KLINIK KELUARGA & SURGERI : PROLOTHERAPY TREATMENT

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PROLOTHERAPY

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Prolotherapy Is the most effective treatment for ligament laxity problems which represented by backache, knees pain, shoulder pain, frozen shoulder, ankle pain, heel pain, elbow pain and etc.

The concept of the treatment is to induce/ stimulates the inflammatory process with the aims of curing the ligament laxity permanently. No NSAID Or any steroid to be take 2 days prior to the treatment or  after the treatment.

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FIGURE 1 : Traditional treatments for pain worsen the condition and actually accelerate the arthritic process.

Pain: It Is Not an Ibuprofen/pain killers   Deficiency

Pain is not, and never will be, an ibuprofen or any other anti-inflammatory medication deficiency. If this is true, why are millions of people taking these medications every day for their chronic pain? Instead of masking the pain with drugs, why not receive a treatment that stimulates the body to repair the painful area? Perhaps the reason for this is because the usual course of events in treating chronic pain by traditional physicians, pain clinics, and sports rehabilitation centers is to first treat the pain with non-steroidal anti-inflammatory medications (NSAIDs), then with cortisone shots, eventually progressing to arthroscopy, and when the painful condition persists, some type of surgical procedure. This scenario is all too real for many people! (See Figure 1.) The problem with this approach is that all of these traditional treatments weaken the body, increasing the likelihood of future injuries and chronic pain.

Pain: An Indication of a Problem

Pain, in many respects, is a God-given gift. A gift you say? Yes, pain alerts the body of a problem. Simply put, pain is due to weakness. Pain in the lower back, for example, indicates that some structure in the lower back is weak and needs to be
strengthened. This is why suppressing the symptoms of pain with NSAIDs, cortisone shots, or allowing a surgeon to scrape away meniscal or cartilage tissue with an arthroscope is dangerous. If the condition causing the pain is not stopped, the
underlying degenerative process will continue. If left unchecked, systemic connective tissue deficiency leading to multiple areas of ligament and tendon relaxation will occur.

Chronic Pain: Look for Ligament and Tendon Relaxation

“Ligament relaxation is a condition in which the strength of the ligament has become impaired so that a stretching of the fibrous strands occurs when
the ligament is submitted to normal or less than normal tension.” George S. Hackett, M.D., made this statement 40 years ago and believed chronic
pain was simply due to ligament and tendon weakness in and around the joint. Dr. Hackett coined the phrase, “ligament and tendon relaxation,” which is synonymous with ligament and tendon weakness. He later coined the term,
“Prolotherapy” and developed the procedure as a treatment for chronic painful conditions.

Strain Versus Sprain: What is the Difference?

A strain is defined as a stretched or injured tendon. A sprain, on the other hand, is a stretched or injured ligament. A tendon attaches a muscle to the bone, whereas a ligament attaches bone to bone. Ligament and tendon injuries often do not heal
because these structures have very poor blood supplies. Perhaps even more importantly, their healing is slowed or even stopped by - you guessed it - NSAIDs, cortisone shots, and more importantly, the R.I.C.E. treatment. Rest, Ice, Compression and Elevation inhibit healing, whereas the M.E.A.T. protocol, consisting of Movement, Exercise, natural Analgesics (proteolytic enzymes), and specific Treatments like Prolotherapy, stimulates healing. (See Figure 2.)

R.I.C.E. versus M.E.A.T.


R.I.C.E. M.E.A.T.
Immune System Response Decreased Increased
Blood Flow to Injured Area Decreased Increased
Collagen Formation Hindered Encouraged
Range of Motion of Joint Decreased Increased
Complete Healing Decreased Increased
Speed of Recovery Delayed
(Lengthened)
Hastened
(Shortened)
FIGURE 2 : The RICE protocol hampers soft tissue healing whereas MEAT encourages healing.

Webster’s Third New International Dictionary defines Prolotherapy as “the rehabilitation of an incompetent structure, such as a ligament or tendon, by the induced proliferation of new cells.” Prolotherapy involves the injection of

substances at the sites where ligaments and tendons attach to the bones, thus
stimulating the ligaments and tendons to proliferate or grow at the injection sites. This area is called the fibro-osseous junction. “Fibro” means fibrous tissue that forms the ligament or tendon and “osseous” refers to the bone.

Prolotherapy, therefore, stimulates the body to repair the exact site of the painful area. (See Figure 3.) Prolotherapy works because it addresses the root cause of chronic pain: ligament and tendon weakness.

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FIGURE 3: The exact site of the pain is injected with Prolotherapy solution.

Prolotherapy Stimulates the Normal Healing Inflammatory Reaction

Most people are shocked when they find out that the body heals by inflammation. Yes, God made the body to heal by one way only... inflammation! Inflammation is the process whereby the immune system is activated to help the body restore home-ostasis or balance. Prolotherapy injections cause immune cells to arrive at the injury site to repair it. (See Figure 4.)

Once the injured tissues achieve normal strength, the chronic pain is eliminated. Prolotherapy injec-tions have been shown to significantly increase lig-ament
mass, thickness, and strength. (See Figure 5.) Prolotherapy outperforms all other treatments such as NSAIDs, cortisone injections, and surgery. (See Figure 6.)

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FIGURE 4: Prolotherapy Stimulates Inflammation Prolotherapy stimulates the natural healing mechanisms of the body via inflammation.

The Effects of Five Prolotherapy Treatments to the Medial Collateral Ligament


Prolotherapy Injected Ligaments Saline-Injected Ligaments (Control)%
Change
Ligament Mass (mg) 132.2 89.7 44
Ligament Thickness (mm) 1.01 0.79 27
Ligament Mass Length (mg/mm) 6.45 4.39 47
Junction Strength (N) 119.1 93.5 28
FIGURE 5: Prolotherapy causes a statistically significant increase in ligament mass and strength as well as bone-ligament junc-tion strength.

Prolotherapy Versus Cortisone


Prolotherapy Cortisone
Effect on Healing Enhanced Inhibited
Effect on Repair Enhanced Inhibited
Effect on Collagen Growth Enhanced Inhibited
Effect on Tendon Strength Enhanced Inhibited
Effect on Ligament Strength Enhanced Inhibited
Effect on Cartilage Growth Enhanced Inhibited
FIGURE 6: Prolotherapy is needed to heal an injury.

Prolo Your Pain Away!

Since pain is caused by injured or weakened connective tissue, i.e. ligaments or tendons, Prolotherapy can cure or substantially alleviate most painful conditions because it strengthens the injured areas.

These are some of the painful conditions that have been treated successfully by Prolotherapy:

Arthritis Migraines Sciatica
Back Pain Myofascial Pain Syndrome Scoliosis
Bone Spurs Neck Pain Slipping Rib
Bunions Osteoporosis Spondylolisthesis
Carpel Tunnel Syndrome Plantar Fasciitis Sports Injuries
Fibromyalgia Post Surgery Pain Subluxation
Herniated Discs Pregnancy Back Pain Tendonitis
Ligament Sprains RSD Pain Tennis Elbow
Loose Joints Rotator Cuff Pain TMJ Syndrome
Meniscal Tear Sacroiliac Laxity ...and a host of others!


Prolo Your Arthritis Pain Away!

Soft tissue injuries to the joints often start the development of degenerative joint conditions. Injury to the ligaments and stabilizing structures of the joint is often the original site of injury. When the ligaments are stretched and weakened, the
other structures in the joint, like the meniscus, sus-tain added pressure. Eventually these structures become fatigued and the cartilage begins to deteri-orate.
Prolotherapy can stop the degenerative process and eliminate the pain. (See Figure 7.) Because Prolotherapy gets at the root cause of the arthritic process it has been used successfully to treat a myriad of common degenerative conditions. (See Figure 8.)

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FIGURE 7 : Soft tissue injury leads to degenerative arthritis, where Prolotherapy halts the process.

Common Degenerative Conditions Treated Successfully with Prolotherapy

Area Condition
Knee Osteoarthritis, Chondromalacia Patellae
Hip Osteoarthritis, Hip Ligament Sprain
Lower Back Degenerated Disc, Herniated Disc
Neck Degenerated Disc, Herniated Disc
Shoulder Osteoarthritis, Rotator Cuff Tendonitis
Ankle/Feet Ligament Sprains, Plantar Fasciitis
Hands/Fingers Osteoarthritis, Ligament Sprains
FIGURE 8: Regeneration occurs in all joints of the body.

Connective Tissue Healing Involves Many Factors
Prolotherapy stimulates the body to repair painful areas. It starts the normal inflammatory healing reaction, but the body’s immune system must respond and grow the collagen that is necessary to repair the injured ligaments, tendons, or cartilage. If a person has lost the ability to heal, the response to Prolotherapy will not be optimal. This person is said to have connective tissue deficiency, definedas a disorder characterized by a weakening of the connective tissues and a deficiency in the amount, strength, or functioning of the connective tissues leading to a myriad of painful and chronic symptoms. Since there are many factors that affect connective tissue healing, the condition may have many causes. (See Figure 9.)

Factors Affecting Healing of Connective Tissues

Age Overall health status
Blood Supply pH and lactate concentration
Degree of hypoxia (systemic and local) Pharmacological agents (drugs)
Dietary intake Psychological influences (placebo
effects and psychoneuroimmunological links)
Electrical fields Severity of injury
Growth factors, cytokines, eicosanoids Structural (physical) deformities
Hormonal influences Temperature
Mechanical load forces Timing and return to physical activity
Metabolic and cell turnover rates of
connective tissue
Type of injury
Mobility (local & whole body) Type of onset (acute or chronic)
Muscular strength and forces Type of tissue(s) affected
Nutritional status Underlying disease processes
FIGURE 9: Connective tissue deficiency has many causes.

The cause of the connective tissue deficiency is very often due to the actual traditional treatment the person received, including NSAIDs and corti-sone shots. Other common causes include nutritional factors and hormone deficiencies.

Women are much more likely than men to suffer from the effects of connective tissue deficiency, and thus chronic pain, because of their high estrogen levels, which inhibit collagen synthesis. (See figure 10.) When tested at Caring Medical in Oak Park, Illinois, most people with chronic pain are found to have low levels of hormones, such as Growth Hormone, testosterone, DHEA, and progesterone, all of which are necessary for connective tissue health and healing. For the person with a suspected systemic connective tissue deficiency problem, we recommend a formal evaluation by a doctor who not only does Prolotherapy, but natural medicine as well.

Disclaimer: Certain persons considered experts may disagree with one or more statements made. Nevertheless, what is stated is based on sound authority, medical experience, and actual treatments of patients.

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FIGURE 10: Collagen synthesis is inhibited by increased estradiol levels.
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