Prolotherapy causes your body to heal. It is particularly helpful for tendons and ligaments. Alas, it is not as helpful as I had hoped for restoring major amounts of cartilage inside the joints. But it is a protocol that in many cases should tried before submitting to the surgeries that modern medicine is so proud of.
Originally published 2015
Muscle tissue tends to repair itself fairly well, because there are many capillaries and lots of blood flowing through the tissue. Joint cartilage and ligament tissue don’t have those capillaries, so they tend to heal slowly. In fact, after youth (when the body is flooded with growth hormone) after a small amount of healing occurs, the process tends to stop, leaving you short of a full recovery.
Enter Prolotherapy — a procedure that creates the conditions that causes your body to heal itself. (Prolotherapy comes from a branch of medicine known as “Osteopathy”–which despite the name, is not devoted solely to bones. The philosophy of Osteopathy is that body heals itself, and that the physician’s job is to help create the proper conditions for it do so — a philosophy that I heartily subscribe to.
The basic procedure injects a sugar or salt solution — an irritant that initiates healing. The next step up adds platelets derived from your own blood. (Platelet aggregation is the first step in the healing process.)
The step above that is considerably more aggressive. It distills stem cells from a teaspoon of your abdominal fat, and adds them to the irritant. It is a considerably more effective, but also a lot more costly, and somewhat riskier. So the general procedure is to do platelet-rich plasma protocol (PRP) until you hit a plateau, and then move on to the stem cell procedure.
The treatment does not involve any drugs, so there aren’t millions to made on it. As a result, there are no “studies” (many of which are borderline fraudulent, in any case) to prove its effectiveness. For that reason (and because the insurance companies and drug companies are generally in league), insurance does not cover the treatments.
However, the mechanism of action is quite well understood — and that is the one infallible guide I have found for choosing wisely. When you understand exactly what is happening, you know whether to expect real healing or a host of side-effects. If the mechanism of action can’t be explained, the proposed remedy is little more than snake oil — it might do some good, but don’t expect much.
In this case, as described in the references below, the irritant causes inflammation (swelling, fluid accumulation, heat). The inflammation attracts platelets. The platelets attract fibroblasts. Those attract the next thing, which attract… and so on , until the tissue is fully formed. (See the resources for more details.) At each stage, particular growth factors are released which initiate the next stage in the process.
Even so, when I found that an acquaintance had done the procedure for her neck, I asked what she thought of it. Her reply: “It was a life changer”. Pretty convincing! So I decided to try it.
The basic PRP treatments run about $1000 each. Generally, 3 or 4 of them are sufficient. (But not always. I’ve had six.) It takes 6 weeks to fully recover, so they should be scheduled 8 months apart. That gives you 2 weeks to assess where you are before you go in again.
The first couple of procedures caused a lot of soreness. But after that, it only took a week or two for the legs to feel like they were back to normal. The nurse said it was something like rubbing salt on your skin — if there’s nothing to heal, it doesn’t hurt at all. But if there is a large, open wound, it hurts like hell. So the soreness from the initial procedures is a pretty good indicatation that a lot of healing was going on.
The stem cell procedure runs $3500 or so. Obviously, the total bill is pretty darn high. (Going on $10,000 at the moment.) But the alternative after having screwed up my knees was to continue living a less-than-truly-active life, slowly accumulating weight in the process. Fortunately, I had been part of a start up that got acquired. I didn’t make enough to retire, but I got enough to afford the procedures, and have something left over. So financially, I was able to do it.
Full recovery after the stem cell procedure takes 3 months, with intermittent stiffness throughout that period (generally). But you’re mobile after a day or so, so you can get to the store when you need to. After a week, you can begin to gradually resume normal activities. (Any activity that doesn’t cause pain can be engaged in, up until the point that it does.)
After that, it took maybe twice as long before the legs began to feel “normal” (4-5 weeks, in fact). But I began to engage in a much more regular schedule of activities about that time — including some “run/walks” once a week (emphasis on the walking part). After only a couple of weeks, I began to feel like I was making real progress. The spring in my legs had improved enough in just a week that began to feel that “Yes! — maybe, just maybe, I’ll be able be able to resume the kind of running I once used to do”.
The people I go to are at the Hemwall Medical Center, who have offices in Los Angeles and Alamdeda. So far, the results haven’t exactly been “miraculous” (which I would define as 100% healing after one treatment), but the improvements have nevertheless been dramatic.
These days, I do a lot of activities without even thinking about my knees. Shopping for one. I used to grab a shopping cart in the parking lot, to lean on as I walked to and through the grocery store. Now, I still grab one and take it in, just to be nice. But it doesn’t even occur to me lean on it. Cycling, I find that I am pedaling with both legs — not just the one with the better knee. So I cycle longer and stronger, with less effort. Playing golf, usually back, arms, and legs are sore. But the last time I played, only back and arms were sore. Legs were fine! I realized that I had been playing and standing in a semi-squat, heretofore, in order to keep pressure off the knees. But now that I wasn’t unconsciously doing that, the legs felt great!
Meanwhile, the big bulge behind my knee (accumulated fluid) has reduced considerably. It was so large, it prevented me from bending my leg enough to sit in a cross-legged position. So now it’s time to get back to Yoga. (I was working to get into Lotus position — a position that lets you nod off without falling over, so the slight movement of your head keeps you in the semi-awake/semi-sleeping state that is so conducive to meditation. The inability to bend my knee made that impossible! I still have flexibility to improve, but now that the major obstacle is gone, it’s possible!
- Free Yourself from Chronic Pain, by Dr. Donna Alderman
- Prolo Your Sports Injuries Away! by Ross and Marion Hauser
- Hemwall Medical Center
The papers on this site were the source for my understanding of the mechanism of action described in PRP Proplotherapy vs. Arthroscopy
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