Traditional “Prolotherapists” use a technique developed by George Hackett, MD. The Hackett Hemwall Foundation (HHF) continues to teach this technique and trains doctors all over the world. It is a subspecialty that requires significant education, work, and practical hands on training in an apprentice setting to perform well.
Basically, many docs who claim to do “Prolo” or “PRP” may really just putting solution into the joint with one injection and that’s the end of it. Traditional Prolotherapists, inject nearly every ligament and tendon surrounding the joint in an attempt to stabilize it—because it is aberrant joint movement that causes joint degeneration, depending on the patient’s needs. This often goes beyond just one shot under ultrasound guidance.
Dr. Tyna Moore, owner of Core Wellness Clinic, is a traditionally trained Prolotherapist. Her training came mainly from her time spent with Dr. Rick Marinelli, ND who had performed several thousands of injection treatments over the course of nearly 30 years. She has also trained with the Hackett Hemwall Foundation, the American Association of Orthopedic Medicine and teaches seminars on injection therapy techniques.
Dr. Moore looks at the entire injured area and treats the entire joint, it’s supporting structures, and the inside of the joint as well. She also looks at the patient’s overall state of health and takes into consideration their unique conditions, ability to heal and possible concomitant issues that may be contributing to their pain. What she uses in her syringe changes, according to the injured areas needs.
We asked Dr. Moore what to specifically look for when choosing a doctor for regenerative injection therapy:
“I would ask what is the doctor’s experience with musculoskeletal medicine in general? Do they do use manual therapies in their practice? If they do body work and manual therapies, they are generally better at palpation and biomechanics.
Proper diagnosis is everything with these therapies. Any doctor can load up the joint, spine, or extremity with a solution, however, if the diagnosis has been misidentified, the patient’s money is being wasted.
Ask how long they have been practicing Prolotherapy and what was their training? Many doctors can attend a weekend seminar, inject a cadaver a few times and come back and start doing Prolotherapy. You really want to look for a practitioner who has hundreds, if not thousands, of procedures under their belt as well as extensive training in a variety of training settings. A doc who has trained in an apprentice setting with a skilled Prolotherapist is also an asset.
Do they rely solely on Ultrasound guided injections? While you may think this is the gold standard, I can tell you that Prolotherapists have successfully provided safe and effective injection therapy long before musculoskeletal ultrasound was invented. While I do utilize ultrasound guidance when needed and especially for deeper joints, prolotherapy, as a technique, relies far more on palpatory skills than imaging. Doctors cannot image a pain generator. They can image tears and terrible looking ligaments or tendons, but that doesn’t necessarily mean that is where the pain is coming from. If you can palpate pain generators, that means you can usually successfully treat them with injection therapy.”
We then asked Dr. Moore if she felt that her Chiropractic training has helped her gain mastery in her injection therapy skills.
“Absolutely it has. As a Chiropractor, I spent my entire education learning to palpate tissues and bodily structures and I can tell you with certainty that anyone who works regularly on the body has the advantage here. If I can palpate the pain, I can successfully locate and inject the pain generator. This leads to less treatments necessary and better outcomes for the patient.
Our education in Anatomy, Orthopedic testing, Biomechanics and Palpation is impressive. A Chiropractor’s training is very extensive and far more exhaustive in these areas than any other medical profession that I know of.
We start day one in the cadaver lab and have an extremely detailed Anatomy experience. We also have extensive training in biomechanics, which really lets us understand and appreciate the way a joint is supposed to move. This understanding helps us determine what is going wrong, or has gone wrong, and what is causing the pain. We can also detect referral patterns that may be causing a patients pain. We put this anatomy and biomechanics training to good use by spend many years learning, reviewing, and utilizing Orthopedic testing, as to be succinct as possible with musculoskeletal diagnoses.
Lastly, Palpation. Palpation is King with these therapies. A doctor cannot simply order an image of the pain generator the way patients would like to believe. However, a doctor who is has solid palpation skills can locate where it hurts and recreate the patient’s chief complaint pain. I believe this makes all the difference in the world in successful outcomes with these therapies.
Many of my colleagues who do Prolotherapy have spent time honing these skills as well. I humbly feel that I do have an advantage as a Chiropractor, as these skills were the core curriculum of my training.
Bottom line is, as a patient, you want to ultimately trust the hand that is holding that needle.”
Dr. Tyna Moore is an expert at diagnosing and treating pain, and restoring functions lost through injury, illness or disabling conditions. Dr. Moore’s goal is to treat the whole person—not just the symptoms. Dr. Moore strives to provide the best non-surgical treatment available.
If you are interested in becoming a patient or simply having a conversation about your pain, would like me to review your case or would like a referral to a practitioner in your area, this can be done via an Online Consultation.
Due to the high volume of requests, I am unable to answer individual requests for specific doctor referrals in your area. To find a doctor in your area who offers these therapies, please refer to my PRP 101 Insiders Cheat Sheet and Free Academy.
There is a tremendous amount of information on my website about these therapies, so please have a look around and see if you can’t find answers to your questions there. We have testimonials on every page and even a Research page with supporting studies. Enjoy!
© Dr. Tyna Moore and www.corewellnesspdx.com, 2014-2017. Unauthorized use and/or duplication of this material without express and written permission from this site’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Dr. Tyna Moore and www.corewellnesspdx.com with appropriate and specific direction to the original content.