If you have suffered from chronic joint pain or a sports injury to a ligament or tendon, PRP (Platelet Rich Plasma) and Prolotherapy, regenerative injection therapies that promote repair and self-healing naturally, may be a treatment option for you. There are different levels of joint dysfunction. There are also different levels of treatment. The right injection therapy can help you increase function, decrease pain and healing time, and get you back to living your best life faster. Injection therapies also help some people avoid orthopedic surgery! Regenerative injections can also be used to rejuvenate aging skin and regrow hair.
PRP – Platelet Rich Plasma
Platelet-rich plasma is an injection procedure that uses concentrates from your own blood, the platelet-rich portion of your plasma, to help your body heal and regenerate naturally. Platelets are very small cells in your blood that are involved in the clotting and healing process. When injected into the damaged area, PRP causes a mild inflammation that triggers a healing cascade. As the platelets organize in the treatment area, they release a number of enzymes to promote healing and tissue responses, including attracting stem cells and releasing growth factors to repair damaged tissue. As a result, new collagen and elastic fibers begin to develop. As the collagen matures, it begins to shrink, causing a tightening and strengthening of the tissue in the damaged area.
Prolotherapy
Prolotherapy is a safe and simple regenerative medicine injection treatment used to strengthen weak and damaged ligaments and tendons due to chronic injury or overuse. Many patients with stretched, torn, or injured ligament and joint attachments have difficulty returning to pre-injury level of functioning due to limited blood supply to these structures. Chronic anti-inflammatory/ NSAID use or overuse of steroid injections further impairs this process. Surgery can often produce scarring and a limited range of motion without addressing the root cause of dysfunction. The technique requires injection of Dextrose or Ascorbic Acid (Vitamin C), and methylcobalamin (Vitamin B12) precisely into the site of pain or injury, where the ligament or tendon attaches to the bone, joint capsule, trigger point, or inside joint.
Prolotherapy creates a mild, controlled inflammation that stimulates the body to lay down collagen with the formation of new tendon, ligament, and cartilage, resulting in a strengthening of the weakened structure. This injection process stimulates the body’s natural wound repair process. A typical treatment course is 3-6 series of injections, given every 3-4 weeks. Prolotherapy has been used for over 60 years with numerous case reports and an increasing number of controlled studies showing its effectiveness.
Physical Conditions that Can Benefit from Injection Therapies:
The best way to find out if you are a good candidate for either PRP or prolotherapy is to receive a comprehensive evaluation to rule out other possible causes of your pain (through appropriate medical testing) and to provide you with an accurate diagnosis first before recommending the most effective treatment.
If you have any of the conditions mentioned above and are looking for a non-surgical treatment option to treat your condition, please give us a call today to schedule your appointment.
We are here for you, and we want to help.
Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2
References:
Bae G, Kim S, Lee S, Lee WY, Lim Y. Prolotherapy for the patients with chronic musculoskeletal pain: systematic review and meta-analysis . Anesth Pain Med (Seoul). 2021 Jan;16(1):81-95. doi: 10.17085/apm.20078. Epub 2020 Dec 16. PMID: 33348947; PMCID: PMC7861898.
Everts P, Onishi K, Jayaram P, Lana JF, Mautner K. Platelet-Rich Plasma: New Performance Understandings and Therapeutic Considerations in 2020. Int J Mol Sci. 2020 Oct 21;21(20):7794. doi: 10.3390/ijms21207794. PMID: 33096812; PMCID: PMC7589810.
Characterized by widespread pain, fatigue, and cognitive difficulties, fibromyalgia (FM) is a complex disorder of the central nervous system (CNS). It affects the brain’s messaging system causing those who have it to experience heightened sensitivity to pain. A fibromyalgia flare-up can last for months at a time and cause debilitating physical and emotional distress. Symptoms can vary from person to person and often suggest other conditions, making it a very difficult diagnosis. Despite all that has been learned about fibromyalgia over the last two decades, people with FM can go years without a proper diagnosis.
Fibromyalgia is associated with many other conditions like Chronic Fatigue Syndrome (also known as Myalgic Encephalomyelitis), sleep dysfunction, infections like Lyme disease or E-BV (Epstein-Barr Virus), digestive problems such as SIBO (Small Intestinal Bacterial Overgrowth), or Celiac Disease and other food allergies that can cause leaky gut. It can lead to autoimmune disorders like Hashimoto’s thyroiditis or autoimmune arthropathies. People suffering from FM may also exhibit reactions to environmental toxin exposure, like mold or heavy metals, which can be diagnosed through specialty labs looking at stool, urine, breath, and bloodwork.
A functional approach to treatment
Once you receive a fibromyalgia diagnosis, there are various treatment options and lifestyle habits to consider. As a functional medicine practitioner, my approach to treating fibromyalgia is multifaceted; I look at digestion and diet, sleep, hormone imbalances, injuries (psychological and physical), infections, environmental exposures, genetics, and more.
For example, I often find that fibromyalgia is related to a deficiency in delta-wave deep sleep; medications like Xywav, which promotes deep-wave sleep have been helpful in reducing chronic pain. If you don’t get enough deep delta wave sleep your body can’t recover, and chronic pain can be an issue. (We find that this is common in those with fibromyalgia.)
A common area of pain is the cervical spine. Treatments like physical therapy, acupuncture, or injection therapies like prolotherapy, perineural injection therapy (PIT), or PRP (platelet-rich plasma) therapy may be helpful. You may also consider having your jaw evaluated for TMJ by a dentist specializing in temporomandibular joint problems, which can often cause referred pain in the head, neck, and shoulders.
If you have leaky gut from a food allergy, then inflammation of the intestinal tract leads to nutritional deficiencies and toxicity; I’ll want to look at dietary changes and supplementation. Supplements that may be helpful include D- ribose, fish oil, glutathione, and IV magnesium with B complex and Vitamin C (also known as Myers cocktail).
Emotional impacts of fibromyalgia
Because FM affects the CNS, it can influence your experience of pain and emotional sensations; therefore it’s very important to consider my patients’ emotional health which is often not addressed in chronic pain. There are many stress-reduction therapies that can be done from the comfort of your own home including yoga, mindfulness-based meditation, breathing exercises, and even a therapy called Emotional Freedom Technique which involves tapping acupressure points and utilizing positive affirmations. However, if you feel overwhelmed by symptoms, look for a psychotherapist who specializes in working with people with chronic pain. Dealing with chronic pain is emotionally exhausting; seeking help can be a vital lifeline for many.
As with other chronic illnesses, treating fibromyalgia is not a straightforward process; it requires a multifaceted treatment approach with close collaboration to help you recover or better manage your illness.
We are here for you, and we want to help.
Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2
According to the U.S. Department of Veteran’s Affairs, it is estimated that approximately 6% of the population will experience Post-Traumatic Stress Disorder (PTSD) at some point in their lives. By some estimates, that percentage more than doubles for people who have been exposed to a traumatic event.
To be diagnosed with PTSD one must meet a specific set of criteria which includes:
exposure to a traumatic stressor;
a re-experiencing of symptoms (physical and/or emotional);
avoidance behavior and emotional numbness;
hyperarousal;
symptom duration of at least one month; and
significant distress or impairment of functioning.
How does one move beyond this emotional pain, or provide support to the most vulnerable population, our children? The following 3 therapies have shown to be effective in treating PTSD in clinical settings for both adults and children.
PTSD is a family illness. Family members often experience feelings of guilt, sadness, and isolation when a loved one is suffering. A safe setting where emotions, fears, and concerns can be communicated under the guidance of a therapist can help strengthen relationships and promote group healing during difficult times.
Mindfulness-Based Stress Reduction (MBSR)
MBSR is a program that uses meditation, breathing techniques, and movement, such as yoga, to bring awareness to the present moment, without judgment. There is a growing body of medical research that shows that a mindfulness-based meditation practice can help people bounce back after highly stressful situations.
A 2015 study reported that veterans suffering from PTSD who participated in a mindfulness-based stress reduction program for a period of 8 weeks, reported a decrease in symptom severity.
A 2018 review confirmed that mindfulness-bases therapies are “effective in reducing PTSD symptomatology” and indicated that additional studies should be done to investigate its role as a first line treatment.
Children can also benefit from the practice. This 2017 review of research concluded that “high-quality, structured mindfulness interventions improve mental, behavioral, and physical outcomes in youth.”
Eye Movement Desensitization and Reprocessing (EMDR) therapy
EMDR is an integrative psychotherapy that has proven highly effective for the treatment of trauma. Traumatic memories are memories that tend to be “frozen in time” and each time they are triggered a person may re-experience the same disturbing sights, sounds, smells, feelings, and sensations suffered during the original event. Traumatic memories have a long-lasting impact because they change core beliefs that we hold about ourselves and the world around us.
EMDR helps the brain adaptively process traumatic information by replicating what naturally happens during dreaming or REM (rapid eye movement) sleep. During EMDR therapy, a person is asked to bring a difficult thought or memory to mind, holding it in awareness, while also following the therapist’s hand movements across the field of vision, mimicking the biological process of REM sleep. Over time, though an event may remain as a bad memory, it eventually ceases to be a physiological stressor, because the person has learned to experience disturbing events or memories in a new and less distressing way.
Left unresolved, PTSD can be devastating, but with appropriate support, there are ways to move beyond the pain. If you or a loved one may be affected, please seek help – no one needs to suffer alone.
Platelet Rich Plasma (PRP) and Prolotherapy – Non-surgical Treatments for Musculoskeletal Pain
/in Treatments/by Kaplan CenterIf you have suffered from chronic joint pain or a sports injury to a ligament or tendon, PRP (Platelet Rich Plasma) and Prolotherapy, regenerative injection therapies that promote repair and self-healing naturally, may be a treatment option for you. There are different levels of joint dysfunction. There are also different levels of treatment. The right injection therapy can help you increase function, decrease pain and healing time, and get you back to living your best life faster. Injection therapies also help some people avoid orthopedic surgery! Regenerative injections can also be used to rejuvenate aging skin and regrow hair.
PRP – Platelet Rich Plasma
Platelet-rich plasma is an injection procedure that uses concentrates from your own blood, the platelet-rich portion of your plasma, to help your body heal and regenerate naturally. Platelets are very small cells in your blood that are involved in the clotting and healing process. When injected into the damaged area, PRP causes a mild inflammation that triggers a healing cascade. As the platelets organize in the treatment area, they release a number of enzymes to promote healing and tissue responses, including attracting stem cells and releasing growth factors to repair damaged tissue. As a result, new collagen and elastic fibers begin to develop. As the collagen matures, it begins to shrink, causing a tightening and strengthening of the tissue in the damaged area.
Prolotherapy
Prolotherapy is a safe and simple regenerative medicine injection treatment used to strengthen weak and damaged ligaments and tendons due to chronic injury or overuse. Many patients with stretched, torn, or injured ligament and joint attachments have difficulty returning to pre-injury level of functioning due to limited blood supply to these structures. Chronic anti-inflammatory/ NSAID use or overuse of steroid injections further impairs this process. Surgery can often produce scarring and a limited range of motion without addressing the root cause of dysfunction. The technique requires injection of Dextrose or Ascorbic Acid (Vitamin C), and methylcobalamin (Vitamin B12) precisely into the site of pain or injury, where the ligament or tendon attaches to the bone, joint capsule, trigger point, or inside joint.
Prolotherapy creates a mild, controlled inflammation that stimulates the body to lay down collagen with the formation of new tendon, ligament, and cartilage, resulting in a strengthening of the weakened structure. This injection process stimulates the body’s natural wound repair process. A typical treatment course is 3-6 series of injections, given every 3-4 weeks. Prolotherapy has been used for over 60 years with numerous case reports and an increasing number of controlled studies showing its effectiveness.
Physical Conditions that Can Benefit from Injection Therapies:
The best way to find out if you are a good candidate for either PRP or prolotherapy is to receive a comprehensive evaluation to rule out other possible causes of your pain (through appropriate medical testing) and to provide you with an accurate diagnosis first before recommending the most effective treatment.
If you have any of the conditions mentioned above and are looking for a non-surgical treatment option to treat your condition, please give us a call today to schedule your appointment.
We are here for you, and we want to help.
Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2
References:
Bae G, Kim S, Lee S, Lee WY, Lim Y. Prolotherapy for the patients with chronic musculoskeletal pain: systematic review and meta-analysis . Anesth Pain Med (Seoul). 2021 Jan;16(1):81-95. doi: 10.17085/apm.20078. Epub 2020 Dec 16. PMID: 33348947; PMCID: PMC7861898.
Everts P, Onishi K, Jayaram P, Lana JF, Mautner K. Platelet-Rich Plasma: New Performance Understandings and Therapeutic Considerations in 2020. Int J Mol Sci. 2020 Oct 21;21(20):7794. doi: 10.3390/ijms21207794. PMID: 33096812; PMCID: PMC7589810.
Managing Fibromyalgia Pain
/in Conditions/by Lisa Lilienfield, MDCharacterized by widespread pain, fatigue, and cognitive difficulties, fibromyalgia (FM) is a complex disorder of the central nervous system (CNS). It affects the brain’s messaging system causing those who have it to experience heightened sensitivity to pain. A fibromyalgia flare-up can last for months at a time and cause debilitating physical and emotional distress. Symptoms can vary from person to person and often suggest other conditions, making it a very difficult diagnosis. Despite all that has been learned about fibromyalgia over the last two decades, people with FM can go years without a proper diagnosis.
Fibromyalgia is associated with many other conditions like Chronic Fatigue Syndrome (also known as Myalgic Encephalomyelitis), sleep dysfunction, infections like Lyme disease or E-BV (Epstein-Barr Virus), digestive problems such as SIBO (Small Intestinal Bacterial Overgrowth), or Celiac Disease and other food allergies that can cause leaky gut. It can lead to autoimmune disorders like Hashimoto’s thyroiditis or autoimmune arthropathies. People suffering from FM may also exhibit reactions to environmental toxin exposure, like mold or heavy metals, which can be diagnosed through specialty labs looking at stool, urine, breath, and bloodwork.
A functional approach to treatment
Once you receive a fibromyalgia diagnosis, there are various treatment options and lifestyle habits to consider. As a functional medicine practitioner, my approach to treating fibromyalgia is multifaceted; I look at digestion and diet, sleep, hormone imbalances, injuries (psychological and physical), infections, environmental exposures, genetics, and more.
For example, I often find that fibromyalgia is related to a deficiency in delta-wave deep sleep; medications like Xywav, which promotes deep-wave sleep have been helpful in reducing chronic pain. If you don’t get enough deep delta wave sleep your body can’t recover, and chronic pain can be an issue. (We find that this is common in those with fibromyalgia.)
A common area of pain is the cervical spine. Treatments like physical therapy, acupuncture, or injection therapies like prolotherapy, perineural injection therapy (PIT), or PRP (platelet-rich plasma) therapy may be helpful. You may also consider having your jaw evaluated for TMJ by a dentist specializing in temporomandibular joint problems, which can often cause referred pain in the head, neck, and shoulders.
Another treatment to consider is Low-Dose Naltrexone (LDN). When chronic pain is a result of neuro-inflammation (brain inflammation), LDN can help by reducing the upregulation of the microglia that cause this inflammation.
If you have leaky gut from a food allergy, then inflammation of the intestinal tract leads to nutritional deficiencies and toxicity; I’ll want to look at dietary changes and supplementation. Supplements that may be helpful include D- ribose, fish oil, glutathione, and IV magnesium with B complex and Vitamin C (also known as Myers cocktail).
Emotional impacts of fibromyalgia
Because FM affects the CNS, it can influence your experience of pain and emotional sensations; therefore it’s very important to consider my patients’ emotional health which is often not addressed in chronic pain. There are many stress-reduction therapies that can be done from the comfort of your own home including yoga, mindfulness-based meditation, breathing exercises, and even a therapy called Emotional Freedom Technique which involves tapping acupressure points and utilizing positive affirmations. However, if you feel overwhelmed by symptoms, look for a psychotherapist who specializes in working with people with chronic pain. Dealing with chronic pain is emotionally exhausting; seeking help can be a vital lifeline for many.
As with other chronic illnesses, treating fibromyalgia is not a straightforward process; it requires a multifaceted treatment approach with close collaboration to help you recover or better manage your illness.
We are here for you, and we want to help.
Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2
Additional Resources:
Consumer Guide: 18 Things You Should Know Before Choosing a Doctor to Treat Your Fibromyalgia
Moving Beyond Trauma: Healing Therapies for PTSD
/in Mental Health, Treatments/by Kaplan CenterAccording to the U.S. Department of Veteran’s Affairs, it is estimated that approximately 6% of the population will experience Post-Traumatic Stress Disorder (PTSD) at some point in their lives. By some estimates, that percentage more than doubles for people who have been exposed to a traumatic event.
To be diagnosed with PTSD one must meet a specific set of criteria which includes:
How does one move beyond this emotional pain, or provide support to the most vulnerable population, our children? The following 3 therapies have shown to be effective in treating PTSD in clinical settings for both adults and children.
Family or Couples Therapy
PTSD is a family illness. Family members often experience feelings of guilt, sadness, and isolation when a loved one is suffering. A safe setting where emotions, fears, and concerns can be communicated under the guidance of a therapist can help strengthen relationships and promote group healing during difficult times.
Mindfulness-Based Stress Reduction (MBSR)
MBSR is a program that uses meditation, breathing techniques, and movement, such as yoga, to bring awareness to the present moment, without judgment. There is a growing body of medical research that shows that a mindfulness-based meditation practice can help people bounce back after highly stressful situations.
Eye Movement Desensitization and Reprocessing (EMDR) therapy
EMDR is an integrative psychotherapy that has proven highly effective for the treatment of trauma. Traumatic memories are memories that tend to be “frozen in time” and each time they are triggered a person may re-experience the same disturbing sights, sounds, smells, feelings, and sensations suffered during the original event. Traumatic memories have a long-lasting impact because they change core beliefs that we hold about ourselves and the world around us.
EMDR helps the brain adaptively process traumatic information by replicating what naturally happens during dreaming or REM (rapid eye movement) sleep. During EMDR therapy, a person is asked to bring a difficult thought or memory to mind, holding it in awareness, while also following the therapist’s hand movements across the field of vision, mimicking the biological process of REM sleep. Over time, though an event may remain as a bad memory, it eventually ceases to be a physiological stressor, because the person has learned to experience disturbing events or memories in a new and less distressing way.
Left unresolved, PTSD can be devastating, but with appropriate support, there are ways to move beyond the pain. If you or a loved one may be affected, please seek help – no one needs to suffer alone.
Additional Resources:
National Suicide Prevention Lifeline –24-hour hotline for anyone in emotional distress: 1-800-273-TALK (8255).
National Alliance on Mental Illness (NAMI) – Helpline: 1-800-950-NAMI (6264)
TRE® – Tension and Trauma Releasing Exercise methods by Dr. David Berceli
Veterans Crisis Line – For veterans and their families and friends: 1-800-273-8255
We are here for you, and we want to help.
Our goal is to return you to optimal health as soon as possible. To schedule an appointment please call: 703-532-4892 x2
This article was published in May 2017. It was reviewed and updated in June 2023.