Intravenous (IV) and Injection Therapies

Prolotherapy Platelet Rich Plasma (PRP) Trigger Point Injections Neural Therapy IV Therapy

Prolotherapy
Prolotherapy is a regenerative injection therapy (RIT) used to strengthen joints weakened or damaged by over-use or chronic injury. Ligament or tendon attachments once stretched, torn, or otherwise injured often have difficulty returning to pre-injury level of functioning due to limited blood supply to these structures. Surgery can often produce more scarring and limited range of motion without addressing the root cause of dysfunction. Prolotherapy can actually stimulate healing of the joint structures without cutting into, or removing, tissue. While there are conditions for which surgery is definitely indicated, it can sometimes be avoided or at least delayed with prolotherapy.

How Does Prolotherapy Work?
Chronic knee pain even following meniscus surgery? Ongoing neck pain after a motor vehicle accident requiring months of physical therapy with minimal improvement? How about cycles of muscles tightness and spasm ever since a shoulder injury, despite lots of massage? Or chronic back pain or disc problems ever since giving birth to your child? All of these scenarios are typical of injuries not healing correctly, leading to instability and weakness around a joint. The result is a pattern of chronic pain, with muscles tightening in attempts to compensate.

When tissues are initially injured, sugars and fats are released at the site to help stimulate the immune system's repair mechanims. When there is ongoing overuse of an area (such as tennis elbow or achilles tendinosis) the repair process never gets a chance to finish, leading to ongoing breakdown of the tissues. Chronic anti-inflammatory/NSAID use or steroid injections further impair this process. Prolotherapy attempts to reinitiate repair mechanisms at the specific site of injury by injecting dextrose (or other natural stimulants) to the area, creating focalized inflammation and mimicking the original repair process. It stimulates the generation of new fibrous tissue, strengthening tendon and ligament attachments. Once joint structures are strengthened, both joint and muscle pain can be significantly, if not fully eliminated. Degenerative processes, such as those seen in osteoarthritis, can also be stopped, and new cartilage encouraged to regenerate.

Treatment Course
Treatment course varies and depends on the joint being treated, but typically results are seen within 3 treatments, although often patients will see significant improvement after one visit. A typical treatment course is 3-6 series of injections, given every 2-4 weeks. Prolotherapy has been used since before the '50's and numerous case reports and an increasing number of controlled studies showing its effectiveness.

Articles on Prolotherapy (click on the title to view)

• Prolotherapy – A Simple Solution With Powerful Effects, by Ryan
  Minarik, ND, LAc
• Prolotherapy and the Athlete, by Mark L. Johnson, M.D., FACS
• Connective Tissue Damage Syndrome, by Mark L. Johnson, M.D., FACS

Websites for Prolotherapy

• American Osteopathic Association of Prolotherapy Integrative Pain Management (AOAPIPM, formerly ACOSPM), www.acopms.com
• Hackett Hemwall Foundation, www.hacketthemwall.org
• www.prolotherapy.org

Platelet Rich Plasma (PRP)
Platelet Rich Plasma, or PRP, is a relatively new form of regenerative therapy injections. A sample of the patient's blood is collected, and then centrifuged to concentrate the platelets, and growth factors which directly encourage cell repair and tissue regeneration. The solution is then injected at the site of injury in the same manner as dextrose solutions. Blood draw and injections are done in the same visit, typically with 1 hour.

PRP has similar applications to standard prolotherapy, but may be preferred specifically for tendon tears and some forms of arthritis. It is also used in dentistry and some surgical procedures to encourage quicker healing.

Websites for PRP

• Harvest Technologies, www.harvesttech.com

Trigger Point Injections
Trigger points are regions of hyper excitability in soft tissue, that lead to exceedingly tender points in muscles and chronic pain surrounding the area. Trigger points can often cause referred pain, in well established patterns, leading to symptoms extending beyond the simple area of affected muscle - such as headaches being due to referred neck muscle dysfunction. There are numerous techniques to eliminate these points. Injection of procaine, or other similar substances, is an easy and quick method to often immediately reduce or eliminate musculoskeletal pain. It allows chronic, tight or inflammed muscles to relax, allowing increased blood flow and oxygen, toxic metabolite elimination, and the establishment of a more functional muscle group.

Neural Therapy
Neural therapy utilizes a local anesthetic, procaine, and often homeopathic preparations to remove or treat electrical interference fields in the body, originally caused as a result of wounds, scars, surgery, infection, even mental-emotional trauma. These interference fields may produce chronic pain or musculoskeletal dysfunction, or produce more broad ranging problems such as chronic sinus issues, menstrual dysfunction, pelvic pain, digestive disturbances, insomnia, breathing difficulty, etc - the list goes on. The procaine and additional medicines are injected either at the surface of the body, such as around painful areas, or slightly deeper to get at nerve bundles suspected to be "stuck" in a dysfunctional pattern.

Injections are done with tiny needles, and are usually very well tolerated, with minimal, if any, discomfort. Procaine is one of the earliest, and safest anesthetics, being easily metabolized in the plasma, and not requiring the liver for breakdown and detoxification, as with other more complicated compounds. Most patients tolerate this medicine well, even if previous problems with other anesthetic medications.

IV Therapy
Intravenous therapy can be formulated for a wide spectrum of conditions. Simple vitamin and mineral solutions are generally safe and can be administered easily, for example to boost the immune system during acute illness or help with energy during times of fatigue or heavy stress. Treatments such as these may take as little as 15 or 20 minutes. In more serious conditions, such as heavy metal toxicity, autoimmune disease, or chronic infections, longer-term approaches using more sophisticated IV solutions can be utilized with potentially dramatic effects. Protocols are tailored according to the individual and their condition, and a thorough screening is required prior to commencing any treatment.

Our Practitioners offering Prolotherapy, Trigger Point Injections and IV therapy
Ryan Minarik, ND, LAc.

Our Practitioners offering Neural therapy
Ryan Minarik, ND, LAc.
Shannon Weeks, ND