Dr. Ryan Minarik

Prolotherapy – A Simple Solution With Powerful Effects

As indicated by the title, I am always amazed by prolotherapy for its ability to stimulate the body to heal itself.  No drugs involved.  The mechanisms by which prolotherapy affects the pain response and injury to the ligaments, tendons, and nerves is actually quite complex.  But the products we use to inject are almost profound in their simplicity.

Combine locations of the body that undergo constant strain, movement, stress, and overuse with a poor blood supply and you have a perfect setup for chronic injury, lack of complete healing and… pain.  Add overuse of anti-inflammatory medications (advil, steroids) and it can even worsen the scenario.  The locations:  ligaments, tendons, and joints.

The basics of this treatment involve injections of dextrose (sugar) at concentrations that stimulate, or re-stimulate to be more accurate, healing of soft tissue injuries.  The solution both creates a very focal inflammatory effect (you need inflammation to get proper healing) and stimulation of soft tissue building cells.  These injections are placed at, or near, ligament or tendon attachments to the bone, where there is often damaged, weak, torn, or stretched tissue.

A typical scenario I describe to patients is what happens following whiplash.  The bowling ball weight of the head is thrown forwards and/or backwards, causing immense strain and stretch to the ligaments and tendons at the back of the head.  Xrays and MRIs often don’t show much, and you are given pain meds and muscle relaxers and sent to physical therapy. If you are lucky you see a chiropractor and/or acupuncturist.  For many people, these treatments work well and they are back to normal in a few months.  For some, however, they notice cycles of chronic pain and muscle tension, that improves temporarily but continues to relapse. This is a classic example of the muscles (bone movers) taking over for weak, damaged, or stretched ligaments (bone stabilizers).  When we do an exam, we frequently find tender areas along the skull or other boney areas, where the ligaments attach, not just in the muscles. The muscle stay tight, get relaxed from treatment, then tighten up again when the ligaments don’t stabilize.  This is also common in those people who get repeated chiropractic adjustments (beyond a typical treatment series) that just don’t seem to “hold.”

The above is an example of a force trauma causing ligament and tendon stretch or microtears.  Other conditions that are similar, but have slightly different mechanisms are chronic strains (tennis elbow, achilles tendinitis) where repeated stress or movement at an area have caused chronic degeneration of the connecting tissues.  Osteoarthritis is another area that responds well to prolotherapy, due to the mechanism of cartilage breakdown in the joint.

Prolotherapy and chiropractic care are quite complimentary modalities, in fact, I believe almost necessary to be done in conjunction with each other.  I am always happy to meet briefly with potential patients to describe this procedure further, or assess if it is worthwhile for you to schedule an actual visit and exam. Your chiropractor can also help decide if it would be beneficial for you at a given point in your treatment plan.

Dr. Minarik offers no-charge 10 minute phone or in-office consultations to answer additional questions about prolotherapy and your condition.  Call either clinic to schedule!

Excellent Article on Fructose

I couldn’t have written it better, so I’m not going to try.  You should read this article by my colleague, Dr. Shannon Weeks, on his blog site:  The Devil in the Fructose.  Its an excellent overview of the dangers of fructose and how it significantly contributes to the obesity epidemic in our country.


You can find my Prolotherapy and Platelet Rich Plasma services now on Thumbtack!

Struggling with shin splints?

Shin splints, medically referred to as medial tibial stress syndrome or MTSS, can be a painful condition often leaving runners no option but to discontinue training. The injury involves damage to the muscle insertions along the medial part of the tibia, or lower leg. Standard treatments of ice and anti-inflammatory medications (NSAIDs) may help temporarily alleviate pain, but they can actually make the tissues weaker by inhibiting blood flow and interrupting healing, resulting in a recurrence of the condition.

Acupuncture, and myofascial treatments such as graston technique often administered by chiropractors and physical therapists, can provide definite improvements beyond the standard therapies, yet some patients continue to struggle with the condition long term. Prolotherapy injections directly to the region of pain can actually strengthen the damaged tissue resulting in decreased pain and sustained healing. The injections can be done alone or in tandem with other modalities. A recent study published in the British Journal of Sports Medicine, helps support the effectiveness of prolotherapy for shin splints.

Click here to view the article abstract.

Study shows PRP superior to steroid injection for chronic tennis elbow (lateral epicondylitis)

Steroid injections can sometimes help relieve pain with tennis elbow that is unresponsive to conservative treatment. The relief often lasts a limited time, however, and then the pain recurs, sometimes worse. Further, with steroids there is always the potential of further weakening and breaking down the precious tendon fibers making the problem more chronic. This study shows it is better to eliminate pain by encouraging healing and supporting the strength of the tendon attachment naturally with your own blood (PRP), rather than inhibiting the pain and inflammation with steroid.

Click here to view the study posted on Shoulderdoc.co.uk