We sat down with Dr. Tyna Moore, a talented Prolotherapist, (please see our blog “Choosing the Right Doctor” for more information), with over 15 years experience, to gain some insight into Prolotherapy and find out what you can expect from these treatments.
How long have you administered Prolotherapy?
I was trained and mentored by Rick Marinelli, ND who had been doing Prolotherapy for about 30 years. I began in his clinic as his receptionist right out of college and learned from him for over 15 years. I assisted him with many procedures during that time. I graduated from Naturopathic college in 2008 and have been treating my own patients with injection therapies ever since.
Why did you choose to do Prolotherapy?
As Dr. Marinelli’s receptionist, I watched patients come into the clinic in wheelchairs or walking with terrible limps. Then I would see them walk out of the clinic unassisted and smiling. I couldn’t believe the changes I was seeing and how much pain was being relieved from Dr. Marinelli’s treatments. Also, I personally experienced relief from Prolotherapy in helping me recover from a very painful back injury due to a serious automobile collision. Prolotherapy and regenerative injection therapy was my go-to treatment whenever I injured myself or had pain in a joint or my spine. The results were always extraordinary so I decided to devote my schooling and career to the practice. It is a safe and effective alternative to surgery that can help virtually any patient, any age, with nearly any painful condition that is musculoskeletal in nature.
What is Prolotherapy?
Prolotherapy is a type of Regenerative Injection Therapy. It is a specialized technique aimed at tightening up and stabilizing ligaments and tendons that have become compromised or overstretched. Traditional Prolotherapy, as I apply it, involves injections of a hyperosmotic solution, which causes a local inflammatory reaction to these compromised ligaments/tendons where they insert onto bone. Ligaments and tendons notoriously have a poor blood supply and heal slowly. By giving the body a second inflammatory response, it stimulated the patient’s own immune system, giving the area another chance at healing. We also inject into the joint capsule, as the solution is known to regenerate cartilage and heal degenerative joint disease.
Is Prolotherapy new?
No, it has been around since the 1930’s. Actually, Hippocrates used to treat painful shoulders by burning them with a red-hot poker, so the idea of stabilizing a joint has been around for a long time. The technique of Prolotherapy was really brought to attention and developed by George S. Hackett, M.D. in the 1950’s. He was really the one to point to ligamentous laxity as a major pain generator. The idea that ligaments could cause pain was more popular back in the days before MRI and soft tissue imaging was invented. Now that we have these imaging techniques everyone wants to blame the spinals discs or nerve roots for pain, however, I find in practice, that most pain comes from the ligaments of the low back. Dr. Hackett knew this and conducted several studies to prove it, successfully treating thousands of patients with Prolotherapy.
What is the solution that is injected into the body?
That depends on what treatment we are doing. Traditional Prolotherapy is a hyperosmotic dextrose solution. Dextrose does more than call-up the immune system; it’s actually been shown to effectively treat neurogenic pain.
If we are doing Platelet Rich Plasma Prolotherapy, then the technique remains the same, it’s simply a different solution in the syringe. Platelet Rich Plasma (PRP) utilizes the patient’s own blood to harvest growth factors and stem cells which are then injected into the damaged and injured tissues and joints.
We can also harvest Adipose Stem Cells from the patient in a simple, in-office procedure and mix those stem cells with the growth factors from the PRP and use that as scaffolding and the healing treatment for the most severely degenerated joints.
What are the areas of the body that can be treated?
Virtually anywhere in the musculoskeletal system can be treated. Most often, I treat spinal pain, knee and hip pain from trauma or arthritis, shoulders, elbows, wrists, ankles, feet, toes, arthritis hands, pelvic pain, TMJ, etc. I can use PRP for wound healing, muscle tears and defects. It can be used on the hairline to regenerate hair growth, on the face to regenerate collagen (same mechanism as joints), even the vaginal region to treat atrophy, incontinence, inability to orgasm and painful conditions like lichen sclerosus. As for the stem cells, they will change into whatever tissue we inject them into. Any region that needs regeneration, we can use these treatments to literally regenerate tissue without surgery.
Is Prolotherapy painful?
Most of my patients say the same thing, which is “That was not nearly as big of a deal as I thought it was going to be.” Injection therapy is an art and a talent and so much of it comes down to who is holding that syringe. Patients tell me all the time that I am a “nice injector.” I even have patients who have had other doctors perform Prolotherapy on them, and they tell me that my treatments hurt much less. As I am a Chiropractor, I have extensive training in palpation and know how much tension I can put onto a tissue region, so the needle becomes an extension of my palpation hand. I think that having a woman’s touch doesn’t hurt either!
Do you use painkillers or sedatives to ease the injection pain?
Generally, they are not necessary. However, if a patient is in terrible pain and has a lot of anxiety about the procedure, we may offer something to calm them. Following the treatment, most patients are fine with an over the counter analgesic and a hot compress. When indicated and for more painful procedures, we do offer small amounts of painkillers, although most patients report only needing to use them for about 24-48 hours post-procedure. Patients can return to work the day of or next day following dextrose Prolotherapy. We usually suggest that patients lay low for a day following PRP and/or stem cell therapy.
Can Prolotherapy help anyone?
Generally, I would say yes. However, we are relying on the body’s own ability to heal so people who are diabetic, have hormonal deficiencies and/or nutritional deficiencies tend to not respond as well. Smokers do not respond as well. Patients with fibromyalgia or chronic fatigue issues may not respond as well. People who eat very inflammatory diets and who don’t exercise do not do as well, although generally, they still receive some level of relief. I am constantly amazed at how well patients respond in general.
It’s not just athletes that we treat. We see a lot of patients who rely on their bodies to function for their work: electricians, plumbers, construction workers, pipe layers, chiropractors, massage therapists, doctors, physical therapists, as well as body builders, fitness enthusiasts and anyone who enjoys an active lifestyle. People who are active tend to like to remain in motion!
Is Prolotherapy a good alternative to surgery?
Absolutely! When you consider the cost-benefit ratio, I would recommend Regenerative Injection Therapy any day over surgery. Surgery is permanent: there is risk of infection, the possibility of severe complications, the risk of ill health directly following the surgery and large co-pays and deductibles associated with surgery. Not to mention the long down time and missed work following surgery, which results in lost wages. I’ve also seen a few patients get severe pneumonia following joint replacement surgeries, as it’s a major stress to the body.
Injection therapy, on the other hand, is generally far less expensive than most patient’s deductibles, is low risk, completely natural and patients can return to work the same or next day. No time lost from work, no lost wages, and no recovery time from surgery.
How often do you recommend treatments?
Prolotherapy is generally done about every four weeks, for three-six rounds of treatment. I find that I need far fewer treatments with Platelet Rich Plasma, as one treatment works as well as roughly three Prolotherapy treatments. Stem cell treatments vary, but they are the most potent so we also need far less.
What is the success rate of Prolotherapy?
That depends completely on the patient, their cellular milieu (how healthy they are overall), the nature of the joint issue (new, old, or severely degenerated, etc) and which treatment we choose to use with the patient. I don’t often have a patient who does not respond, and overall, most do improve to some degree. Many get spectacular results.
Does insurance pay for Prolotherapy?
Unfortunately they do not. Prolotherapy is considered investigational by Medicare so is therefore not covered by private insurance companies. For more on costs please call us and ask to speak to our Patient Care Coordinator.
Dr. Tyna Moore is an expert at diagnosing, 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.