By Ross Hauser, MD, and Marion Hauser, MS, RD

When you get up in the morning, do you feel refreshed, energized, and ready to get out of bed?

Or are you like so many Americans who suffer from some sort of painful condition that makes even getting out of bed in the morning a chore?

If you answered “yes” to the latter question, please know you are not alone. A study by Yong published in the International Association for the Study of Pain indicated that one in five adults in the US experiences chronic pain. Study participants reported limitations in daily function, activities of daily living, and ability to participate in exercise or more strenuous activities.

In a National Health Interview Survey, 50 million adults reported pain on most days or every day. The most common painful areas were the back, hip, knee, and foot. What we see at our clinic in Fort Myers, FL, are patients with the above conditions, but even more so, extreme cases of neck pain and instability leading to many chronic conditions due to structures in the neck becoming compressed leading to all sorts of disease processes.

The Good News? There is Hope!

Nearly 30 years ago we met an amazing physician named Gustav Hemwall, MD. He taught us that most chronic pain develops as a result of joint instability. Ligaments and tendons hold bones together. They are white in color and have very poor blood supply compared to their counterparts—the muscles. 

Muscles are beefy and red in color and are what allow your body to move. They are not meant to be support structures that hold bones together. However, when the underlying ligaments and tendons weaken, the muscles try to take over and help stabilize, resulting in muscle tightness and soreness. Other ways the body compensates include swelling and the formation of boney overgrowths, such as arthritis and/or bone spurs. 

Some people who develop pain will look for relief ASAP and find it with the right skilled massage therapist, chiropractor, and/or physical therapist. Unfortunately for many, however, they either do not address the pain issue readily, thinking “ah, I’m just getting older” or they have tried some of the above modalities with partial or short-lived results. Understandably, if the underlying cause of pain that has now become chronic is not addressed, then long-lasting, curative results are less likely to happen. 

You may ask, “what is the underlying cause? How can it be successfully treated?” 

The short answer is joint instability. Specifically, every joint in the body can become weak and/or loose. The supporting structures that hold the bones together break down—either from trauma, injury, or overuse. When this happens, the joint moves too much. We liken this to the example of loose hinges on a cabinet door. When the hinges become loose, what happens? The cabinet door moves too much. How do we fix this? We don’t remove the door or paint the door—we tighten the screws of the hinges that hold the door, resulting in a smooth gliding cabinet door, right? 

The same is true for the ligaments and tendons that hold the bones together—they need to be tightened. And what is the process in the body that induces healing? Inflammation. What? Don’t we prescribe anti-inflammatory medications and shots for pain? Well, it’s true that traditional medicine providers will treat pain by prescribing anti-inflammatory medications and eventually move to injecting steroids into the area(s)—which are even stronger anti-inflammatories. This is not good. It is anti-healing. It is a known fact that anti-inflammatory medications and steroid shots accelerate the degenerative process. Yes, accelerate DE-generation (not RE-generation!).

Prolotherapy Explained

Since the body heals by the process of inflammation, what kind of treatment can be done to stimulate that healing process? Well, the answer is Prolotherapy or proliferative injection therapy. Proliferate means “to grow.” 

Prolotherapy stimulates the body to repair these painful, injured areas. Natural substances are given in one-milliliter injections to all of the ligament and tendon attachments of the injured joint—much like tightening of the screws that hold the hinge onto the cabinet door. In fact, it is like spot-welding the joint. 

When these injections are given, healing cells rush to the injured area that is now “inflamed” and start the healing process. The healing cascade takes about six weeks. Most patients receive significant healing with the first set of injections. That said, the average number of treatments required for resolution of the problem is about three to six depending on the severity of the case. The injections are typically given every four to six weeks. 

Patients are also asked to concurrently work on strengthening their overall bodies and take measures that support healing, such as adequate protein intake, fresh produce, limited sugar and/or junk food, adequate sleep (seven to eight hours per night), stress reduction, and movement—either on their own or with the help of a movement expert (eg, physical therapist or chiropractor who is knowledgeable about Prolotherapy).

What is Injected and how many injections are given? 

The basic Prolotherapy solution is made up of the natural-occurring sugar of the cells in the body: dextrose, as well as an extract of the pitcher plant called Sarapin, which can help with nerve involvement and act as a proliferant. Additional solutions include a numbing agent such as procaine and some sterile water. Additives may be used to increase the proliferation of cells, such as extracts of fatty acids, vitamins, minerals, or even the patient’s own blood for growth factors or stem cells. 

When the blood is drawn, it is processed, and the growth factors are extracted and then injected back into the injured area(s). This is called PRP or platelet rich plasma, which is given in addition to the traditional Prolotherapy solutions—ensuring the treatment is stronger (and may result in more soreness after the treatment). 

The “strongest” solution used is through the process of extracting stem cells from the patient and then reinjecting them into the injured area(s). The stem cells are obtained from drilling into the bone and extracting them from the bone marrow or from a lipoaspirate procedure to obtain stem cells from the patient’s fat (eg, love handle area or abdomen). These cells are processed and then injected into the injured area(s) in conjunction with the base Prolotherapy. 

The most effective type of Prolotherapy is called Comprehensive Prolotherapy, meaning that the entire area including the joint and the support structures are all injected at one visit. This means that a patient receiving a knee treatment would receive about 30 injections, a back 60 injections, and so on. Why do this? Back to joint instability. If all the loose areas are not tightened, then the joint will not fully heal.

What area(s) of the body can be successfully treated with prolotherapy?

You name it, it can be treated! Prolotherapy has been shown to successfully treat conditions such as low back pain, knee issues (eg, meniscus and ACL tears), neck pain and headaches, elbow pain, wrist pain, finger and toe pain, sports injuries, groin and pelvic pain, and TMJ pain. Finding an experienced and skilled Prolotherapy provider takes some work on the part of the patient. Look for someone who treats all areas of the body and uses a comprehensive approach, not just one to three injections.

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Ross Hauser, MD, and Marion, MS, RD (aka The Doctor and the Dietitian) are co-founders of the comprehensive Prolotherapy and natural medicine clinic, Caring Medical, in Fort Myers, Florida. They are so thankful to have learned Prolotherapy early on in their careers and have been tremendously blessed to be able to provide this life-altering treatment to help thousands of patients. They also have benefited from receiving Prolotherapy for their many sports-related injuries over the years. Remember, there is hope! You do not have to suffer every day in pain or take long-term medications. Learn more at www.CaringMedical.com