When you ask your doctor what you can do about your arthritic knees, painful Achilles tendon or torn rotator cuff, you’re likely to be told about using ice or pain medication. Your physician might even discuss surgical options. But there is a very effective, non-surgical treatment that your medical provider may not mention -– prolotherapy. Why isn’t it discussed? Prolotherapy technique is difficult to learn and requires extensive specialized training; thus very few doctors are familiar with its benefits and even fewer are truly qualified to administer the procedure.
That having been said, if you are suffering from chronic joint pain or a muscle, ligament or tendon injury, you should at least consider prolotherapy. “Why?” you might ask.
“Because it’s a safe, efficient, and non-surgical way of healing the micro-tears in the fibrous tissue that connects joint capsules, tendons and ligaments to bone. This connective tissue supports the proper functioning of every joint and muscle in the human body”, explains Dr. David Wang. “When, through trauma or disease, these attachments are damaged, the joint can become weak and unstable, leading to increased pain and potentially further injury. Furthermore, the body’s ability to heal these injuries is not great because tendons, ligaments, and cartilage have a poor, natural blood supply.”
How does it work? With prolotherapy (short for “proliferative therapy”), a proliferant, often dextrose (sugar), is injected into the injured area, causing a proliferation, or increase, of growth factors that activate the body’s cells to heal the injury. A more recent innovation, platelet-rich plasma (PRP) therapy, is considered by many to be a particularly powerful type of prolotherapy, and has seen growing success among many professional athletes as well as the general public. PRP directly harnesses the body’s own growth factors by concentrating the platelets, which are where the growth factors are stored and released to activate tissue healing. MRI and sonography studies have clinically demonstrated the regeneration of healthy tissue in areas treated with prolotherapy.
Says Dr. Wang of the resulting benefits, “The result of the injection process is that the injured tendons and ligaments heal more completely, which in turn strengthens the entire joint area, allowing people to return to their normal activities faster, with less pain and greater confidence than they would ever be able to do otherwise.”
Can you benefit from prolotherapy? If you have pain that you can localize and literally “put a finger on” (e.g. inner edge of the knee, base of the skull, etc.), then there is an excellent chance that prolotherapy can help you. Some common painful conditions involving the network of joints, muscles, ligaments, tendons, and other connective tissue that can improve with prolotherapy include:
Arthritis, affecting any joint, including the knees, hips, hands, feet, and the spine
Prolotherapy is not a cure-all, but it can offer a minimally-invasive, non-surgical way of relieving, and in some cases resolving, chronic pain conditions. When performed in combination with advanced imaging technology such as diagnostic musculoskeletal ultrasound (sonography), the treatment can be delivered with an unparalleled precision of about 0.2 mm, thereby maximizing safety and effectiveness.
The best way to find out if you are a good candidate for prolotherapy is to receive a comprehensive evaluation from a physician who is an expert in treating musculoskeletal pain of all types, and who also has extensive training in prolotherapy. A knowledgeable physician can rule out other possible causes of your pain through appropriate medical testing, and can provide you with an accurate diagnosis first before recommending the most effective treatment.
Does your doctor tell you to exercise and eat right? Most docs do, but this one walks her talk big time. Lisa Lilienfield, MD, is an accomplished athlete who has won numerous awards for power-lifting and previously held the Maryland State Women’s Master Level record for deadlift. She is also a certified spin-cycling and yoga instructor.
In addition to those personal accomplishments, she was chosen by Washingtonian magazine as one of the best physicians in the Washington, D.C. area. Her board certification is in family medicine but she is also a licensed acupuncturist and osteopath as well as a professor at Georgetown University School of Medicine’s Department of Community & Family Medicine.
Dr. Lilienfield practices at The Kaplan Center for Integrative Medicine in McLean, Va. The motto on their website defines the practice: “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” This quote, taken from the constitution of the World Health Organization, is Dr. Lilienfield’s focus also.
The Kaplan Center specializes in hard-to-diagnose problems. They deal with complex medical cases – unraveling symptoms and signs, but most of all, understanding the whole person. Holistic health is emphasized; including the role of nutrition, physical exercise, sleep, hormonal balance, and the mind-body connection.
“We look at the patient’s family history, medical history, medications taken, lifestyle, vitamin deficiencies, sleep problems, adrenal, and other endocrine problems. We do a thorough workup, then develop a plan. Sometimes a change in diet or sleep is all that is needed. The body wants to heal itself — you can help it to resolve problems,” Dr. Lilienfield said.
Many patients she sees have underlying nutritional deficiencies. A typical example of a patient might be one who comes in concerned about chronic back pain. They may be taking anti-inflammatory medications. But the real cause may just be a lack of magnesium. When that deficiency exists, that person may exhibit all kinds of muscle pain and problems. The anti-inflammatory medications can cause gastritis and bleeding, which results in the patient receiving yet another medication. The patient winds up with a complex set of symptoms from a simple underlying problem.
Another body system to be considered is digestion. Antibiotics can destroy the good, healthy bacteria that allow bad bacteria to overtake the intestines and result in acid reflux, diarrhea, or constipation. Food sensitivities, such as gluten intolerance, are often seen in combination with thyroid dysfunction. Food sensitivities can also create additional difficulties involving the intestines and bowel. You can develop irritable bowel syndrome and if you are not absorbing enough good stuff, immune system problems can result.
Quality of sleep can also affect the functioning of the body. Dr. Lilienfield points out that if a patient has sleep apnea, the body may not be able to recover from stress and that weakens the function of the adrenals. The patient becomes exhausted. If no stage-four sleep is obtained, then fibromyalgia can develop. With sleep apnea, if the person is not getting enough oxygen at night, the functioning of all the glands is affected. Sleep apnea may lead to even more serious conditions, like heart disease or stroke.
A difficult-to-diagnose case was that of a woman from the Richmond area. She exhibited signs of thyroid malfunction but registered as borderline on standard tests. She was taking medication for low thyroid function but was not responding. She was fatigued to the point that she had to stop working. She had been to multiple doctors, was losing her strength and vitality and knew something was wrong. Dr. Lilienfield took a closer look and found that adding the hormone triiodothyronine (T3) to her medications allowed her body to utilize the hormone thyroxine (T4) she was already taking. The woman regained her health and is back full time in her job. “I can’t tell you how many of my patients have responded to a mere change in the combination of thyroid medications,” Dr. Lilienfield said.
This holistic perspective epitomizes Dr. Lillenfield’s perspective of medicine. “My emphasis is to help my patients find a balance in life – in mind, body, and spirit,” she said.
Chronic Joint, Tendon or Ligament Pain? Have You Tried Prolotherapy?
/in Conditions/by Kaplan CenterWhen you ask your doctor what you can do about your arthritic knees, painful Achilles tendon or torn rotator cuff, you’re likely to be told about using ice or pain medication. Your physician might even discuss surgical options. But there is a very effective, non-surgical treatment that your medical provider may not mention -– prolotherapy. Why isn’t it discussed? Prolotherapy technique is difficult to learn and requires extensive specialized training; thus very few doctors are familiar with its benefits and even fewer are truly qualified to administer the procedure.
That having been said, if you are suffering from chronic joint pain or a muscle, ligament or tendon injury, you should at least consider prolotherapy. “Why?” you might ask.
“Because it’s a safe, efficient, and non-surgical way of healing the micro-tears in the fibrous tissue that connects joint capsules, tendons and ligaments to bone. This connective tissue supports the proper functioning of every joint and muscle in the human body”, explains Dr. David Wang. “When, through trauma or disease, these attachments are damaged, the joint can become weak and unstable, leading to increased pain and potentially further injury. Furthermore, the body’s ability to heal these injuries is not great because tendons, ligaments, and cartilage have a poor, natural blood supply.”
How does it work? With prolotherapy (short for “proliferative therapy”), a proliferant, often dextrose (sugar), is injected into the injured area, causing a proliferation, or increase, of growth factors that activate the body’s cells to heal the injury. A more recent innovation, platelet-rich plasma (PRP) therapy, is considered by many to be a particularly powerful type of prolotherapy, and has seen growing success among many professional athletes as well as the general public. PRP directly harnesses the body’s own growth factors by concentrating the platelets, which are where the growth factors are stored and released to activate tissue healing. MRI and sonography studies have clinically demonstrated the regeneration of healthy tissue in areas treated with prolotherapy.
Says Dr. Wang of the resulting benefits, “The result of the injection process is that the injured tendons and ligaments heal more completely, which in turn strengthens the entire joint area, allowing people to return to their normal activities faster, with less pain and greater confidence than they would ever be able to do otherwise.”
Can you benefit from prolotherapy? If you have pain that you can localize and literally “put a finger on” (e.g. inner edge of the knee, base of the skull, etc.), then there is an excellent chance that prolotherapy can help you. Some common painful conditions involving the network of joints, muscles, ligaments, tendons, and other connective tissue that can improve with prolotherapy include:
Prolotherapy is not a cure-all, but it can offer a minimally-invasive, non-surgical way of relieving, and in some cases resolving, chronic pain conditions. When performed in combination with advanced imaging technology such as diagnostic musculoskeletal ultrasound (sonography), the treatment can be delivered with an unparalleled precision of about 0.2 mm, thereby maximizing safety and effectiveness.
The best way to find out if you are a good candidate for prolotherapy is to receive a comprehensive evaluation from a physician who is an expert in treating musculoskeletal pain of all types, and who also has extensive training in prolotherapy. A knowledgeable physician can rule out other possible causes of your pain through appropriate medical testing, and can provide you with an accurate diagnosis first before recommending the most effective treatment.
– David Wang, D.O.
Dr. Lilienfield Noted for Excellence in Holistic Medicine
/in News/by Kaplan CenterDoes your doctor tell you to exercise and eat right? Most docs do, but this one walks her talk big time. Lisa Lilienfield, MD, is an accomplished athlete who has won numerous awards for power-lifting and previously held the Maryland State Women’s Master Level record for deadlift. She is also a certified spin-cycling and yoga instructor.
In addition to those personal accomplishments, she was chosen by Washingtonian magazine as one of the best physicians in the Washington, D.C. area. Her board certification is in family medicine but she is also a licensed acupuncturist and osteopath as well as a professor at Georgetown University School of Medicine’s Department of Community & Family Medicine.
Dr. Lilienfield practices at The Kaplan Center for Integrative Medicine in McLean, Va. The motto on their website defines the practice: “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” This quote, taken from the constitution of the World Health Organization, is Dr. Lilienfield’s focus also.
The Kaplan Center specializes in hard-to-diagnose problems. They deal with complex medical cases – unraveling symptoms and signs, but most of all, understanding the whole person. Holistic health is emphasized; including the role of nutrition, physical exercise, sleep, hormonal balance, and the mind-body connection.
“We look at the patient’s family history, medical history, medications taken, lifestyle, vitamin deficiencies, sleep problems, adrenal, and other endocrine problems. We do a thorough workup, then develop a plan. Sometimes a change in diet or sleep is all that is needed. The body wants to heal itself — you can help it to resolve problems,” Dr. Lilienfield said.
Many patients she sees have underlying nutritional deficiencies. A typical example of a patient might be one who comes in concerned about chronic back pain. They may be taking anti-inflammatory medications. But the real cause may just be a lack of magnesium. When that deficiency exists, that person may exhibit all kinds of muscle pain and problems. The anti-inflammatory medications can cause gastritis and bleeding, which results in the patient receiving yet another medication. The patient winds up with a complex set of symptoms from a simple underlying problem.
Another body system to be considered is digestion. Antibiotics can destroy the good, healthy bacteria that allow bad bacteria to overtake the intestines and result in acid reflux, diarrhea, or constipation. Food sensitivities, such as gluten intolerance, are often seen in combination with thyroid dysfunction. Food sensitivities can also create additional difficulties involving the intestines and bowel. You can develop irritable bowel syndrome and if you are not absorbing enough good stuff, immune system problems can result.
Quality of sleep can also affect the functioning of the body. Dr. Lilienfield points out that if a patient has sleep apnea, the body may not be able to recover from stress and that weakens the function of the adrenals. The patient becomes exhausted. If no stage-four sleep is obtained, then fibromyalgia can develop. With sleep apnea, if the person is not getting enough oxygen at night, the functioning of all the glands is affected. Sleep apnea may lead to even more serious conditions, like heart disease or stroke.
A difficult-to-diagnose case was that of a woman from the Richmond area. She exhibited signs of thyroid malfunction but registered as borderline on standard tests. She was taking medication for low thyroid function but was not responding. She was fatigued to the point that she had to stop working. She had been to multiple doctors, was losing her strength and vitality and knew something was wrong. Dr. Lilienfield took a closer look and found that adding the hormone triiodothyronine (T3) to her medications allowed her body to utilize the hormone thyroxine (T4) she was already taking. The woman regained her health and is back full time in her job. “I can’t tell you how many of my patients have responded to a mere change in the combination of thyroid medications,” Dr. Lilienfield said.
This holistic perspective epitomizes Dr. Lillenfield’s perspective of medicine. “My emphasis is to help my patients find a balance in life – in mind, body, and spirit,” she said.
FIFTYPLUS Magazine
JULY 2011
by DIANE YORK, MS, CRC