and osteoarthritis of the hip. One shot of PRP into a joint is not going to regenerate an injured, lax ligament that is responsible for providing joint stability.
● Platelet Rich Plasma (PRP) is another form of Prolotherapy
● I wish I would have never gotten a meniscectomy
● Running Injuries
Enhancing Healing Through Diet
● 10 tips for getting your health back on track – get back to basics
● Five ways to stay healthy during the holidays
● How the cold can make you gain weight
● 5 common causes of sugar cravings & what to do about them
