Regeneration Injection Therapies
All tissues – especially injured or aging tissues need additional help to be able to regenerate, repair, and maintain essential normal healthy function. The body’s normal injury repair cycle is fairly well understood- except when it comes to certain types of injuries. How to restore/regenerate function of nerve, ligament, joint, and cartilage issues have not been well understood – until fairly recent developments in technology and information have spread the concepts. The following primer is designed to help you understand current methods involving injection methods that have proven to help regeneration and restoration of function in these types of injuries/tissues.
Specialized training and licensing certifications are required to administer these types of therapies in British Columbia.
Perineural Injection Therapy(PIT) and Basic Neural Therapy (NT)
The peripheral nerves traverse thru channels in bone, fascia, and muscles to supply sensory innervation and also to repair properties in skin, muscles, joints, and bone.
Neural therapy (NT) involves the use of minimally invasive injections of mild local anesthesia (procaine) to restore nerve function and cellular communication to nerves injured from traction, compression, or toxicity states. Neural therapy was pioneered by the German Huneke brothers in the mid-20th Century and was initially used for scar therapy injections. Sites were termed interference fields – because they caused interference of normal communication and regulation within the nervous system. Over the years interference fields have been found other than at scars – in deeper sites such as autonomic ganglia (nerve hubs), teeth, bone injury sites, and brain ganglia. This has resulted in development of a whole region of medical treatment applications in Europe, South America, North America, and Asia – that has practical and scientific roots that foster its growth and spread.
Perineural Injection Therapy (PIT) involves the diagnosis and application of minimally invasive injections of 5% dextrose or mannitol to reset and regenerate peripherally injured nerves that cause neuropathic (injured nerve generated) pain.
Training at post-graduate workshops involves understanding the various nerve pathways that traverse from the joints and spinal region through the fascial layers and along to the skin and peripheral tissues is a major part to the study of PIT.
The use of minimally invasive injections with 1/2″ needles and dextrose/mannitol results in almost instant changes of sensation and function when properly applied. This indicates proper location of pain generating areas/sources of nerve pain. The process similar to neural therapy usually needs repeating at regular intervals for complete healing to occur.
This novel form of treatment of neuropathic pain has been researched and revived by Dr. John Lyftogt, MD of New Zealand – and further information can be followed on his website – Lyftogtmed.com
Dr. Brown has taken advanced courses of training in Peripheral Injection Therapy with Dr. Lyftogt, MD
Prolotherapy is an injection technique using a base solution called P2G consisting of 1% procaine, 15-25% solution of dextrose, glucose, and 1%phenol – to restore, regenerate, and normalize ligament and tendon – bone periosteal injuries. Joint sprains, subluxations, and dislocations all involve stretching and tearing of ligaments, tendons, or joint capsule structures that are attached to bone elements. Xrays can determine bone injury but the soft tissue components are better visualized with MRI and preferably in stressed positions to show disruption of normal integrity and holding/stabilizing function of the joint, ligament, tendon complex. Prolotherapy was developed by American physicians in the mid-20th Century and has been proven to improve ligament and joint integrity through proliferation of normal fibroblast tissue that make up your ligament, tendons, and joint complexes. For detailed information on research studies regarding prolotherapy see Dr. Reeves.com
Dr. Brown has taken basic and advanced training in all forms of prolotherapy.
Prolozone is the injection of prolotherapy solution along with a mixture of minerals, B-vitamins, and various homeopathic solutions then coupled with injection of ozone (activated oxygen) into injured joints and tissues. This is designed to enhance stimulation of repair and regeneration locally by up-regulating energy and mitochondrial function in the involved tissues – by supplying needed materials for increased metabolism and repair. This would be particularly useful for individuals in compromised nutritional states – such as the elderly, chronically injured, or those with systemic conditions such as diabetes etc.
Prolozone was developed and forwarded by Dr. Frank Shallenberger, MD or Reno Nevada. Dr. Dennis Harper, DC of Orofino, Idaho has taken the original work of Dr. Shallenberger and developed the Harper Restoration System of protocols to advance and enhance upon the results of Prolozone techniques.
Dr. Brown has taken advanced training from both Dr. Shallenberger and Dr. Harper.
Platelet Rich Plasma – PRP
Platelet Rich Plasma is the use of concentrated platelets from the patient’s own blood which is injected into the area of injury needing to be healed. The platelets contain or stimulate repair through up-regulation of growth factors necessary for repair and regeneration of tissues. This becomes another method of enhancing regeneration and repair of injury sites.
Ozonated Clot Matrix – OCM
Following from the basic PRP- if a scaffolding is needed in order to rebuild a larger defect in the injured site- then calcium chloride is added to the harvested platelets in order to cause a clot to form a matrix for cells to build from. An enhancement of this procedure is to use the principles of Prolozone plus PRP – to infuse platelets, plus prolotherapy, plus micronutrients and repair factors and ozone – to literally jumpstart and maintain repair at the site of injury for several weeks.
Stem or Progenitor Cell Therapy
Stem cells are undifferentiated cells that stimulate regrowth into the type of tissue that is selectively required for repair of damaged or injured cells. Thus one can regrow and regenerated nerve, muscle, tendon, ligament, cartilage, bone or organ tissue needed for repair. Various types of stem cells can be harvested and used – from embryonic placental cord tissue, bone marrow, or adipose (fat) tissues. Each type of harvesting and use has its merits and liabilities.
If stem cells are derived form your own tissues they are termed autologous and no antibody reactions should occur. The main thing to understand is that since stem cells are primitive and undifferentiated and therefore neutral, there is no antibody or allergy cross reaction possible with their use whether from your own tissue or proper embryonic source. However – if other types of tissue are in the mix of tissues given then it is possible to have immune cross reactivity. So the source and testing protocols should be done by a licensed reputable laboratory.
The second issue regarding stem cells is harvesting – bone marrow requires puncturing in the bone of hip crest or tibia, and adipose requires macerating and liquefying fat tissue usually from the abdomen. Each of these procedures has inherent risks from puncturing and creating of wounds with medically invasive procedures. (These protocols can be viewed on the internet – by googling – ‘prp’)
The third issue regarding autologous stem cells is one of tissue toxicity or quality control of what is being harvested and put back into the system. Recognized and measured controls for cell counts and toxicity should be done to the standard of tissue transplant (ie heart transplant tissue) by licensed laboratory facilities. These standards and batch references should be available for each tissue administered.
Note: Bone marrow or Adipose stem cell harvesting procedures are not currently authorized for use in British Columbia by Naturopathic physicians.
This primer hopefully gives you a progressive overview of the types of Regeneration Injection Therapy that are currently available at our clinic. These procedures are only done after a consultation, history, and examination – in order to determine the type of procedure that is most suitable for the type of injury and conditions of healing required for your situation.