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Understandably, patients who receive Regenerative Injection Therapy - whether that is Prolotherapy or Platelet Therapy - want to know how long to expect their benefits to last. And as much as I would like to forecast each unique scenario with exact precision, I am left with two realms of information to draw from in order to answer that question - observations of myself and colleagues' RIT work, and research. So today I am discussing Prolotherapy research published in 2012 (document below). I am wanting in particular to look at Prolotherapy because, as I explain to any patients considering either RIT therapy, while both stimulate the body to regenerate the damaged tissue, Prolotherapy is a more gentle force (Platelet Therapy is roughly three times stronger in its effect per treatment). After injections to the knees for osteoarthritis symptoms such as pain and stiffness (this condition is also known as Degenerative Joint Disease), participants noted improvement around the 4 week mark. I usually counsel patients that we will assess an initial effect in the 3 to 4 week time-frame. The surprising conclusion is that participants continued to see improvement "through the 52-week followup." That means continued regenerative healing seen one year later. That is impressive. Can you think of any other treatment recommendation for a chronic musculoskeletal disease, where positive effects continue and accumulate and are seen at least one year afterward?! The conclusion from that study was that, "prolotherapy may result in safe, significant, sustained improvement of knee pain, function and stiffness." This is why I do RIT my friend, because it is safe, it is profound and it truly stimulates healing to deeply, chronically injured areas where surgery is often the only conventional recommendation (and you can see my prior post about how that may be a completely ineffective option). Where would you like to be in a year? How would you like to feel right about this time in 2017? Do yourself the favor to at least see whether RIT techniques might be the right fit for you. If you are in or travel to the Portland area, you can give our office a call to set up a consultation or new patient appointment. I look forward to helping you (and your joints!) reach their maximum potential! To your best health, Dr. Angela Cortal 
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Or, "Try other therapies first before going under the knife for knee pain!" Maybe you have osteoarthritis (OA) of the knees or other joints (hips, spine, etc). And I'll bet that if you don't you know more than one family member or friend who does. Also called Degenerative Joint Disease, it is very common, especially with those who are middle-aged or older. There are more than 3 million new cases diagnosed each year, in the US alone! After years (decades even) of chronic low-grade inflammation, wear and tear, perhaps poor work or activity ergonomics, nutritional deficiencies and many other factors, joints try their best to repair and respond to these insults by replacing cartilage with bone. Cartilage is a smooth connective tissue, with glass-like surfaces gliding together to give our knees their hinged movement. Bone is tougher, more solid and also has a more bumpy, irregular surface, so is not the best gliding surface. This is the essence of the development of OA. So what can be done? Well, being a Naturopathic Doctor, of course I want to treat the source and influencing factors (by correcting all those I mentioned above as much as we are able). But then what can we do for the aches and pains that often come on with moderate to severe OA? Conventional medicine will often offer physical therapy (which can be beneficial to be sure), and anti-inflammatory medications (such as Tylenol or Ibuprofen) or pain medication to be taken daily as needed. Then after years of that, a joint replacement will often be recommended. Not only do those anti-inflammatories themselves accelerate the cartilage degeneration problem (see previous blog post and research link here), they do nothing to solve the situation. And joint replacement surgeries are harsh, hard on the body, involve long recovery periods and are nothing to take lightly. As an intermediate step, arthroscopy is often recommended. This is a minimally-invasive surgical procedure where visualization scopes are used for the surgeon to remove small bony growths seen within the joint capsule. And does this work? Does this correct the OA? In short, no. It has proven to be less effective than "sham surgery" (incisions in the skin alone with no further surgery) and less effective than physical therapy. This is huge news. The most common procedure done for knee OA has basically been proven to be worthless. And this is no news flash, this research was published in 2008 in the New England Journal of Medicine. I included both the full document and a pdf link below as I think this is important information that needs to be disseminated and wanted you to be able to access it. So if arthroscopy is shown to be basically ineffective, what can be done? (after you get your movement, nutrition, etc in order or at it's a work in progress) That is exactly where Regenerative Injection Therapies can step in and truly help with restoration and healing of chronically degenerated knees (among other joints). By stimulating the body to re-initiate its healing process, and by bringing stem cells and other healing factors to the exact location they are needed, real regeneration is possible. I see it all the time, and am so grateful to be able to offer these techniques to my patients. For research information, see the above RIT link (which has its own specific research links) and also this national organization's website has many more research citations. Suffice to say, if "conservative care" hasn't worked well enough for you (PT, other movement therapies, NSAIDs, pain medication) and you are faced with surgical recommendations, do yourself the favor to at least see whether RIT techniques might be the right fit for you. If you are in or travel to the Portland area, you can give our office a call to set up a consultation or new patient appointment. I look forward to helping you (and your joints!) reach their maximum potential! To your best health, Dr. Angela Cortal
Sure it's safer than Oxycontin, but it has its own unwanted side effects Millions of Americans take handfuls of over the counter anti-inflammatories on a daily basis. I would guess that most don't once consider that there is anything unsafe or unwanted in effect from that Ibuprofen (or aspirin, Aleve, Tylenol, etc).
After all, it's over the counter, so it's gotta be safe, right? No! Not always. Particularly in my field of Regenerative Injection Therapies, I talk a lot about someone's use (dependency maybe) on these medications, called NSAIDs as a group. Not only do most of them interfere with the actual injection procedure and immediately thereafter with the healing process, they are not good for you long term! They are not benign and I never want my patients to gain benefit from Prolotherapy or Platelet Therapy/ PRP and go on to continue taking (a smaller) handful of NSAIDs on an on-going basis. Why? Because they undermine the exact healing processes that the injections are seeking to stimulate. They interfere with stem cell activity, therefore interfere with new growth of cartilage, ligaments, joints, whatever connective tissue it is that we are seeking to repair. Here is a great article from a colleague, talking more about this with primary research links. Suffice to say, make a game plan to change your medication routine if it involves a daily dose of Ibuprofen, Aleve or Tylenol - for the long-term health of your body. |
I'm Dr. Angela, and I want to help you and your joints feel their very best.
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