Treating knee and joint problems without surgery: Is prolotherapy an option?

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(Nov. 25, 2014) - Prolotherapy has been around since the 1950s, but only in the last few years has it gained in popularity.

“Essentially we take really safe ingredients and inject them into soft tissue. That causes a mild inflammatory response so your body will send blood, growth factors, platelets and all kinds of good stuff to the area to help it heal it on its own,” said physician’s assistant Danielle Steilen.

Steilen says prolotherapy can be a replacement for surgery, or at least something to try first. Steilen works with Dr. Ross Hauser, who’s been performing prolotherapy at Caring Medical and Rehabilitation Services for 25 years. Hauser tells FOX59 the blood supply to what surrounds your joints is simply not good!

For example, look at a tendon or ligament. You’ll find it's white with very little blood supply.

“So even if a person is healthy, and you have a torn ligament or torn cartilage, it doesn't heal well. So that's why the normal treatment is often for the orthopedic surgeon to remove the tissue because that tissue doesn't heal well,” Hauser said.

But instead of doing that, prolotherapy injects natural substances, like D-glucose or in some cases, components of your own blood, which then promote healing.

“So, thus the ligament gets stronger, the meniscus gets repaired, the labrum gets repaired, the joint becomes stable and the pain is removed,” Hauser said.

Several of Hauser’s patients who spoke to FOX59 said the treatment has done wonders for them.

“It’s been extremely effective for me or I wouldn't be coming back. The results are fantastic. I mean I wouldn't trade this for anything. I had four back surgeries before I started prolotherapy. I haven't had any since,” said Tom Ganz.

Ganz has been traveling to Chicago from West Lafayette to Caring Medical and Rehabilitation Services for 14 years. He says, as he needs it, they perform prolotherapy.

If it’s getting positive results with patients, why haven’t most people heard of the procedure?

“A lot of people don't know about prolotherapy, quite frankly, because it's really not taught in a lot of medical programs. I never learned about it until I was out in the field, and a student in this same office with Hauser,” said Steilen.

But what do surgeons think of it?

We asked Dr. Frank Kolisek, a joint replacement surgeon for Ortho Indy. He says no large studies verify if prolotherapy works. However, he also knows a lot of patients say it is effective for them.

“That brings up another point, if the patient feels better, does it really matter if there’s science behind it? Here at Ortho Indy, we try everything else before surgery. Surgery is a last resort, so this could be a possible option if proven,” he said.

But the doctor isn’t ready to endorse it just yet.

“I have trouble tying those ends together of how sugar water makes an unstable knee stable, but as far as the other biological things of making the patient feel better, I'm sure that could be true,” Kolisek said.

Hauser says he's written dozens of papers, submitted studies and has a 90 percent success rate with good candidates. “Good candidates” are those who still have a good range of motion in their joints.

Prolotherapy is not accepted by the FDA, and often, it’s not accepted by insurance. Hauser says one of the biggest obstacles is current thinking that icing for an injury is good, and inflammation is bad.

“The normal way the body heals to grow muscle tissue, to grow ligament tissue, and cartilage is by inflammation. For modern medicine to accept prolotherapy, you would actually have to admit your paradigm for the last 50 years has been wrong,” said Hauser.

For the doctor’s patients, the studies don’t matter as much as the results. Reem Shammas is a patient who flies to Chicago to get the treatment done.

“I've been coming here since 2013, and I come in from Abu Dhabi. It's a 14-hour flight and it's worth every second. I have a neck and back injury and I could barely sit. I was even scheduled for surgery until my boss told me about Dr. Hauser and prolotherapy,” said Shammas.

Shammas tells FOX 59 the results of the treatment were very fast, despite her extensive injuries.

“I saw a complete improvement the first session. And that has made me come back. And after the first three sessions, it was unbelievable. I gained my motion back in my neck. I could drive again and I could walk properly again,” she said.

Even though large scientific studies on prolotherapy, involving thousands of patients, haven’t been done, Hauser points to his own studies of his patients.

“I'll give you an example. In 2007 we followed 34 patients who were told by surgeons that they needed various surgeries. When it was all said and done 31 out of the 34 didn't need surgery when they were done with their prolotherapy. And 27 out of 28 knee patients who had meniscus problems didn’t need surgery either,” he said.

Prolotherapy is a quick treatment performed in the doctor’s office. For the knee, the series of injections only takes a couple minutes. Within a couple of days, the doctor says people can get back to their normal schedules, including cycling and running.

I also have knee pain and stiffness, which is made worse by sitting for long periods of time at the TV anchor desk. Indianapolis chiropractor Dr. Phillip Boroff told me about prolotherapy as a possible option to ease the pain.

Nobody performs prolotherapy in Indianapolis, so I went to Chicago to see Hauser and had it done in early November. I didn’t know what to expect or if it would work. I was told my issue relates to an injury of my medial collateral ligament. It was painful to walk, and running was out of the question.

Here’s my experience with prolotherapy.

First, are the needles painful? I got stuck about 30 times in each knee to inject the fluid. Some of the needles are long, and others are short. I found the pain depends on how deep the doctor must go to get to the injured area. The short needles were barely noticeable. The longer ones did cause a dull pain, but it wasn’t bad, and it was over in a few minutes.

You also get a topical numbing agent and sedation if you request it. It takes some of the sting out of the needle going through the skin.

Some patients have more extensive procedures in more painful areas. I saw Reem Shammas get her procedure done to her back and neck. She said it was painful, but she barely made a peep. She also had all her problem areas done at once to make the most of her long flight to Chicago from the Middle East.

Prolotherapy is for all joints, not just knees. Here’s a link to various videos showing the procedures for different body parts.

Many prolotherapy videos can also be found on YouTube. For my knees, the cost was $425 per knee and $375 for the exam. That's less than many insurance co-pays for surgery.

The average patient needs about three treatments. It's a different cost for different parts of your body. I plan on going back one more time. Many patients go far more often.

“I've come here five or six times. And I’m allergic to most painkillers, so they have to do my prolotherapy without it, so I do it even more natural. I admit the pain is not fun, but it’s over very quick,” said patient Susan Bova.

Bova has dealt with pain so bad in her toes, thumbs and knees, she had a tough time walking until prolotherapy.

“So the pain is getting greatly reduced. And it's all natural. I mean there are no adverse side effects. There's no cutting, there's no recuperative time,” she said.

For me personally, my knees were only a bit sore the day after the injections. The lubricating effect of the solution provided almost immediate relief from any pain.

Three weeks later, and I still don’t have any knee pain. But it'll be a matter of time to see if there's a more permanent effect, and actual healing.

Here’s another link to some of the top questions about prolotherapy to a doctor in Los Angeles.