ORTHOPAEDIC NEURAL PROLOTHERAPY

“Health is a large word. It embraces not the body only, but the mind and spirit as well; …and not today’s pain or pleasure alone, but the whole being and outlook of a man.”
– James H. West

What Is Neural Prolotherapy?

The future of medicine involves the ability to allow the body to heal itself, and also to regenerate where necessary. There are a variety of options available that are able to facilitate the treatment of orthopaedic conditions in a regenerative manner. One method that is a few decades in existence that has helped in the treatment of ligament-tendon healing is that of prolotherapy. The current day has identified an evolution of the prolotherapy methodologies, to those that are focused on the healing of subcutaneous nerves. The treatment of these nerves is known as neural prolotherapy. Low dextrose prolotherapy is a treatment that is able to facilitate the healing of neurogenic inflammatory pain. Regenerative therapies are the wave of the future.

How Neural Prolotherapy Evolved As a Treatment 

Neural Prolotherapy is an evolving aspect of regenerative orthopaedic medicine, and is utilized in the treatment of neurogenic inflammation. Neurogenic inflammation is an effect that is attributed to conditions such as osteoarthritis. Within ligaments, tendons and joints, there are nerve receptors that have the ability to activate pain sensations in patients. These receptors are classified as C pain fibers. Irritated C pain fibers will transmit a variety of impulses along their plains. Where possible, these pain fibers also have the ability to generate a reflex action that generates a muscle spasm. 

Research in nerve treatment indicated that neurogenic inflammation can be treated with lidocaine and steroid injections. The introduction of dextrose prolotherapy took place subsequent to this initial treatment. The swelling of the nerves causes a variety of injuries to their source sites. Healing agents such as nerve growth factors are essential for nerve health and repair. They are hindered in the presence of neurogenic swelling. Understanding the biology of a nerve site is therefore key to improving the health of a site like a joint and optimizing its healing capabilities. 

How Neurogenic Inflammation is Treated Via Prolotherapy

Via a variety of clinical studies, it was identified that a 5% dextrose solution with sterile water was able to achieve an effect that enabled the mitigation of pain propagation in an affected site. The range of healing is from 4 hours to 3 weeks, depending on the severity of the case. The treatment mechanism is believed to be one that involves the binding of dextrose to various active sites in the nerves, and results in a reduction of the inflammation experienced inside of the nervous system. The reduction in inflammation results in the normal flow of the nerve growth factor, and enables the repair of the nerves to actually take place. The patient also experiences reduced pain. Neural prolotherapy is found to have outstanding results, and proven effective in the treatment of both deep and superficial tissues. Any region where there is an indication of swollen or painful nerves, indicates that NPT will be a treatment worth considering. In some instances, a fusion with platelet rich plasma is recommended. 

In some case studies, in a week by week incremental with both PRP-Prolotheraphy fused with physical therapy, patient improvement was seen within 6 weeks or so. Areas of treatments included the knees. An orthopaedic consultation will usually identify the points of treatment and the duration of therapy.

References: 

  1. Neural Prolotherapy: http://journalofprolotherapy.com/neural-prolotherapy/

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Dr. Gordon Slater

Dr. Slater is one of the first foot and ankle surgeons in Australia to adopt minimally invasive surgical techniques. He routinely uses MIS to treat a range of conditions, including bunions.

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Dr Gordon Slater is a highly-skilled surgeon specialising in foot and ankle conditions and sports injuries. Dr Slater is one of the first foot and ankle surgeons in Australia to adopt minimally invasive surgical techniques. He routinely uses MIS to treat a range of conditions, including bunions. MIS  has many advantages including shorter operating times, reduced post-operative pain, reduced risk of infection, minimal scarring and better cosmetic outcomes.

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