Prolotherapy
Dr. Greenberg Interview
Dr. Scott R. Greenberg, M.D. received his B.A. in Biology at Rutgers University in 1992. He attended medical school at Hahnemann University in Philadelphia from 1992-1996 achieving many academic honors in addition to community service awards. Dr. Greenberg completed his residency in Family Practice in 1999 at The Bryn Mawr Hospital in Bryn Mawr, Pennsylvania, where he began a clinical trial on the use of the immune-boosting herb, echinacea and served as a member of the hospital Institutional Review Board. Dr. Greenberg is a diplomate of the American Board of Family Practice, a member of the American College for The Advancement in Medicine and a member of the American Association of Orthopedic Medicine. He holds Board Certification in Family Practice and Chelation Therapy. He is also a diplomate of the National Board of Medical Examiners and is a recipient of the Physicians Recognition Award from the American Medical Association. He currently practices medicine in Cherry Hill, NJ, where he lives with his wife. Dr. Greenberg's techniques have been featured on television programs and in magazine articles. He is the author of the book Self Care Anywhere by New Century Publishing.
Pain.com: To start, what is prolotherapy?
Dr. Greenberg: Prolotherapy (proliferative therapy), also known as ligament reconstructive therapy or sclerotherapy, is a recognized orthopedic procedure that stimulates the body's natural healing processes to strengthen joints weakened by trauma or arthritis. Prolotherapy (also called sclerotherapy) is named for its proliferative effect on tendons and ligaments. Although an industrial surgeon coined the term in the 1950s, prolotherapy was first used in ancient times. Hippocrates treated injured rotator cuffs of javelin throwers back around 400 B.C. with hot lances to create small amounts of scar tissue around the shoulder joint. The technique evolved in the 1930s and was used to repair hernias before modern surgical techniques became available. Dr. George Hackett refined the procedure and described the use of localized injections into the junction of a bone and tendon, causing a controlled rate of inflammation and healing.
Pain.com: Why would a patient seek treatment by prolotherapy?
Dr. Greenberg: A patient who has had pain for over six months would seek prolotherapy. The majority of my patients have back, neck, or knee pain and have failed surgery or hope to avoid surgery. Many people needlessly suffer with pain and arthritis because of undiagnosed ligament and tendon damage. Joints weakened when ligaments and tendons are stretched, torn, or fragmented, become hypermobile and painful. Traditional approaches with anti-inflammatory drugs, cortisone and surgery often fail to stabilize the joint and relieve pain permanently. Prolotherapy has the unique ability to directly address the cause of instability and repair the weakened sites, resulting in permanent stabilization of the joint. When precisely injected into the site of pain or injury, prolotherapy creates a mild, controlled inflammation, which stimulates the body to lay down new tendon or ligament fibers, resulting in a strengthening of the weakened structure. When the joint becomes strong, pain will be relieved and joint function will be restored.
Pain.com: Is prolotherapy limited to the treatment of joints?
Dr. Greenberg: No, actually prolotherapy can be used to relieve a broad spectrum of conditions, including: arthritis, backaches, carpal tunnel syndrome, compression fractures, knee conditions, herniated discs, chronic headaches, tennis elbow, shoulder pain, varicose veins, temporal mandibular joint dysfunction and work-related injuries.
Pain.com: Does prolotherapy have a role in the treatment of chronic pain?
Dr. Greenberg: I believe prolotherapy is part of the comprehensive approach to curing chronic pain. I evaluate each patient thoroughly with a personal history and physical exam and specialized laboratory analysis. I may ask patients to have X-rays performed before receiving prolotherapy. In all cases involving chronic pain, I will use my expertise in dietary and nutritional medicine and recommend specific supplements to maximize health and ability to heal while minimizing pain.
Pain.com: How effective is prolotherapy in the treatment of chronic pain?
Dr. Greenberg: The success of prolotherapy depends on a number of variables, including the patient's severity of injury, age, and ability to heal. Some 85-95% of patients suffering from low back pain with hypermobility, for instance, experience remission when treated with prolotherapy. In comparison, the Journal of Bone and Joint Therapy reports only a 52% improvement in patients treated with disc surgery.
Pain.com: Are prolotherapy treatments painful?
Dr. Greenberg: Patients can have prolotherapy without the need for anesthesia. The injections are very well tolerated. In fact, I have had several patients, including one physician, who have told me they look forward to having follow-up injection treatments. Because prolotherapy uses inflammation to heal the body, it may result in mild swelling, pain and stiffness for several days after the procedure. This often can be treated with pain relievers such as Tylenol. However, I strongly discourage the use of any anti-inflammatory drugs during prolotherapy.
Pain.com: How often are treatments administered?
Dr. Greenberg: Prolotherapy treatments are administered as determined on an individual basis, usually every one, two, or three weeks. The length of the treatments is variable and depends on several factors, including nutritional status, ability to heal, and the degree and site of the injury involved. Some patients may experience complete relief from pain along with restoration of full function after only one or two treatments. Generally speaking, however, back and neck problems require six to twelve sessions and less extensive injuries may resolve after an average of four sessions. We ask patients to avoid any heavy-duty exertion during the treatments, but they are otherwise usually able to pursue their normal life and work schedules in between sessions.
Pain.com: Is there anything you would to add in closing?
Dr. Greenberg: Prolotherapy is a safe and effective treatment for pain. It presents a superior treatment option for relieving chronic pain when compared to drugs that interfere with the inflammatory pathways of healing. Proper and complete healing can only occur when the natural pathways are left disrupted. As a result, prolotherapy should be considered a tool in treating chronic pain.
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