Regenerative Injection Therapies
By Dustin Moffitt, N.D.
A treatment modality, dating back to 1830, for chronic pain and injury
From a physiological standpoint, our body is a system of levers, pullies, and mechanical components that allow us to sit, stand, dance, and move. The study of how these pieces move together is called Kinesiology.
Translating this metaphor to the body, the mechanical levers are our bones. Skeletal levers vary in size and shape and move our joints. Between the levers lie the joints. Each joint has a sac that contains synovial fluid, which creates protective cushioning between each skeletal connection. Often this joint contains another fluid-filled sac, called a bursa, which provides additional protection during movement from rubbing.
Over the joints are several ligaments, which are cord-like pieces of fibrous connective tissue that reach from one bone to the next. In a perfectly functioning body, these ligaments are an ideal length – neither too long, nor too short – and provide just enough movement to allow the joint to perform its actions. Tendons, a fibrous collagen tissue, connect each bone to a muscle. Muscles contract and relax, pulling on these tendons to create movement. Ligaments work diligently to ensure muscles do not pull too hard, thus preventing movement from occurring in the wrong direction. This is our “pulley system.”
Let’s look at the knee as an example. Comprised of four bones, the knee is where the femur (a long bone in the thigh) meets with the tibia and fibula (two long bones forming the lower leg). The patella provides a “cap” where these bones meet, preventing forward movement past 180 degrees. The meniscus and bursa are internal components that insure the bones do not damage each other during movement. Our knee has groups of ligaments: anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament, lateral collateral ligament, and fibular collateral ligament, which prevent the bones from moving too far in any direction. In addition, there are several muscles that act upon the knee joint, coming from our thigh, our calf, and even reaching down into our foot, that help create actions within our legs. Each muscle is connected by a tendon to at least one bone.
This brings us to the study of Kinesiology, and the development of Prolotherapy. If the body is geared to prevent damage, then how does it occur? And secondly, rather than applying a bandage, an artificial structure, or a crutch, how can we help the body return to what it was meant to do? How do we repair the ligaments, tendons, muscles, and joint space so that the body works in harmony?
If every system in our body was in perfect physiological form, and moved exactly as it was meant to, kinesiology would be an uninteresting subject. The body optimally prevents injuries. However, circumstances are not always within our control. When an injury does occur, our bodies are equipped with the tools necessary to repair the injury.
Sometimes the damage is too great, whether it be too fast, too strong, or too long in duration. We also sometimes lack the patience needed to allow our bodies to heal. Other times a nutritional deficiency prevents the body from having the tools it needs to repair, sort of like missing a wrench in your tool box.
In some cases the injury begins small injury and grows over time, like a minor oil leak. We are frequently moving our bodies in ways it was not originally designed to move, bearing excess weight or stress on a joint, and overusing or misusing the machine. This causes uneven and excessive wear, resulting in conditions such as joint inflammation, torn ligaments, and strained muscles. Before we know it, that small and manageable oil leak becomes a gusher, and prevents our machine from working properly.
When an injury occurs, our brain is very aware of it. With a high level of attention, our body does its best to recover. If it doesn’t have the tools needed, has too many other problems to focus on, or doesn’t have enough time between injuries, it must adapt. It creates a “work around” for the problem, often at the expense of our quality of life.
From pain relievers and anti-inflammatories, to braces and patches, the more common solution has been a bandage approach. However, these treatments do not return the body to its original state. Individuals are more frequently ending up with metal pins and plates, pharmaceutical dependencies, or immobilized solutions to their pains.
Back to our original question – how do we return the body to normal? The holistic medicine perspective has taken a different, more functional approach to repairing these systems. By studying the biochemistry of healing and our kinesiology roots, we have discovered safer, less invasive, and often more permanent solutions to repairing damage in the structure of the body.
Science shows that our body will produce and shuttle certain nutrients upon injury. When it is not given enough tools, time, or attention to the system, a “work around” is formed. In order to heal, we must remind the body of the injury again and encourage it to solve the problem.
With the help of procedures such as Prolotherapy, Prolozone, and Platelet-Rich Plasma Injections (PRP), collectively referred to as Regenerative Injection Therapies (RIT), we can provide essential nutrients directly to an injury. This shuts off the pain receptors, decreases long-term inflammation, and promotes natural healing.
RIT are injection-based modalities that target the injury directly by providing nutrients and attention. Prolotherapy uses dextrose, a sugar solution, to cause a temporary inflammatory response. This gets the brain’s attention. In addition to dextrose, a nutrient package is used to help heal the injury. Sort of like lending the body a wrench, the body now has the tools it needs for healing. Prolotherapy takes time. Typically, 3-6 treatments are needed, with 4-6 weeks between each treatment. After the treatment, we continue to provide the body with the tools it needs. Additional supplements can be recommended to encourage growth and healing. The use of pharmaceutical inflammatory suppressants is discouraged during the healing process, as they tend to encourage the brain to lose focus on the injury.
Sometimes the use of Prolotherapy is not enough. Here at the Riordan Clinic, we often combine Prolotherapy with Ozone Therapy. In brief, Ozone is a naturally-occurring molecule consisting of three atoms of oxygen. Because Ozone is highly reactive, it stimulates rebuilding by increasing available oxygen and nutrients to the new forming tissue. It helps expand the joint space, which allows for more fluid movement, especially blood, which brings nutrients and fresh oxygen into the area. This treatment is known as Prolozone.
Key nutritional supplements can aid the body in reducing inflammation and stimulating growth and repair, especially during times of injury.
Platelet-Rich Plasma Therapy (PRP) is the combination of platelets and Prolozone or Prolotherapy. A co-learner first gets blood drawn, and then the blood is spun down in a centrifuge, separating the platelets, and a small syringe is used to transfer the platelets from the blood to the injection. This increases the rate of new growth and repair by up to 10x the normal rate, which is a great option for active individuals.
Severe injuries, or injuries not responding to Prolozone, may need a super-charged approach. Let’s take another anatomy detour. Our blood consists of four main components: red blood cells (nutrient shuttles), white blood cells (soldiers and cleaning crews), platelets, and plasma (fluid medium). Platelets are most commonly known for their ability to coagulate when an injury occurs. They prevent us from losing excessive blood by forming clots and scabs over injuries. However, platelets are also jam-packed with hundreds of proteins, called Growth Factors, that help in healing injuries. Growth Factors help stimulate cellular growth (the formation of new cells), proliferation (removing dead cells), and healing.
Techniques for Regenerative Injection Therapies vary. Some providers believe that if the entire injection is placed at the center of the injury, the body will diffuse the solution as needed. Other providers (including myself) believe that sometimes the inflammation and stagnation of the region requires a more comprehensive approach. Rather than putting the entire solution in one spot, I inject several different sites surrounding the injury. This insures that every damaged fiber gets a fair share of nutrients. While the process takes a bit longer (30 minutes to an hour on average), patients tend to respond quicker and heal faster.
What types of injuries respond best to Regenerative Injections? In short, if the body can take care of the damage with proper nutrients and time, these injection procedures will help. These injuries include (but aren’t limited to):
- Back pain (with or without disc degeneration and bulging)
- Neck pain (with or without disc degeneration and bulging)
- Shoulder pain (including rotator cuff injuries)
- Chronic tendon issues
- Arthritic joints
- Tennis elbow
- Sports injuries
- Carpal tunnel
- Plantar fasciitis
- Sprains/strain injuries
- Acute ligament and muscle injuries
- Anything less than a 75% tear, even when surgery is recommended (such as ACL and rotator cuff injuries)
- Whiplash injuries
The time has come to consider Regenerative Injection Therapies that repair before replace and allow our bodies to return to a state of balance. Through proper nutrition, therapeutic exercises and regenerative injections, we can provide natural assistance to the body. By allowing the body to heal itself with natural assistance, we decrease the need for pharmaceutic “bandages”, surgeries, and life altering deterioration.
Dustin Moffitt, ND, is the primary provider at the Riordan Clinic, Hays location. He was born and raised near Whitewater, Kansas. He received his Doctorate of Naturopathic Medicine from the National College of Natural Medicine (NCNM), now known as National University of Natural Medicine (NUNM).
Dr Moffitt spent five years working with the community to teach nutrition and wellness with the Food as Medicine Institute. While practicing in Oregon, Dr. Moffitt worked alongside Acupuncturists, Massage Therapists, and Chiropractors as a primary care physician. He specializes in regenerative injection techniques, pain management, sports rehabilitation, chronic illness, functional medicine, and weight loss. He is currently accepting new patients at the Riordan Clinic Hays location.