PROLOTHERAPY!
Dr. Janiga blends traditional evidenced- based interventional pain techniques with Prolotherapy.
Dr. Janiga's traditional medical training looked down upon Prolotherapy. With, however, the majority of his patients experiencing high quality and lasting pain relief from Prolotherapy, Dr. Janiga now firmly believes in the value of Prolotherapy.
Frequently asked questions about Prolotherapy:
1. What is Prolotherapy?
Prolotherapy is a simple, elegant, and natural technique of an injection that stimulates the body to heal itself.
Prolotherapy simply "assists" the body in healing itself. The healing is initiated by injecting natural medication into a patient's entheses. Entheses - or enthesis- is a term that describes where tendons and ligaments attach to bone. This attachment to bone, the enthesis, is where many patients' pain is felt to come from because they are weakened. This weakening causes the ligaments and tendons to be stretched out or loose- ligament laxity.
These loose ligaments and tendons allow undesirable excess movement in joints. This excess movement in our joints causes increased wear and tear on the joints in our body. Over time this increased wear and tear can lead to degeneration or "wear and tear arthritis"-- osteoarthritis. Unlike traditional treatments like anti-inflammatories (e.g. Ibuprofen or Aspirin), which actually can inhibit normal healing of these weak ligaments and tendons, Prolotherapy strengthens and rejuvenates injured, painful, and weak ligaments, tendons, and joints.
Prolotherapy brings more nutrients in the form of cells called fibroblasts to these weakened ligaments and tendons. New collagen (connective tisssue) is formed and old collagen is made stronger. Prolotherapy strengthens this ligament and tendon junction (the enthesis) in almost any part of the body!
2. How many treatment sessions does Prolotherapy require?
The number of treatments that each person requires is determined by how the person responds.
Backs and necks require the most amount of treatments- on average, 6-10 treatments. Referral joints- like shoulders, wrists, knees, and hips- usually require less treatment, on average, 4-6 treatments.
Many complex cases require only one or two treatments and some very simple cases have required many more treatments than expected. The amount of treatments is an individual decision based upon how well the person has done with previous treatments and how much pain relief they have been afforded.
3. What kind of success can be expected from Prolotherapy?
Dr. Janiga's results have shown that more than 80% of patients experience greater than 50% pain relief.
The hardest part when dealing with Prolotherapy is convincing patients that they will almost certainly need more than 1 or 2 treatments. Remember, Prolotherapy relies on a patient's own body "healing" itself and this can be a slow process.
The connective tissue strengthens 4 to 6 weeks after each treatment session. It is normal to experience waxing and waning of functionality and pain relief during the course of treatment. Almost invariably patients will have some return of pain after only a couple treatments. Assuming a patient's immune system is healthy, repeated treatments should provide longer and more pain relief until sustained pain improvements are realized.
4. What advantage does Prolotherapy have over steroid injections?
The biggest advantage is that the pain relief and strengthening of the tendons and ligaments tends to be permanent!
Some patients, after obtaining pain relief, may need a "top off" treatment every 3 to 5 years. The biggest downside of local anesthetic/steroid injections is that they can actually break down connective tissue. Many pain phyicians continue to indefinitely inject patients using steroids. This is great for the pain doctors' wallet, but may actually hurt patients in the long run! One of the few places that steroids seem to provide long term pain relief with little negative side effects, however, is the nerve roots in the spine. This is also assuming very small steroid doses are used, which they usually are not!
5. Who is not a candidate for Prolotherapy?
Generally, most patients are candidates. The poorest responders are smokers. The immune system of a smoker inhibits a patient from self-healing.
6. Will my insurance plan pay for Prolotherapy?
Unfortunately, most insurance carriers do not cover this service.
Even though more and more physicians are realizing the tremendous pain relief Prolotherapy provides patients, this is still not a covered therapy.
Ironically, insurance covers other treatments that are not permanent and, in the long run, may even hurt patients; e.g., trigger point injections with steroids or joint injections with steroids!
7. How much does Prolotherapy cost?
Each area of the body is unique and each patient is unique.
Link to "Prolotherapy pricing" for the cost per treatment per body part. You may also ask Dr. Janiga during your initial visit for a personal estimate for your particular condition.
Additional resources for Prolotherapy:
Click HERE for WCCO report on Prolotherapy
2-8-09 NY TIMES article re: Ward Hines and Prolotherapy
Click HERE for article on SportingNews.com regarding Prolotherapy and how it helped Simon Gagne of Philadelphia Flyers
Click HERE for CBS News report about PRP (Platelet Rich Plasma)
Click HERE for youtube.com video presentation about PRP (scientific explanation)
Click HERE for video about PRP
Article in 2008 Practical Pain Management Journal regarding Platelet-Rich Plasma