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Neural-Prolo

What is Neural Prolo?

What Is Prolotherapy?

“Gateway drug for regenerative autologous ortho-biologics (stem cells and PRP)”

“Prolo” is shorthand for proliferative therapy. Its origins can be traced as far back as the ancient Egyptians and Hippocrates when they used cauterization to induce scaring for laxity.  Modern-day prolotherapy was first described for orthopedic use in 1930 when an orthopedic surgeon injured his thumb and was told his surgical career was over.  Dr. Earl Gedney DO sought an alternative therapy that was used for abdominal hernia via using an irritating substance. Dr, Gedney later published the first article, “The Hypermobile Joint” published in 1937 – and termed the treatment “sclerotherapy.”

Prolotherapy was named by Dr. Hackett in the 1950s when he published a series of articles describing injection techniques for various musculoskeletal injuries such as ligamentous laxity and enthesiopathy.  In short, Prolotherapy is the injection of an irritating solution that stimulates an inflammatory response, producing a localized healing stimulus. Early injectates used were sodium morrhuate and various concentrations of hypertonic dextrose.

Neural-Prolo

Neural-Prolo, is also known as Neurofascial Prolotherapy (NPT).  Born from traditional prolo-therapy, Neural-Prolo is described as: Subcutaneous peri-neural injection of 5% dextrose. It was created by a New Zealand physician, Dr. John Lyftogt while he was treating a series of Achilles tendon injuries. Similar to how traditional prolotherapy helps strengthen loose ligaments and damaged tendons, Dr. Lyftogt discovered that a low concentration of dextrose (5%) in the subcutaneous tissue can help in resolving chronic nerve inflammation and restoring the normal physiology of the nerve cell.

Neuritis is also thought to be a contributing factor to chronic pain syndromes and why sometimes the pain continues even after the tissue has healed!  Nerves are the central processor of our bodies and our bodies respond one way or the other based on what the nerves are telling it to do. 

Neuritis can create a vicious cycle of inflammation: inflammation neuritis messes with the regular flow of impulses, switching direction of nerve impulses in the wrong direction and cause confusion!  These are transmitted vià blood vessels in nerves and surrounding tissues stimulating a release of excess neurohumoral mediator substance (the nerves are over-reacting as in panic) which cause a neurovascular vasdilation-edema-sterile inflammation neuritis.

When Do We Use Neural-Prolo?

NPT is a great treatment option that is typically used in conjunction with other Ortho-biologics. A good example of this is a knee injury to an ACL or MCL, which creates local tissue edema and intra-ligamentous neuritis. As an adjunct therapy, we can utilize Neural-prolo at the same time as treating the underlying issue such as sprain in other ligaments to address the original injury and subsequent neuritis that resulted from the injury.  We can also use it as a solo treatment, for example, post-operative pain after an invasive surgery often creates chronic neuritis and the patient continues with pain – this is a good time to use NPT as a solo therapy to help calm the nerves down to allow for pain reduction.

Upside

At the Centeno Schultz Clinic, our physicians are armed with years of expertise in musculoskeletal medicine. We know that no 2 patients are alike!   We take the time to examine, listen and understand your unique injury or condition to develop a comprehensive personal treatment plan designed to get you back to living your best life!

Doctors That Provide Neuro-Prolotherapy

Christopher J. Centeno, MD

Christopher J. Centeno, M.D. is an international expert and specialist in Interventional Orthopedics and the clinical use of bone marrow concentrate in orthopedics. He is board-certified in physical medicine and rehabilitation with a subspecialty of pain medicine through The American Board of Physical Medicine and Rehabilitation. Dr. Centeno is one of the few physicians in the world with extensive experience in the culture expansion of and clinical use of adult bone marrow concentrate to treat orthopedic injuries. His clinic incorporates a variety of revolutionary pain management techniques to bring its broad patient base relief and results. Dr. Centeno treats patients from all over the US who…

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John Schultz, MD

My passion and specialization are in the evaluation and treatment of cervical disc, facet, ligament and nerve pain, including the non-surgical treatment of Craniocervical instability (CCI). I quit a successful career in anesthesia and traditional pain management to pursue and advance the use of PRP and bone marrow concentrate for common orthopedic conditions. I have been a patient with severe pain and know firsthand the limitations of traditional orthopedic surgery. I am a co-founder of the Centeno-Schultz Clinic which was established in 2005. Being active is a central part of my life as I enjoy time skiing, biking, hiking, sailing with my family and 9 grandchildren.

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John Pitts, M.D.

Dr. Pitts is originally from Chicago, IL but is a medical graduate of Vanderbilt School of Medicine in Nashville, TN. After Vanderbilt, he completed a residency in Physical Medicine and Rehabilitation (PM&R) at Emory University in Atlanta, GA. The focus of PM&R is the restoration of function and quality of life. In residency, he gained much experience in musculoskeletal medicine, rehabilitation, spine, and sports medicine along with some regenerative medicine. He also gained significant experience in fluoroscopically guided spinal procedures and peripheral injections. However, Dr. Pitts wanted to broaden his skills and treatment options beyond the current typical standards of care.

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Jason Markle, D.O.

Post-residency, Dr. Markle was selected to the Interventional Orthopedic Fellowship program at the Centeno-Schultz Clinic. During his fellowship, he gained significant experience in the new field of Interventional Orthopedics and regenerative medicine, honing his skills in advanced injection techniques into the spine and joints treating patients with autologous, bone marrow concentrate and platelet solutions. Dr. Markle then accepted a full-time attending physician position at the Centeno-Schultz Clinic, where he both treats patients and trains Interventional Orthopedics fellows. Dr. Markle is an active member of the Interventional Orthopedic Foundation and serves as a course instructor, where he trains physicians from around the world.

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Matthew William Hyzy, D.O.

Doctor Hyzy is Board Certified in Physical Medicine and Rehabilitation (Physiatry) and fellowship-trained in Interventional Orthopedics and Spine. Dr. Hyzy is also clinical faculty at the University of Colorado School of Medicine in the Department of Physical Medicine and Rehabilitation; In addition, Dr. Hyzy is an Adjunct Clinical Assistant Professor at The Rocky Vista University College of Osteopathic Medicine. Dr. Hyzy also maintains an active hospital-based practice at Swedish Medical Center and Sky Ridge Medical Center. He is also recognized and qualified as an expert physician witness for medical-legal cases and Life Care Planning. He is published in the use of autologous solutions including…

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Brandon T. Money, D.O., M.S.

Dr. Money is an Indiana native who now proudly calls Colorado home. He attended medical school at Kansas City University and then returned to Indiana to complete a Physical Medicine and Rehabilitation residency program at Indiana University, where he was trained on non-surgical methods to improve health and function as well as rehabilitative care following trauma, stroke, spinal cord injury, brain injury, etc. Dr. Money has been following the ideology behind Centeno-Schultz Clinic and Regenexx since he was in medical school, as he believed there had to be a better way to care for patients than the status quo. The human body has incredible healing capabilities…

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Mairin Jerome, MD

Mairin Jerome, MD

Dr. Mairin Jerome is a physiatrist with subspecialty fellowship training in Interventional Orthopedics and Regenerative Medicine. This subspecialty serves to fill the gap for patients who are interested in therapeutic options that lie between conservative treatment and surgery. Dr. Jerome uses regenerative medicine techniques, including prolotherapy and orthobiologics, via X-ray or ultrasound guidance to precisely deliver injections to areas of musculoskeletal injury or degeneration. Orthobiologics refers to tissue harvested typically from a person’s own body, such as platelets (platelet-rich plasma, PRP) or bone marrow, for use in treating painful musculoskeletal conditions. The goal is to stimulate the body’s healing mechanisms to improve pain, function, and decrease inflammation.

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References
  1. Alderman D. A history of the American College of Osteopathic Sclerotherapeutic Pain Management, the oldest prolotherapy organization. J Prolotherapy. 2009;1(4):200-204.
  2. Gedney E. Special technic: hypermobile joint: a preliminary report. Osteopathic Prof. 1937;9:30-31
  3. Hackett GS. Ligament Uninhibited reversible antidromic vasdilation in brochiogenic pathophysiologic disease. Lancet. 1966;86:398-404.
  4. Hackett  GS. Ligament relaxation and osteoarthritis, loose jointed versus close jointed. Rheumatism. 1959;15:28-33.
  5. Hackett GS, Huang TC, Raftery A. Prolotherapy for Headache. Pain in the Head and Neck and Neuritis. Headache. 1962;3-11.
  6. Hackett GS, Huang TC. Prolotherapy for sciatica from weak pelvic ligaments and bone dystrophy. Clinical Medicine. 1961; 8:2301-2316.
  7. Hackett GS. Uninhibited reversible antidromic vasdilation in pathophysiologic diseases: arteriosclerosis, carcinogenesis, neuritis and osteoporosis. Angiology. 1966;17, 2-8.