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So what are we to do?
There are an increasing number of studies on the efficacy and safety of
Prolotherapy
or regenerative injection therapy in soft tissue pain, joint instability,
tendinopathies,
chronic low back pain, and osteoarthritis. Many of
you have had direct experience of the benefits of this approach and as we are
able to use specific growth factors the effects of prolotherapy will improve to
an even greater degree. There is also an increasing body of evidence to support
the long known effects of diet, nutritional supplements, herbal medicine, and
exercise on the healing of collagen and specifically on osteoarthritis. Let’s
just briefly mention the best studied of these. Glucosamine sulfate:
Ever since the Lancet study in 1999 on oral
glucosamine for knee osteoarthritis,
it has been clear that our observations were correct. Many doctors have been
using glucosamine for years prior to this study showing that not only are
functional symptoms greatly improved (e.g. pain-free walking time) but in some
cases cartilage regrowth and an increase in thickness of the cartilage was able
to be seen on xray. Similar results have been associated with the oral ingestion
of other GAGs (glycosaminoglycans) such as chondroitin (more chondroprotective
than regenerative), bovine trachea cartilage, green-lipped muscle, etc. Dr.
Reeves knee prolotherapy studies have shown similarly impressive results with
only the use of local anesthetic and glucose! Many of us have used glucosamine
for years as an addition to our
Prolotherapy solutions in the hope of even
better results. I believe future studies will show there is an increased benefit
with this approach for most patients. Fish oil: Type
in fish oil on the query line of the National Library of Medicine (Pub
Med) and you get almost 10,000 hits. To say there are many articles on the
benefits of taking fish oil as a supplement is a gross understatement. In
addition to its well-recognized effects on cardiovascular risks (decreases in
strokes, blood pressure, blood viscosity, triglycerides, vascular inflammation),
you will find studies suggesting benefits in osteoarthritis, soft tissue pain
and inflammation, and reduction of the breakdown of the collagen matrix we have
been talking about. Antioxidants:
Despite recent flawed studies on the negative effects of antioxidants, the
majority of studies show an overall reduction in cancer, degenerative diseases,
and cardiovascular mortality from the use of antioxidant supplements.
Clinically, this is especially apparent in osteoarthritis. Whole food
antioxidants such as fish, green tea, berries, chocolate, garlic, and nuts are
especially easy additions to one’s diet. Herbal medicine:
Historically, in traditional herbal medicine many formulae have been
successfully used. Prominent among these are those containing the herbs ginger,
boswellia, angelica dahurica, salvia, atractylodes, lycium, bupleurum, poria,
etc. The complexity of these herbal medicines and the lack of research funding
(like prolotherapy) has hampered understanding from a scientific perspective.
These herbal medicines will gain prominence in use as they are better
understood. Many important discoveries in pharmacology have been associated with
the study of traditional herbal medicine prescriptions. Exercise: The
lack of exercise in our culture is certainly a huge problem with soaring rates
of
obesity, cardiovascular mortality, and diabetes as a result. This is hardly
news to prolotherapy doctors who along with others have been advocating and
prescribing exercise to their patients from the beginning. In older athletic
patient, or with “weekend warriors” there are greater challenges with optimizing
the amount of exercise. Many of these folks also have excessive collagen
breakdown due to exceeding their bodies’ repair abilities. This repair function
is often improved with the addition of glucosamine, fish oil, antioxidants, and
herbal medicine and a more reasonable and varied exercise approach. Often, there
are deficiencies of anabolic repair (hormones such as
Testosterone,
Growth Hormone, thyroid) inhibition by metabolic factors (excess sugar intake, insulin
resistance, cytokine imbalance) or a combination of these factors. An
experienced practitioner can help to sort these out. Overall though, more
exercise is better! Conclusion: From the preceding discussion, I think it is clear there are many good natural alternatives to the use of NSAIDs. If you are a patient, seek out those practitioners (like most that are listed here) who have experience in these areas. If you are a doctor that would like to use these approaches but have little experience, please seek out some of the excellent continuing education courses offered. Your patients will be glad you did. |
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Getprolo.com cannot guarantee the accuracy of any resources or information from or about the physicians listed on this website. The opinions and statements in this website DO NOT necessarily reflect the opinions of the physician members of the getprolo.com referral network and are those of the article author only. A medical testimonial is intended to represent that everyone will obtain the same favorable results from a given therapy. Getprolo.com disclaims any such intention.
Prolotherapy is a medical
technique. As with any medical technique, results will vary among
individuals.
Prolotherapy may not work for you and as with all medical
procedures there are risks involved. These risks should be discussed with a qualified
health care professional prior to any treatment.
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