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How do you relive back pain, knee pain, hip pain without surgery?

At Explore Health in Scottsdale, AZ, our mission is to provide affordable care to patients so they can optimize their quality of life. For many, this may mean helping them avoid elective orthopedic surgery utilizing prolotherapy or just helping them to become pain free after suffering from acute or chronic injuries. Read on to discover everything you need to know about prolotherapy and whether it can help you return to playing golf, yoga, working out, weight training, tennis, biking, running, aerobics, hiking, playing with your children/grandchildren or your favorite exercise. 

What is Prolotherapy? 

Prolotherapy is a non-surgical orthopedic procedure that strengthens and repairs the ligament laxity and damaged tendon attachments to the bones of an injured spinal vertebra or joint (knee, hip, shoulder, etc).  Prolotherapy is not commonly practiced by most doctors or taught in conventional medical school, but has a long and safe history of treating back and joint injuries by strengthening the ligaments and tendons that hold the spine and the joints in proper alignment.  Prolotherapy is safe and effective to treat injuries from auto accidents, sports injuries, etc including whiplash, post-concussion syndrome and headaches, low back pain (degenerative and bulging discs, OA and DJD), injuries to the knee (ACL, meniscus, bakers cyst, Osgood-Schlatter, DJD “bone on bone”), hip (osteoarthritis, piriformis syndrome and sciatica), shoulder (rotator cuff, bursitis, frozen shoulder), elbow (golfer or tennis elbow), wrist (carpal tunnel), ankle (ankle sprain), TMJ, achilles tendon, and plantar fasciitis.

How does Prolotherapy Work?

Prolotherapy Injections cause a mild and localized inflammatory response in the targeted damaged soft tissue(s), ligaments and tendons of the spine and joints.  The inflammation initiates a strong and purposeful healing response that directs the body to breakdown and recycle damaged tissue and replace it with healthy ligaments and tendons.  A simple analogy is that the damaged ligaments and tendons are like rubber bands that were left outside in the scorching Arizona sun for a month in July.  After being exposed to the extreme heat and dry air, the rubber bands become weak, brittle and when stretched show micro-tears and fissures.  These areas are highly innervated and can be extremely painful both at the location of the injury and in other areas caused by referral pain patterns.  The Prolotherapy injections are like repairing or replacing the damaged rubber bands [ligaments] with new ones that hold the bones in place or allow the joint to be moved by the muscles [tendons] without pain. 

What is the success of Prolotherapy?

According to the American Osteopathic Association of Prolotherapy Regenerative Medicine, “The anticipated rate of success depends on a number of variables, including the patient’s history and ability to heal, and the type of solution used. In patients with low back pain, studies have shown 85% to 95% of patients experience improvement with prolotherapy (compared to studies showing only a 52% improvement with back surgery). Many studies done over the years show a high success rate when prolotherapy is used for various ligament, tendon or joint pain/injuries.”

How should I prepare for Prolotherapy?

In order to decide if this treatment method is right for you, please bring copies of your diagnostic imaging and reports, so we know exactly what we are dealing with. This may include X-rays, CT, and MRI scans.  Our office also includes on-site diagnostic ultrasound for evaluating the extent of the soft tissue injury and ultrasound guided injections to ensure the injections are accurately and safely performed.  

It is important that you eat before your treatment. We strongly recommend that you consume a reasonable portion of protein and drink enough water prior to your appointment. You should stop taking aspirin, (except for baby aspirin taken for heart conditions), ibuprofen, corticosteroids and MAOIs in the 48 hours leading up to your treatment.  If you feel any pain or discomfort, you may take acetaminophen.

What Should I Expect During Prolotherapy?

Dr. Nelson will take your history, review your X-Rays, CT’s and/or MRI’s and perform a physical exam, orthopedic tests, and a detailed ultrasound exam to assess the structures at the root of your pain.  After discussing the options Dr. Nelson will recommend as series of standard prolotherapy, Platelet Rich Plasma (PRP), or stem cell derived exosome injections. 

Do Prolotherapy Injections hurt?

Our office specializes in making your regenerative injections as stress free as possible.  We offer oral conscious sedation and cold ethylchloride spray followed by local anesthesia or nerve block when necessary to make our injections relatively pain free.  

How long does it take for Prolotherapy to work?

Often, the injected area will be tender for a few days following the injection.  This means the injections are helping your ligaments and tendons to strengthen and heal which will help hold the spine or the joint in alignment.  

Although young people or patients with acute injuries may only require 1 -2 treatments, most conditions require multiple sessions with a few weeks between the injections.  The number of sessions will usually range from 3 - 6 or more depending on the extent of the tissue damage, the health of the patient, and their ability to respond to the treatment.  

Am I a good candidate for Prolotherapy? 

If you experience any acute or chronic joint or back pain, you are most likely a great candidate for prolotherapy. The ideal candidate for prolotherapy has joint instability, reduced range of motion, weakness, pain, swelling, and muscle spasms.  

Prolotherapy is especially helpful for injured ligaments or tendons such as torn rotator cuff, ACL, MCL, or meniscal tears, ankle sprains, whiplash, low back or hip pain, sciatica, TMJ, plantar fasciitis, osteoarthritis of knee, hip back, bursitis, bakers cyst, and disc degeneration.  Other indicators of an excellent candidate for regenerative injections include pain that benefits from massage, acupuncture or chiropractic adjustments but the pain relief is only temporary so those therapies need to be frequently repeated. 

What are the risks for Prolotherapy?

Prolotherapy is very safe.  The biggest risk is that you may not respond to the injections.  People on prednisone or immunosuppressive medications may not respond well to Prolotherapy.  Also, patients with uncontrolled diabetes, smokers, or immune compromised patients are not good candidates.  

How many injections will I get during a single procedure?

Many doctors performing PRP, stem cell, or Hyaluronic Acid injections only perform a single intra-articular injection into the knee, hip, shoulder, etc.  Patients that have received regenerative injections from other doctors are often surprised because Dr. Nelson performs multiple injections during each procedure in addition to the injections inside the joint.  Dr. Nelson states, “In 1996, I was trained by old school Hakkett-Hemwell trained physicians that understood that we need to treat all of the compromised ligament and tendon attachments to get the best results.  Sometimes this involves just a few injections.  Other times this involves injecting multiple structures on each vertebra and multiple spinal levels on the same visit.  When I treat the knee, I may need to treat one or all of the following:  the ACL, medial and lateral coronary ligaments (which support the medial and lateral meniscus), both collateral ligaments (MCL and LCL), pes anserina, TFL attachment, the patellar tendon and retinaculum, PCL, vastus medialis trigger point, and maybe even a neuroprolotherapy injection to correct the nerve impingement of the peroneal nerve in addition to the intra-articular injection.  This takes more time and is a little more involved for the patient, but our patient’s results when we use this more comprehensive approach speaks for itself.”

What do patients say about the benefits of Prolotherapy?

“I’m writing to thank you for the incredible gift you’ve given me.  After years of pain due to osteoarthritis, I had recently scheduled a total knee replacement surgery based on my X-rays and my orthopedic surgeon’s recommendation.  I didn’t want the surgery because I knew I was in for a difficult and painful recovery with no guarantee that I would have a successful outcome.  I thought I had exhausted all my alternatives and decided to go ahead with the surgery.  

Luckily, I came into your office for an unrelated medical concern (your weight loss program where I lost 20 lbs and 6 inches off my waist) prior to my surgery, and you explained the potential benefits of prolotherapy.   You said you couldn’t promise anything, but you recommended we give it a try because if it didn’t work, I could always go ahead with the surgery.

I went ahead with the prolotherapy and I am astounded that not only am I pain free, but I cancelled my total knee replacement.  I want to thank you from the bottom of my heart.  You are a skilled doctor and I have referred at least 10 people I know with knee, hip, shoulder and back problems to your office.  I tell them you are a “miracle worker.”

You told me it might require 3-6 prolotherapy sessions to get results, but after the first prolotherapy treatment, I had the first pain-free day I’d had in over 8 years.  I’m walking without a limp and have started walking for 20 minutes 2x/day.

Once again, thank you.  I wish I could pay you 1/10th of what my insurance was going to pay for my “medically necessary” knee replacement, but I guess the insurance companies and conventional medicine doesn’t believe that prolotherapy is effective.  I am living proof they are dead wrong.”

D.R. Mesa, AZ 

What do Conventional Medical Experts say about Prolotherapy?

“After being diagnosed with incurable pain by two separate neurological clinics, I received prolotherapy treatments that remarkably improved my condition to the point where my pain ceased to be a problem.  

Not many physicians are aware of Prolotherapy, and even fewer are adept at this form of treatment.  One wonders why that is so.  In my opinion, it is because medical folks are skeptical and Prolotherapy, unless you have tried it and proven its worth, seems to be too easy a solution to a series of complicated problems that afflict the human body and have been notoriously difficult to treat by any other method.  Another reason is the simplicity of the therapy:  injecting an irritant solution at the junction of a ligament with a bone to produce the rather dramatic therapeutic benefits that follow.

I was so impressed with what Prolotherapy could do for musculoskeletal disease that I, at one time, thought that might be the way I could spend my years after formal retirement from the University of Pennsylvania.  But the call of President Reagan to be Surgeon General of the United Stated interrupted any such plans”  

  1. Everett Koop, MD, Former US Surgeon General and Deputy Assistant Secretary for US Public Health Service

Does insurance pay for regenerative injections and Prolotherapy?

Our office is not an ACCCHS,  or Medicare provider and we are not an in-network provider for any insurance companies, so we operate on a fee-for-service basis.  We will provide you with an itemized service summary with the procedure and diagnosis codes that you can submit to your insurance company for possible reimbursement.  The invoice will indicate to provide any reimbursement directly to you.  

I was in an automobile accident, will my car insurance pay for regenerative treatments and rehabilitation?

Our office works with patients suffering from whiplash, low back pain and other injuries caused by motor vehicle accident (MVA) injuries.  Please contact us with the details of your accident, your auto insurance contact info or your personal injury (PI) attorney so we can coordinate your care.   Depending on your insurance coverage or the coverage of the driver at fault, our services may be covered in full or in part as part of your personal injury claim with no out of pocket expenses for you.  

How do I choose a Prolotherapy doctor?

Dr. Nelson has been providing safe and effective prolotherapy treatments for over 24 years.  He receives the continuing medical education (CME) every year to master and incorporate the latest advancements in regenerative treatments.  Last year Dr. Nelson performed over 1000 procedures using Prolotherapy, PRP, and stem cell derived exosomes.  Many providers offer Prolotherapy but lack the experience and expertise to perform it well.  Dr. Nelson performed anatomy and palpitation guided injections successfully for years with thousands of patients before adding the benefits of ultrasound guided injections.  Dr. Nelson often successfully treats patients that are in pain even after receiving expensive “Stem cell” injections from other Prolotherapy doctors.  When considering your options, its important to choose someone with the experience necessary to get results.   

Schedule Your Initial Consultation Today

Are you sick and tired of stiff, achy joints that just don’t move as well as they used to? If you are, pain relief injections with prolotherapy may be just what you need to get back to enjoying your active lifestyle.

To discover if these injections are right for you, please contact Dr. Nelson today at Explore Health in Scottsdale, AZ to schedule your initial consultation. Whether you would prefer a consultation over the phone, via video chat or in person, we can accommodate your preference.


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