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deliver certain growth factors to the site of application. The repair process for Dextrose Prolotherapy and PRP can


be thought of as taking place through the use of contractors and general contractors. Initially after an injury, the contractors au- tomatically get right to work to repair the injured structure as soon as it occurs. This can continue for weeks to several months. This is often all that is necessary to finish the repair. People with chronic pain however have contractors that have


not finished the job. Their contractors had essentially gotten tired. Instead of completing the task, they go home and go to sleep. Doing Prolotherapy and PRP is like having the general contrac- tor call up the contractors to get them back to work. But it’s not always that easy. As long as the road is open, the


contractors are able to make their way to the job site. If there are impassable roads as a result of flooded roadways (blocked gan- glia, interference fields or scars, blocked qi, etc.) or severe traffic congestion (caused by poor circulation to the area), these block- ages need to be cleared.


If they are unable to be cleared; the contractors may need


to be helicoptered to the worksite. This transplantation of the contractors to the worksite is essentially how Stem Cell therapy works. These Stem Cells are taken from adipose tissue or bone marrow and transplanted where they are needed. But in addition to merely sending in contractors, the theory is that the Stem Cells are able to transform themselves into the normal version of the surrounding structures. This sounds very nice in theory, but the medical literature


supporting the efficacy for Stem Cell treatments is still not very impressive. One study showed that Dextrose Prolotherapy “pro- vides equal or superior short-term, intermediate-term, and long- term results to alternative treatment modalities” including PRP2 Another study showed that although the use of Stem Cells


.


has great potential as an efficacious treatment for patients with knee arthritis, the safety and efficacy must be evaluated with a more rigorous, larger sample size validation before Stem Cell therapy can be used in clinical practice3


. A Systematic review of the literature for the use of Stem Cells


for knee arthritis showed “Six trials with high risk of bias showed level-3 or level-4 evidence (low level evidence) in favour of Stem Cell injections in knee osteoarthritis.” It concluded that “In the absence of high-level evidence, we do not recommend Stem Cell therapy for knee osteoarthritis4


.” Overall, there are several things to consider when deciding


whether to undergo Stem Cell, PRP or dextrose prolotherapy. One is the cost. Stem Cell is most expensive followed by PRP. Dextrose prolotherapy is the least expensive. The advantage of Stem Cell Therapy and PRP over dextrose


prolotherapy is that they are considered by some to be more effective. They believe that even though Stem Cell Therapy and PRP are more expensive, it may be more cost effective to use because fewer treatments may be necessary. This is also a factor for people with limited time.


Although there are no studies indicating that Stem Cell


Therapy is more cost effective than Dextrose Prolotherapy, and although the literature is not strongly supportive of Stem Cell treatments at the current time, it is possible that in the future Stem Cells Therapy will be found to be better than PRP and PRP better than Dextrose Prolotherapy. So if the cost is not a concern, Stem Cells Therapy may be the treatment of choice.


NOVEMBER 2018 23


There are some drawbacks regarding Stem Cells and PRP.


The optimal way to process the cells is not clear. Also, different people with different conditions may need very different prepa- rations. Another drawback to the use of Stem Cell and PRP is the limited area able to be treated due to the limited amount that can be produced with one draw. One way to minimize the problem of limited size is by cau- tiously combining Stem Cells and/or PRP with Dextrose Prolo- therapy in a special way as to not interfere with the biological activity of the PRP and Stem Cells. If you decide to undergo PRP for arthritis it is important to make sure the physician is using a technique that minimizes the amount of white blood cells. Studies currently show that this achieves the best results with the least discomfort5


. Overall Dextrose Prolotherapy and Neural Prolotherapy


(which will be discussed in another article) can very success- fully treat the vast majority of complex pain problems. The key is to conduct a careful examination and to perform a complete treatment. Most patients who have failed regenerative injection treatments, do so because of those factors.


Article reprinted from October due to publisher error in title.


Written by Mitchell Bloom, MD, a traditionally trained Board Certified Medical Doctor with 30 years of experience in treating patients with challenging painful conditions and 25 years of ex- perience in the use of Regenerative Medicine. His treatments are discussed at IntegrativePainMD.com. Location: 7-E Oak Branch Drive, Greensboro. For more information or an appointment call 336.944.9400. See ad on page 31.


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