Feb
18
2018

Causes Of Back Pain And Their Treatment

There are many possible causes of back pain and their treatment is described in this blog. I have listed the 10 most common causes of back pain below. I also added brief therapeutic suggestions.

Facet joint disease (lower back strain)

When there is a misalignment of the facet joints, the joint capsules of these small joints are pulled, which can cause severe back pain. Chiropractic or physiotherapy treatments initially followed by active exercises will help (facet joint pain).

Degenerative disc and facet joint disease

Degenerative changes of the disc material between vertebral bodies and osteoarthritis of the facet joints can cause back pain. This is due to irritation of the nerve roots. Anti-inflammatory medication and physiotherapy treatments often help; swimming will be beneficial as well. End stage intractable disease, if confined to one or two levels, may respond to fusion surgery by a spinal surgeon. While you research the surgical option, I suggest you investigate about the possibility of stem cell therapy with PRP (platelet rich plasma). This is less invasive and will likely heal better than conventional surgery.

Spondyloarthropathies

This is a family of chronic inflammatory joint diseases of the spine . The physician treats the underlying disease and uses anti-inflammatories to control inflammation. Most of all, a person with this condition needs a referral to a rheumatologist for more specific therapy.

Osteoporosis

Osteoporosis is a bone condition that can lead to compression fractures of the spine. These in turn can irritate one of the nerve roots to lea to radiating pain into one or both legs. The physician will treat the underlying hormone disbalance, if present. Regular walking and swimming are used to remobilize. Avoid alcohol, caffeine and stop smoking. Supplements like calcium, bisphosphonates, vitamin D in higher doses and vitamin K2 can help re-calcify the bone.

Scoliosis

Scoliosis is often congenital. This spinal curvature leads to back pain and hurts more the more the spine is curved. Treatment: bracing during growth spurts; good posture; strengthening exercises; in severe cases corrective surgery by a spinal surgeon through the use of Harrington rods.

Spinal stenosis

Spinal stenosis is often the end condition of severe degenerative arthritis of the spine. It is more common in the older generation. As this link explains, there is a narrowing of the channel through which the spinal cord travels. In the past decompression surgery for severe cases was the only means to free spinal cord and nerve roots. In the last few years stem cell therapy is a new addition as an alternative to orthopedic surgery. The advantage of stem cell therapy is that there is no scarring following the procedure and the stem cells function like a biological knife from inside.

 Posttraumatic fibromyalgia

Some people develop lower back pain following traumatic injuries. Instead of resolving their muscle sprain, they end up with chronic pain. Often low dose antidepressants and cognitive therapy will help. Mild physical exercises may help to rehabilitate the patient and return to normal muscle mobility. Unconventional therapy like prolotherapy, dry-needling and low-dose laser therapy (Dr. Weber) may be useful.

Disc herniation with or without sciatica

With disc herniation the back pain is intense, which often prompts the orthopedic surgeon to do an early discectomy (back surgery). But long term studies have shown that only in 3% of all acute back pain cases surgery is necessary; many cases heal on their own. In this case the new regenerative medicine approach of stem cell therapy with PRP will give superb clinical results. Stem cells will rebuild the disc and also take care of any arthritis in the small joint along the spine.

Spondylolisthesis and other congenital malformations

There are 4 grades of slipped vertebral body diseases (spondylolisthesis), where grade IV is the most severe case. Grade I to IIIA do not need surgery, stage IIIB and IV need fusion with instrumentation by a spinal surgeon.

Bone metastases

In stage 4 of many cancers metastases travel through the whole body including the skeleton. The underlying cancer needs treatment, often chemotherapy is required. Unfortunately cancers with bone metastases have a very poor prognosis. Here is a link how to manage symptoms of bone metastases.

Causes Of Back Pain And Their Treatment

Causes Of Back Pain And Their Treatment

Conclusion

I have listed the ten most common ones of back pain. For muscle spasms, simple physiotherapy or chiropractic treatment are often very helpful. Early degenerative changes in joints and discs will often respond to anti-inflammatory medication. But anti inflammatory drugs can be hard on your liver and your kidneys. If your back pain is getting more chronic, your doctor may want to arrange for an MRI scan of the area that causes pain. If this shows degenerative change in the discs and facet joints it is time to contact a regenerative medicine clinic. They specialize in stem cell and platelet rich plasma (PRP) treatments. This may be what you need to restore your back to normal. Conventional surgical methods are often the choice, but they are not always successful. Surgery can leave scarring behind, which by itself can give you chronic back pain.

Feb
03
2018

Drugs Are Not An Escape

We have a drug epidemic, but drugs are not an escape. Along with this epidemic there have been thousands of lethal overdoses. I like to review why so many people use street drugs or prescription pain pills. It started years ago with heroin injections had become more popular. But then heroin was getting a bad name, it became illegal, and prescription pain pills replaced heroin. Percocet, OxyContin and morphine prescriptions took off. Together with it the number of people with addiction increased drastically. The latest fashion craze is Fentanyl.  Fentanyl works faster than morphine, but also wears off faster. One of the deadly side effects is respiratory depression. This  means that a person cannot breathe and as a result will die. This is what is happening right now and what creates the news headlines.

Pain receptors

There are pain receptors all over the body, in muscles, organs and the skin. They are called nociceptors. Many medical conditions lead to pain in various parts of the body. For instance, with end stage degenerative arthritis bone rubs on bone. This causes a lot of pain in joints like the knees or the hips. Physicians often prescribe narcotics like OxyContin to control the pain. It may help for some time. But after a few weeks patients complain that the strength of OxyContin has worn off. The same dosage that gave them relief from the pain initially just does not give them relief any more. This observation is crucial. It is exactly what people who use OxyContin as illicit street drug found as well. The drug wears off, because the opioid receptors are getting weaker.

Pain receptor resistance

Nociceptors or opioid receptors are pain receptors. These receptors report pain to the body, and they have connections through the spinal cord to the brain. When an opioid is interacting with the pain receptor it inhibits acute pain to a large extent. But when the pain becomes chronic, the pain receptor is not working as well. More and more of the pain medication is necessary to achieve pain relief.  Eventually the opioid medication is not working to relieve pain any more. The name for this phenomenon is “pain receptor resistance”. Scientific work behind why pain receptors get lazy in responding to opioids is still ongoing. In the meantime it simply is an observation. This is the reason why drug addicts are tending to increase the dosage of OxyContin or of Fentanyl. The toxic threshold of Fentanyl that is exceeded in the process is the reason for the deaths.

Insulin resistance

You may have heard of insulin resistance in diabetics. This is a very similar problem. With insulin resistance the diabetic no longer has a 100% response to insulin. This means that blood sugar is not going through cell membranes effectively as it should when the insulin receptor is working. The blood sugar values stay high and make the diabetes worse.

With pain receptor resistance the opioid is not giving the relief from pain it used to give. No wonder that the patient is feeling frustrated that the pain medication is no longer working properly.

Therapeutic index

The layperson does not normally know that there is a dosage for any drug where it becomes toxic. There is also a lower dosage where the drug is becoming effective. The difference between the two dosages is the “therapeutic window” or the “therapeutic index”.

Morphine has a therapeutic index of 70:1. Compare that to alcohol with a therapeutic index of only 10:1. Fentanyl has a therapeutic index of 300:1.

The danger of Fentanyl

One would think that Fentanyl should be safer than morphine, because the therapeutic index is larger. But the onset of Fentanyl is much faster than that of morphine and by the time drug users take Fentanyl they often are desperate for the drug to take their pain away and they overdose, which causes respiratory depression. If they are not intubated by an anesthetist and connected to artificial respiration, they die very quickly. Janssen Pharmaceutica first developed Fentanyl in 1959. Fentanyl was strictly part of the pre-anesthetic medicine for patients before going into surgery requiring a general anesthetic. The anesthetist was right there and would intubate the patient. That’s why we never heard of deaths from Fentanyl in the past.

If a person gets no pain relief from any opioid because of receptor resistance, the tendency is to increase the dosage. But this is what pushes the person into toxic ranges and this is what causes death from inadvertently suppressing the ability to breathe. People can get into trouble with alcohol overdoses, but the ordinary person usually knows how to handle alcohol. Fentanyl is a lot different due to the fact that respiratory depression (not being able to breathe) is one of the early symptoms that hits you suddenly.

What drugs do to your brain

Dr. Daniel Amen, a psychiatrist and brain researcher has used SPECT brain scans to produce images of different clinical conditions. This link shows the effect of a stroke, of Alzheimer’s disease and of drug abuse on the brain. Dr. Amen says that a brain can be rehabilitated. He has other SPECT images showing the images of an addicted brain and that of a rehabilitated brain. Spect scans are expensive.  But they may be worth it, to impress a drug addict to stop the drugs and get rehabilitated.

Big Pharma and opioid drugs

In 1995 the FDA approved the use of OxyContin for chronic pain. Perdue Pharma, the drug company that had developed this opioid convinced the FDA that OxyContin stayed in the blood for 12 hours and they claimed that by being active longer than other opioids this would lead to better pain control and less addiction. It turns out that this was a slick sales pitch, however it was not true. Pain receptor resistance is as much a problem with OxyContin as with any other opioid. And the drug is as addictive as all the others. But the problem is that the FDA had approved OxyContin. What’s more, Purdue Pharma sent aggressive drug representatives to all the practicing physicians misleading them as well as the FDA that OxyContin would not be as addictive as other opioids.

Penalty for misrepresentation of OxyContin

In 2007 Purdue Pharma had to pay a fine of 634 million $ for misrepresenting the addiction potential of OxyContin. But the drug company was allowed to continue to market OxyContin. Since 2015 Purdue Pharma has been cashing in 2.4 billion $ annually from the sales of opioids including OxyContin. In the meantime Fentanyl, despite its danger of suppressing the ability to breathe, has taken off with regard to sales. Fentanyl also has taken over in terms of causing deaths across the US and other countries.

Alternative treatment of pain

According to Ref. 1 chances are that 70% of patients with back pain will get better with a few visits to an acupuncturist. In 1972 Dr. Ulett’s laboratory at the University of Missouri succeeded in getting the first NIH research grant for the study of acupuncture in the US. During these studies they found remarkable facts, the most important perhaps that electrical stimulation of acupuncture needles resulted in a doubling of the effectiveness of traditional Chinese acupuncture. After extensive research Dr. Ulett stated: ”The ancient practice of traditional Chinese acupuncture is now obsolete” (Ref.1). in the meantime the more effective electro-acupuncture has replaced acupuncture needles with the use of electrical skin pads.”

Other applications for electroacupuncture

Beside pain relief many other applications exist for electro-acupuncture. Addiction medicine makes use of electro-acupuncture in weaning people from morphine or heroine etc. It is effective to treat psychiatric illness, particularly depression. It is useful in relieving nausea and vomiting due to chemotherapy with cancer treatments or associated with pregnancy without affecting the pregnancy.

Prolotherapy

Prolotherapy has been successful for the treatment of back and neck pain, for arthritic pain and pain from chronic muscle spasm. When prolotherapy is done by itself 12.5% Dextrose is injected into the area of injury. Dr. Fields said that the reason it works is that there is activation of local stem cells in the injured area in the area of the Dextrose injection site. These stem cells will do the healing (details explained in an interview with Dr. Reeves). Further improvement of this technique and better results are possible by injecting a small amount of platelet rich plasma (PRP) very focally to an area of ligament rupture. PRP is obtained by centrifuging blood from the patient’s vein. The red blood cells are not necessary, but the platelet fraction and some of the plasma are part of the the PRP preparation.

It is often striking how much pain control occurs after only one or two prolotherapy treatments.

Stem cell therapy with PRP and low-dose laser therapy

This is a more direct way to get stem cells where the doctor wants them to do their work. Stem cell therapy with PRP and low-dose laser activation is the latest in terms of controlling pain. At the 22nd Annual Anti-Aging Conference in Las Vegas (Dec.10 to 14, 2014) Dr. Purita gave an overview of this method of pain control. He discussed the importance of the proper harvesting of PRP. He explained that apart from white blood cells (WBC) and platelets an important component of PRP are very small embryonic like stem cells (VSELs). They are visible through the microscope. The missing link has been the observation that white blood cells produce inflammatory substances, which have been detrimental in stem cell injections with PRP in the past. There was a poor survival rate of stem cells.

Low dose laser activation of stem cells and PRP

Photo-activation of the PRP before injection leads to anti-inflammatory behavior of the WBC in PRP. Dr. Purita calls this “light activated PRP”, which leads to the best results with stem cell/PRP injections.

Soft laser stimulation with red, green and blue soft lasers have also been effective to improve tissue healing significantly when stem cells and PRP are used together with light activation. The main sources for good stem cells are the fat tissue (from the “love handles”) and the bone marrow (obtained from pelvic bone). The stem cells mesenchymal stem cells (from fatty tissue) and bone marrow stem cells. The mix of all of this can mend osteoarthritic joints, degenerative disc of the spine, in short all musculoskeletal injuries that may be painful. The hallmark of healing with stem cells is that chronic pain disappears.

Curative treatment versus symptomatic treatment

It is one thing to treat a patient for pain symptomatically by prescribing OxyContin or other opioids. It is a completely other thing when the physician cures the pain by one of these alternative methods. Let us assume that a patient has a fall of a few step from a ladder and sustains a contusion of the lower back. This can be painful and may require a few pain pills. But if it does not improve within one week and diagnostic tests show that there is no fracture, electroacupuncture may be the solution to treat the pain rather than the use of an opioid. If this does not help, consider the combination stem cell/PRP/low-dose laser therapy. Chances are better than 80% that this will help. The patient will no longer suffer of pain. With healing life can go on: no pain pills. No addiction. No death.

Drugs Are Not An Escape

Drugs Are Not An Escape

Conclusion

Conventional medicine treats pain symptomatically instead of treating the cause. It gets the physician to prescribe opioids, which can be the beginning of a series of tragic events. It can lead to drug addiction, dose acceleration, toxic effects of opioids including possible death through asphyxiation from no longer being able to breathe.

Stem cell therapy

The physician who concentrates on treating causes will use alternative methods to treat pain. The most effective of these methods is stem cell therapy. It is a mixture of adipose mesenchymal stem cells with bone marrow stem cells that are part of the therapy. The addition of platelet rich plasma is another part of the mix, and the final step is activation of stem cells with low-dose laser therapy. The cell mix is injected in the critical area. The end result is that the patient’s pain disappears, and it leads to a cure. The only situation where short-term opioids are justifiable is following surgical procedures. But even in these cases the narcotics should only be necessary for a few days to avoid serious side effects.

Reference 1: George A. Ulett, M.D., Ph.D. and SongPing Han, B.M., Ph.D.: “The Biology of Acupuncture”, copyright 2002, Warren H. Green Inc., Saint Louis, Missouri, 63132 USA

More info about electroacupuncture: https://www.askdrray.com/electro-acupuncture-twice-as-effective-as-conventional-acupuncture/

More about prolotherapy stem cell therapy: https://www.askdrray.com/prolotherapy-and-stem-cell-therapy/

Incoming search terms:

Dec
09
2017

Stem Cells Cure Back Pain

A person with chronic back pain has several treatment options, but only stem cells cure back pain. Stem cell treatment has been available in the US and Canada and many other countries for approximately 10 years.

I come from a family with a strong history of back pain (mother, maternal grandmother and maternal grandfather). They all got their back pain in their mid to late 40’s. From my growing up years I remember that they complained about chronic back pain on and off. Sometimes they had to cancel events they wanted to attend because they could not tolerate sitting. In those times there were no CAT scans or MRI scans. If you had back pain, you just had to put up with it.

My personal experience

Given my family history of back pain I was surprised that my back pain was only a more persistent problem in the last 1.5 years, but not earlier. Normally a monthly chiropractic adjustment would keep my back symptoms under control. But in the last 1.5 years I needed to see a chiropractor more often than that. I took omega-3 fatty acid supplements for the past several years (two capsules twice per day) thinking that this should halt the development of degenerative arthritis in the lower back joints. When I turned 71, it was clear to me that I was now at the point where my immediate relatives were when they were in their late 40’s. Therefore, diet, exercise, weight loss, good nutrition and supplements can only do that much for you. If there is a familiar disposition, it will eventually catch up with you.

Conventional medicine’s approach to lower back pain

I have practiced as a general practitioner for 16 years in the past. In addition I joined Workers’ Compensation for another 16 years as a medical advisor. From this clinical activity I knew of hundreds of cases first hand what the steps were in the treatment of chronic back pain. First of all, physiotherapy treatments or chiropractic treatments were the treatment protocol. In minor back pain cases this would often help the pain symptoms. Furthermore, if residual pain persisted, the patients received anti-inflammatory medication (non-steroidal anti-inflammatory drugs or NSAID’s). Finally, if symptoms continued to persist, a CT scan or MRI scan was necessary for assessment. If it showed moderate changes like my findings, the patient received intermittent physical therapy, chiropractic therapy or acupuncture therapy. 

Surgical procedures for chronic lower back pain

If there were more severe degenerative changes or spinal stenosis with severe degenerative changes, a referral to an orthopedic surgeon or neurosurgeon would be necessary. But this was often the point of no return. If the surgeon felt that the condition was severe enough to do back surgery, various procedures could follow. For disc herniations irritating one of the nerve roots, laparoscopic discectomy was the treatment of choice. For severe spinal stenosis or intractable pain from end stage facet joint disease instrumentation was an option.

Fusion surgery

Under a general anesthetic the surgeon makes an incision in the patient’s back over the lumbar spine. The surgeon identifies the diseased disc level and places stabilizing stainless steel plates over the affected facet joints or the narrowed disc space. Many people think that fusion surgery would be the end of their trouble. In many cases this can actually be the beginning of chronic back trouble. The problem is that the body is designed to move. If the surgeon takes movement away in one area of the spine, the levels above and below have to work harder. It often takes only a few months or a couple of years, and the patient is back with excruciating pain from degenerative changes in the levels above and below the previous surgery. What does the surgeon usually do? He does more fusion surgery above and/or below the previous area of surgery.

Alternatives to back surgeries

New treatment options have opened up new possibilities. On the one hand there is prolotherapy treatment that I have described under this link. On the other hand stem cell therapy is another popular regenerative technique. Prolotherapy strengthens tissues, relieves pain and increases the range of motion in joints. There is 80 to 85% full pain relief and more than 80% improvement in range of motion. Prolotherapy promotes the healing of torn ligaments and tendons. There are many suitable conditions that lend themselves to the treatment with prolotherapy like the hip, knee, shoulder, ankle, neck, lower back and elbow. With prolotherapy the physician uses hyperosmolar dextrose injections into the affected area. Current thinking is that this irritates the tissues, which mobilizes local stem cells to heal the area.

In my case I had two prolotherapy treatments of my lower back, but it did not change my lower back pain.

MRI scans of my lumbar spine

We needed to find out what was happening in my lower back. My general practitioner ordered MRI scans of my lower back in summer of 2017. There are 5 levels of the lumbar spine from L1 to S1. In my case one level of 5 was normal. The other levels showed bulging of the discs. The scans also showed signs of arthritis in the small joints adjacent to the spine. Lucky for me, there was no sign of spinal stenosis. It was not good news: overall 4 levels of my lumbar spine showed signs of  degenerative disc changes. At the same levels I also had arthritic changes in the facet joints. This was enough to consider some intervention, or I would be headed for trouble in the future.

Stem cell treatment for chronic back pain

Following the failed prolotherapy for my lower back pain I needed to figure out what to do next. The MRI scans had shown degenerative changes in the discs of the lower 4 levels of the lumbar spine. There also was arthritis in eight facet joints (two on each side of each of the four L2 to S1 levels). Conventional medicine would have offered corticosteroid injections into the facet joint areas. My experience with many patients who had this procedure was that the effect of the corticosteroid injections wore off after 3 to 6 months. If a patient had more than 3  injections, there usually was a point of no return, and fusion surgery would be next.

Best therapy for my own chronic lower back condition

For me there was no question that stem cell therapy would be the best fit for treating my back condition. In addition platelet -rich plasma and low-level laser therapy could activate the stem cells. This would be the ideal non-invasive treatment option to treat my chronic lower back pain. I had met Dr. H. Michael Weber before. He is a well-known laser expert from Germany who has a double certification as an engineer and as an internist treating various clinical conditions with laser and stem cell therapy. In addition he is an expert of regenerative medicine methods. Also, he invented and designed the laser machines himself. I set up an appointment in the fall of 2017 at his clinic in Lauenförde, Germany.

First day of stem cell treatment

On the first day fat tissue was removed under a local anesthetic from my lower left buttock area. Next a cell separator divides the tissue into connective tissue, fat cells and mesenchymal stem cells. Two blood samples were also taken from me for processing platelet rich plasma (PRP). PRP is a natural stem cell activator. Growth factors and anti-inflammatory cytokines were also part of the mix together with the stem cells.

The very same afternoon I received the stem cell mix by injection. Eight needles, four on each side, were necessary to administer the stem cell combination. I also had a treatment on a light therapy bed with red light to activate stem cells in general. The stem cell injection was a pain free procedure, as I received a shot of a  local anesthetic in the area before. After that the physician inserted laser applicators through the interstitial needles.

Laser activation of injected stem cells

The next step was to use laser treatments with 5 different colors (infrared, blue, red, yellow and green) for 10 minutes for each of the 8 interstitial needles. The laser activation and the PRP mixed with the mesenchymal stem cells were the two main stem cell activators. They are crucial for activating the stem cells. But growth factors and anti-inflammatory cytokines also aided stem cell activation.

Second day of stem cell treatment

On the second day I received an infrared light treatment over my back for 20 minutes. Following that I received light therapy bed treatment for 20 minutes. The physician told me  that all of this was to activate the stem cells further. The next step was a bone marrow low-dose laser therapy.

Bone marrow stem cell activation by low-dose laser therapy

Often stem cell therapists mix mesenchymal stem cells from fat tissue with bone marrow stem cells which they harvest before from pelvic bone marrow. Dr. Weber told me that he would do a direct bone marrow laser activation of the pelvic bone marrow instead. He anesthetized the tissue above the pelvic bone. Following this he made a small hole into the pelvic bone through which he inserted a laser applicator into the bone marrow cavity. 5 different colored lasers were again applied for 10 minutes each to activate the bone marrow stem cells. Studies have shown, as Dr. Weber stated, that low-dose laser activates bone marrow stem cells. They can be found in the blood circulation within 1 hour. This is similar to mixing stem cells in a Petri dish and then injecting it as a mix, except it is a less invasive approach.

Further activation of stem cells

Following these procedures Dr. Weber felt that another light bed therapy was necessary for 20 minutes. He also gave me a Weber medical laser watch called “Regenerate+”. This device fits on the wrist. It is programmed to generate a number of different lasers to shine against the underside of the wrist. This is the area where the ulnar and radial arteries run close to the surface. This device will shine the laser lights for 30 minutes, and the laser light reaches the arterial blood. The circulating stem cells from the stem cell therapy are receiving a further boost this way. Dr. Weber told me to use this device twice a day on an ongoing basis. The Weber medical laser watch stimulates the immune system.  Jet lag also responds to, and it can stimulate stem cells as they circulate in the blood.

Stem Cells Cure Back Pain

Stem Cells Cure Back Pain

Conclusion

Medical tourism is flourishing. I have become a medical tourist myself because I did not want to get crippled by conventional medicine regarding my lower back pain. Two days after my stem cell treatment my back pain was significantly improved. There was mild pain in the area of the fat liposuction site. Four days after the treatment the lumbar spine pain was gone. Innumerable chiropractic treatments and two prolotherapy treatments had not given me relief. Now stem cell therapy in Germany has taken my chronic back pain away in only a few days. I realize that the healing process will take 3 to 6 months to complete, but as a patient what counts most is pain relief.

What, if someone criticizes me for choosing stem cell treatment?

It is difficult to argue with success. Whether somebody criticizes me for having followed a non-conventional treatment protocol does not matter to me. My question back would be: what do you do when conventional methods fail? Are you willing to suffer chronic pain and swallow pain pills that could either get you addicted or have serious side effects? I would try stem cell therapy again, if I had a problem that does not respond to conventional therapy.

Incoming search terms:

Jul
08
2017

Stem Cells For Osteoarthritis

Many clinicians have used stem cells for osteoarthritis of the knee or other joints for some time. However, objective publications about the effectiveness of stem cells are only coming out now. Both stem cell types, derived from fat or stem cells from the bone marrow, are effective. Most doctors are using stem cells from fat (mesenchymal stem cells), because they are so much easier to harvest.

CNN reported about a man, Bill Marlette who had lost one of his arms in the past. He ended up overusing the other arm and as a result developed end-stage osteoarthritis in his wrist. He could not find relief with conventional methods of anti-inflammatories and pain pills. Next he went to a stem cell expert in Munich, Germany who treated him with mesenchymal stem cells from his fatty tissue. Only one treatment took away his chronic pain and helped him regain his wrist mobility.

Approval of stem cell therapy in Germany

Prof. Dr. Eckhard Alt, an expert in regenerative medicine has previously treated patients with end stage osteoarthritis and had good clinical outcomes with it. As a result the German regulatory agency has approved his treatment protocol.

Dr. David Pearce, executive vice president for research at Sanford Health in South Dakota said that Prof. Dr. Eckhard Alt was the first one to use fat cells as a source of mesenchymal stem cells to treat osteoarthritis. He went on to say: ”Those stem cells don’t have to be programmed in any way, but if you put them in the right environment, they will naturally turn into what the cell type around them is.” The physician harvests the stem cells through liposuction. An enzyme mixture is necessary to separate the stem cells from fat cells, oil and connective tissue. A cell separator can also help separating the stem cells from the rest of the cells and tissue.

A case of wrist osteoarthritis

As I mentioned before only one injection was necessary to relieve the chronic pain of Bill Marlette’s wrist. Since his return the doctors in the US have followed Bill closely. They took MRI scans and noted that the bony cysts associated with the severe arthritis have disappeared. His wrist and hand strength have returned to normal. The pain almost disappeared. There were no side effects whatsoever. Because the stem cells are of the same tissue type as all his other cells of his body, one would not expect any tissue rejection by the immune system. Bill Marlette did not need any pain pills following the procedure in August 2016. And he says: “I have more range of motion with my wrist, shaking hands didn’t hurt anymore,” he said. “My wrist seems to continue to improve, and there’s less and less pain all the time.”

Past experiences treating osteoarthritis with mesenchymal stem cells

A 2014 clinical trial from Korea involved 18 patients with osteoarthritis of the knee where adipose mesenchymal stem cells were injected. The high dose group did best. After 6 months there was significant improvement, also confirmed by arthroscopy. The previous cartilage defect in the femoral and tibial condyles had decreased in size. Range of motion in the knee joints and pain had also improved. There were no adverse effects from the treatment.

Chinese study

Mesenchymal progenitor cells have the propensity to develop into cartilage. At the Shanghai Medical College, Fudan University Shanghai, China the following experiment took place in 2015. The researchers grew human adipose mesenchymal cells in vitro. Later they injected these mesenchymal progenitor cells into the knees of rabbits with experimentally produced osteoarthritis. Despite doing xenotransplants (human cartilage to rabbits) with known HLA differences the cartilage grew and cured the osteoarthritis of the rabbits. The new cartilage had human HLA markers while the rabbit cartilage underneath had rabbit HLA markers. At 16 weeks the researchers examined the tissues under the microscope and another exam involved the HLA marker testing.

Tehran study

A study from Tehran, Iran was carried out on 18 patients with ankle, knee and hip osteoarthritis in 2015. Physicians injected stem cells from the bone marrow into the osteoarthritic joint. The doctors followed the patients and ordered occasional MRI scans for 30 months. All of the patients had improved significantly with regard to their joint function and pain. The MRI scans also showed thickening of the joint surfaces from new cartilage production.

French/German study

In a 2016 joint French/German study 18 patients with end stage knee osteoarthritis were treated with stem cells. The stem cells came from adipose tissue that went through a cell separator. Physicians injected the mesenchymal stem cell fraction into the osteoarthritic knees. This was a phase I study to rule out any adverse reactions, but none were evident. It also established that there were significant positive improvements in pain and mobility with regard to the affected knees.

General remarks about how stem cells heal osteoarthritis

The example above with end stage osteoarthritis of the wrist was just one example of where osteoarthritis can strike. Perhaps the more common other locations are hips, knees and the facet joints of the lower lumbar spine (causing chronic lower back pain).

The same treatment procedure, which Bill Marlette’s wrist benefitted from is useful for all these other locations. The common factor in osteoarthritis is that the cartilage is getting thinner and thinner until bone rubs on bone causing excruciating pain. It is here where mesenchymal cells can come to the rescue. The stem cells will assess what requires a repair after injection into an affected joint. They recognize that there is a lack of cartilage. Then they transform themselves into chondrocytes, which are cartilage-forming cells. How can stem cells do that? They come with a program to replace missing cells, particularly cartilage and bone cells. But if they are within fatty tissue, they cannot act within a joint that has osteoarthritis. The doctor has to transport the mesenchymal cells into the joint where they can then begin their healing function.

Other methods to treat osteoarthritis

Stem cells are only one of several regenerative treatment modalities for osteoarthritis. Another method are platelet-rich plasma (PRP) injections. Platelets have a lot of anti-inflammatory substances in them and also growth factors that can stimulate stem cells contained in the synovial membrane, the lining of any joint. To get PRP plasma, it is necessary to spin down blood and harvest the PRP fraction with a syringe. After three PRP injections were given into the knees of 90 patients with end stage osteoarthritis these patients were followed for two years.

In the beginning before treatment 100% of the patients had symptoms. After one year following the treatment with PRP their knee functions were normal in 67% of them. After two years only 59% had normal knee function. The investigators pointed out that this treatment modality initially helped to a certain point, but then the effects were slowly fading away.

Stem cell treatment of osteoarthritis of the knee

The literature on either bone stem cells or fat stem cell use for osteoarthritis of the knee in man is still sparse. Nobody has done larger clinical trials. Part of the reasons could be that total knee and total hip replacement in orthopedics is very lucrative. We are still in a symptomatic treatment mode. Physicians treat osteoarthritis conservatively with anti-inflammatories and pain pills. When bone rubs on bone, there can be excruciating pain. The physician refers the patient to an orthopedic surgeon who likely will do invasive surgical procedures. My own impression in general practice in the past is that these procedures do not always turn out the way they are supposed to work. Following total hip or knee replacement joint swelling often remains; pain issues are still there. There can be unequal height issues, balancing problems and so on.

Here is a review of mesenchymal stem cell therapy for osteoarthritis.  This publication is very conventional medicine. An attitude change by conventional medicine would be useful to catch up with what is happening in real life. Some patients will travel abroad to Munich as Bill Marlette did. But others may travel to other places like India, Mexico or wherever medical tourism takes you. Regenerative medicine is there to stay.

Stem Cells For Osteoarthritis

Stem Cells For Osteoarthritis

Conclusion

We have learnt about a case of severe osteoarthritis of the wrist that has been cured in Germany with one injection of mesenchymal stem cells. More common than wrist osteoarthritis is osteoarthritis of the hips, knees and the facet joints of the lower lumbar spine. The same stem cell therapy can be given for osteoarthritis in these locations. I find it very strange that progress in stem cell treatments is so slow in the US. The FDA has decided to be open to clinical trials with stem cell treatments, but progress seems to be much slower than in other countries. Why? We may never know. In the meantime, patients may seek treatments in other countries where such treatments are offered. In real estate sales there is a saying: “Buyer beware”.

Be cautious, if you get treated abroad

The same goes for stem cell treatments in another country. Should you contemplate doing this, do your homework; ask about the qualification of the treating physician, about safety records and whether the local authorities have approved this procedure. In the case of Bill Marlette’s osteoarthritis of the wrist the procedure in Munich, Germany had been accepted by the European equivalent of the FDA, the European Medicines Agency. Safety is top priority, effectiveness is next.

Incoming search terms:

May
05
2017

New Treatments For Premenstrual Syndrome

Dr. Pamela W. Smith gave a talk about new treatments for premenstrual syndrome (PMS). She presented this talk on Dec. 11 at the 24th Annual World Congress on Anti-Aging Medicine (Dec. 9-11, 2016) in Las Vegas that I attended. The original title was “New Treatment Modalities for PMS”.

Signs and symptoms of PMS

Dr. Smith discussed signs and symptoms of PMS first. She showed 9 slides where she listed all of the symptoms of PMS that commonly occur.

Symptoms are varied; they can mimic various psychological problems like anxiety, depression, panic attacks and more. But physical symptoms like abdominal bloating, acne, back aches, and asthmatic attacks are also common. There are a myriad of more symptoms of PMS: constipation, cramps, clumsiness, dizziness, drowsiness, decreased sex drive, facial swelling, forgetfulness, fatigue, headaches, a herpes-like outbreak, hot flashes, sensitivity to light and noise, insomnia, joint pains, mood swings, palpitations, restlessness, poor memory, sore throat, tearfulness, vomiting and weight gain.

What do we know about PMS?

PMS is due to a hormone dysfunction

There is no definitive test that would help in the diagnosis of PMS. But we do know that there is a hormone dysfunction that leads to a monthly recurrence of symptoms during the two weeks prior to the woman’s menstruation. When her period begins or shortly after all of these symptoms disappear.

PMS due to estrogen dominance

PMS is very common; 70to 90% of women have a certain degree of PMS. In 20 to 40% of women symptoms are severe. Many researchers have shown that there is a problem in the feedback loop between the pituitary gland and the ovaries. This leads to a decrease of progesterone production in the ovaries. The result is an overabundance of estrogen, which many hormone experts call estrogen dominance.

Several hormones need checking with PMS

But things can get complicated when other hormone changes occur. A woman may also turn hypothyroid. When she gets closer to menopause estrogen deficiency may also develop. Electrolyte disturbances can occur from high estrogen levels causing excessive aldosterone levels. This would lead to high sodium and low potassium blood levels. The end result may be an activation of the renin-angiotensin system, which could cause high blood pressure.

Neurotransmitters of the brain can be involved in PMS

Neurotransmitters are often disbalanced. When serotonin is low in the brain, depression can develop. Noradrenalin deficiency leads to a lack of focus, energy and memory.

Women with PMS often have hypoglycemia

Hypoglycemia is also common among women with PMS. This may be due to cravings for sweets and consumption of starchy foods. Women who crave sweets may also consume caffeine excessively. But caffeine increases prostaglandin production in the body. This leads to breast tenderness, abdominal cramping, arthritis and back pains.

PMS after partial hysterectomy

A partial hysterectomy can cause PMS in a woman who never before had symptoms of PMS. The current school of thought is that blood supply to the ovaries after a hysterectomy has decreased, and this could be the reason for the onset of PMS.

Birth control pill can cause PMS

The birth control pill can bring on PMS due to the progestin component in it.

Tubal ligation may cause PMS

Tubal ligations can also be a cause: 37% of women who had tubal ligations develop PMS. The reason is a change in hormone production. In these women estrogen is produced to a higher degree than progesterone is.

Lab tests for women with PMS

Although there is no single test that would be able to diagnoses PMS, a variety of abnormal tests are often abnormal in association with PMS. Frequently there is deficiency for vitamin A, B6, E, magnesium, potassium, zinc and trace minerals. Calcium can be too high or too low, but blood tests will reveal that.

Four PMS types

Dr. Smith said that PMS has been divided into 4 subcategories depending on the main symptoms.

  • Anxiety: PMS A
  • Carbohydrate craving: PMS C
  • Depression: PMS D
  • Hyperhydration: PMS H

PMS A is associated with estrogen excess and progesterone deficiency. There is a diminished stress response in the hypothalamus/pituitary/adrenals axis. Symptoms are mainly anxiety, irritability, insomnia and emotional lability.

PMS C is associated with sugar craving, hypoglycemia, headaches, heart palpitations and spontaneous sweating.

PMS D is leading to increased neurotransmitter degradation. Symptoms consist of depression, crying, despair, feeling hopeless, fatigue, low libido, apathy and insomnia.

PMS H is caused by increased aldosterone activity triggered by estrogen surplus in the late luteal phase. Symptoms are weight gain, swelling of hands and feet, a feeling of bloating, breast tenderness or engorged breasts. Women will find that their clothes simply fit tighter.

Migraine headaches in PMS

Some women with PMS are plagued by migraine headaches. It may have started in puberty or after taking birth control pills for contraception. Sometimes the onset is after a pregnancy, miscarriage or abortion. When PMS develops and a woman has migraines, they usually occur around the same time in her menstrual cycle. With pregnancy the migraines disappear in the last trimester when progesterone hormone production from the placenta is the highest.

Hormonally related headaches can occur for 4 main reasons.

  1. Estrogen and progesterone are on the rise around the time of ovulation
  2. When a woman has hypoglycemia (due to hyperinsulinemia)
  3. Estrogen levels are changing
  4. When there is estrogen dominance

Treatment for PMS

Dr. Smith explained in detail the various treatment modalities for PMS. Treatment has to be personalized according to what type of PMS the doctor thinks that the patient is suffering of.

Dietary factors

In the beginning it is important to pay attention to the diet. Studies have shown that PMS patients tend to eat too many carbs and too much refined sugar compared to patients without PMS. PMS patients also eat too many dairy products and too much sodium. In addition PMS patients are deficient in iron, manganese and zinc. A good start is a Mediterranean diet, which is at the same time anti-inflammatory.

The recommendations is to eat 6 small meals a day. Avoid caffeine and alcohol. They are antagonists to the B complex vitamins. By avoiding sugar, you also avoid fluid accumulation and magnesium deficiency. A low fat, high-complex carb diet helps reduce breast tenderness. Reducing fat and increasing fiber in the diet decreases estrogen levels in the blood. These steps help PMS symptoms.

Nutritional supplements

Magnesium, vitamin B6, A, D3, E, L-tryptophan, calcium, zinc, fish oil (EPA/DHA) and evening primrose oil are the main supplements recommended for PMS patients. Your healthcare provider can advise you what you should take and what dosage.

Exercise

Regular exercise has very beneficial effects on reducing many symptoms of PMS. Even as little as 8 weeks of exercise -as was done in this study- had a significant effect. Exercise elevates endorphin levels, improves blood sugar stability, decreases norepinephrine and epinephrine in the brain and helps to decrease estrogen levels. This will control blood sugar levels, reduce anxiety, reduce estrogen-related symptoms and increase satisfaction.

Thyroid medication

Many women with PMS have borderline hypothyroidism or are overtly hypothyroid. In these cases the patient should receive small amounts of thyroid hormones.

Progesterone

Most PMS patients persistently lack one hormone,  progesterone. The best test for this is a saliva hormone test, because this reflects the tissue levels. Blood levels test too low and are useless. Bioidentical progesterone cream is applied transdermally (through the skin) from day 14 to 25 of each menstrual cycle. Micronized progesterone pills are also bioidentical and can take the place of progesterone cream.

Botanicals

There are a number of home remedies, which are heavily promoted on the Internet. They may, however, not be as effective as advertised.

Estrogen balancing Black Cohosh

Black Cohosh is said to balance estrogen and is anti-spasmodic.

Progesterone raising Chasteberry

Chasteberry decreases LH and prolactin. It raises progesterone, acts as a diuretic and binds opiate receptors. This reduces PMS related aches and pains.

Herbal supplement St. John’s Wort

St. John’s Wort helps these symptoms: anxiety, depression, mood swings, feeling out of control and pain.

Anti-inflammatory Ginkgo biloba

Ginkgo biloba is a mild blood thinner. Women who are on blood thinners should not use it! It improves depressive symptoms and mood, has anti-inflammatory effects and helps with anxiety control.

Nutrient-rich saffron

Saffron: In a clinical trial the Saffron group did significantly better in PMS symptom control than the placebo group.  Saffron is rich in magnesium, vitamin B6, iron and other nutrients that are missing in PMS patients, which explains the effectiveness of this botanical.

Lavender, Motherwort, and Dandelion

Other botanicals: Other botanicals are Lavender, Motherwort, and Dandelion.

Candidiasis

Due to prolonged exposure to high sugar and refined carb intake many women with PMS suffer from candidiasis (chronic yeast infection). Anti-Candida programs help to eradicate Candida overgrowth, which often improves several PMS symptoms.

Mind/body therapy

Cognitive-behavioral therapy helps for depression and anxiety. Hypnotherapy, yoga and biofeedback therapy are also useful methods.

New Treatments For Premenstrual Syndrome

New Treatments For Premenstrual Syndrome

Conclusion

At the present time there is a better understanding of PMS than in the past. Progesterone deficiency and other hormone weaknesses seem to be at the center of this condition. But vitamin and mineral deficiencies also play a role. The healthcare provider should order some baseline blood tests and hormone tests for the patient, including a saliva progesterone level.

Treatment consists of a combination of steps taken simultaneously. The dietary approach comes first: a Mediterranean diet will be beneficial. Next add nutritional supplements. Regular exercise is essential. Finally bio-identical hormone replacement of the missing hormones is necessary.

If there is an underlying chronic candidiasis infection, it needs treatment. The choice of drug would be nystatin. Some botanicals may be helpful, as discussed. When anxiety and depression are important parts of the PMS symptoms, mind/body therapy (such as cognitive therapy etc.) may also be helpful.

The key with PMS treatment is to not give up, but to re-evaluate the condition, if the initial attempt does not bring full relief. By not giving up and using all modalities of treatment the patient will be able to get rid of the condition, eliminate the symptoms of PMS and achieve well being.

Incoming search terms:

Apr
01
2017

When Food Causes Inflammation

Dr. Hal Blatman gave a talk about when food causes inflammation. He gave his talk on Dec. 9 at the 24th Annual World Congress on Anti-Aging Medicine (Dec. 9-11, 2016) in Las Vegas that I attended. The original title was “Food, Pain and Dietary Effects of Inflammation”.

Dr. Blatman is the medical director of Blatman Health and Wellness Center, Cincinnati and Batman Medical Services, Manhattan.

General remarks about nutrition

Dr. Blatman pointed out that mistakes of nutrition are often behind chronic diseases and illnesses. The physician’s task is to explain to patients how they can change their food intake to improve inflammation in the body and to allow the body to heal itself.

Hippocrates said 400 BC “Let food be thy medicine and medicine be thy food”.

In this context Dr. Blatman stated that nutrition could exacerbate symptoms or relieve symptoms and there must be rules for good nutrition. If we do not take care of our nutrition, the gut flora composition changes and causes leaky gut syndrome. But if we consume healthy foods all of this improves.

Mathematical formula for when food causes inflammation

To make it easier to understand the impact of food on our health the speaker offered this formula: G-B+R=P

G = stands for good, beneficial things you can put into your body.

B = bad, toxic things that affect your body negatively.

R = reserves that your body has since birth (minus the amounts you have used up)

P = pain and problems you are going to experience

It is P (pain and other medical problems) what brings the patient to see the doctor. G and B is what the patient can change. When done right, the P value in the formula reduces and the pain or medical problems go away.

Nutritional rules

Dr. Blatman said there are three rules about nutrition.

Rule #1 is to not eat fake or toxic foods

He listed NutraSweet, Splenda, Saccharin, margarine and olestra.

Aspartame

Aspartame experiments on rats showed that it can cause cancer: Dr. Blatman said that aspartame causes multiple myeloma and Hodgkin’s lymphoma in man. Aspartame worsens depression, 10% is metabolized in the liver into methanol, a nerve poison.

Splenda

Splenda (sucralose) originates from sugar. However, several chlorine atoms were inserted into the sugar molecule. It reduces beneficial microflora in the gut. It also interacts with liver enzymes, which interfere with the bioavailability of oral drugs.

Saccharin

Saccharin alters gut bacteria and increases glucose tolerance.

Hydrogenated fat and margarine

Insects don’t eat margarine, mold will not grow on it, and it will not support life. Merchants like it because food does not turn stale on shelves. Hydrogenated fats like margarine are like poisons. They raise the bad LDL cholesterol levels and reduce beneficial HDL cholesterol levels. The prostaglandin balance changes so that inflammation occurs. There is increased evidence of diabetes and the cell membrane composition changes. Proinflammatory cytokines can cause pain in the dorsal root ganglions. It follows from all of this that it is best to cut out all hydrogenated fat and margarines.

Partially hydrogenated vegetable oil

The cell membrane consists of two lipid layers at a specific ratio of omega-6 essential fatty acids and omega-3 essential fatty acids. It also contains triglycerides, phospholipids and protein. Cell membrane absorb nutrients to move into the cell and eliminate waste out of it. The cell membrane needs to remain flexible and within neurons needs to transmit electrical information. The membrane composition is critical for the cell membranes to perform optimally. It is here that the physician has to explain this to the patient. All the fats we eat are the raw material, which will make up our cell membranes. So what fat we eat that day travels into the cell wall that becomes part of it that day. The same process occurs with cell wall repair. If we eat hydrogenated fat that day, it travels into the cell wall.  A membrane with hydrogenated fat will:

  • Not transmit nutrients inside the cell
  • Will not transmit waste out
  • Causes the membrane to lose flexibility
  • In a nerve cell there will be abnormal neuron transmission

If we eat hydrogenated fat, we become like a “genuine GM truck fixed with inferior parts”, so Dr. Blatman. The interesting observation is that it takes 4 months after eliminating hydrogenated oil from the diet to get it out from red blood cells. Be aware that French fries increase pain for 4 months, so why eat them?

Olestra

Olestra, an artificial fat: This fat, Olestra has been developed as an artificial fat and is used in chips. It can cause diarrhea, abdominal cramps and weight gain with long-term use. Olestra belongs into the group of fake/toxic foods. Don’t eat Pringles or chips that are made with this.

Healthy oils

There are two types of essential fatty acids, omega-6 fatty acids and omega-3 fatty acids. Many processed foods contain only omega-6 fatty acids, because this is the cheapest way to produce them (they are based on vegetable oils). Instead you want to eat healthy fats like omega-3 fatty acids contained in nuts and fish. You can also add molecularly distilled, high potency omega-3 fatty acids (purified fish oil) as a supplement to help restore the balance between omega-6 and omega-3 in your food intake. Avoid omega-6 fatty acids from corn oil, safflower oil, grape seed oil, soybean oil, cottonseed oil, canola oil and peanut oil.

Metabolism of omega-6 fatty acids versus omega-3 fatty acids

Compare the metabolism of omega-6 fatty acids with that of omega-3 fatty acids.

The linoleic acid of omega-6 fatty acids gets metabolized into arachidonic acid, which causes pro-inflammatory mediators, PGE2 and LTB4. On the other hand with omega-3 fatty acids alpha-linolenic acid (ALA) is metabolized into EPA, DHA and the anti-inflammatory mediators PGE3 and LTB5.

It is easily understandable why a surplus of omega-6 fatty acids from processed foods will disbalance the omega-6 to omega-3 ratio. This ratio should be 1:1 to 3:1, but many Americans’ omega-6 to omega-3 ratio is 6:1 to 18:1. Omega-6-fatty acids cause arthritis, heart disease and strokes. Be particularly careful in avoiding soybean oil, which is the most popular oil in the last few decades to foul up the omega-6 to omega-3 ratio through processed foods.

Balance of omega-3 and omega-6 fatty acids

When it comes to balancing omega-3 and omega-6 fatty acids in your diet, be aware that nutritional balancing can help you restore the ideal omega-6 to omega-3 ratio of 1:1 to 3:1. An easy way is to cut out processed foods as much as possible. Supplement with molecularly distilled fish oil capsules to add more omega-3 fatty acids into your food intake. Dr. Blatman gave the example of rheumatoid arthritis patients that were put on omega-3 supplements. After 24 weeks their joint swelling and tenderness went down.

Rebalancing the omega-6 to omega-3 ratio was able to treat depression as this research showed. This makes you wonder how much depression may be caused by overconsumption of processed food.

Suggested doses of omega-3 fatty acid supplementation

Dr. Blatman suggested the following doses of omega-3 supplementation for various purposes:

  • 1 gram/day as supplementation for healthy adults with a good diet
  • 1-3 grams/day for people with cardiovascular disease
  • 5-10 grams/day for patients with an autoimmune disease, with chronic pain or with neuropsychiatric conditions

He mentioned that these doses are empirical, but in his opinion definitely help. Due to quality differences he suggested that you buy fish oil capsules in a health food store where the quality is best. Stay away from discount stores (the quality is the worst) and drug stores.

Other healthy oils are olive oil and coconut oil. They are also useful for cooking.

Rule #2 is not to eat inflammatory foods

Our body functions like a luxury car; it needs pure food to function. Anything less leads to inflammation, particularly when you eat sugar and processed foods.

Inflammatory foods are sugar, white flour, fruit juice and white/red potatoes. A medium potato=1/2 cup of sugar! Other problematic foods are wheat grain contained in breads, pasta, cereal and thickeners in soups and sauces.

What is the problem with these foods? They break down the zonulin proteins that are a bridge between the lining cells of the gut.

This leads to an increase of intestinal permeability, and leaky gut syndrome can develop. Inflammatory cytokines from visceral fat add to the gut inflammation, and cardiovascular disease and high blood pressure can develop.

Fried potatoes, in particular the consumption of French fries, have been identified as the cause of inflammatory bowel disorder (IBD). Countries with the highest consumption of French fries have the highest incidence of IBD.

A Mediterranean diet and the DASH diet are anti-inflammatory diets.

Rule #3 is to not disturb the bowel flora

A healthy bowel flora is symbiotic with the body. You achieve this by eating green leafy vegetables. A toxic flora from dysbiotic microbes comes from eating white flour, white sugar and red meat. Red meat leaves residues on which dysbiotic bacteria thrive.

Symbiotic gut bacteria produce vitamin K, cobalamin, pyridoxine, biotin, riboflavin, pantothenic acid and short fatty acids. They also degrade metabolic toxins, prevent pathogens from colonization and they stimulate the immune system to mature.

Dysbiosis occurs when the wrong diet consisting of sodas, white flour, sugar and red meat is over consumed. There are toxins that are produced by the dysbiotic microbes. These injure the bowel wall and make the immune system work harder. Immune system dysfunction, fatigue and fibromyalgia can follow.

Dr. Blatman stated that gut dysbiosis that causes leaky gut syndrome could also cause ulcer disease, diabetes, heart disease, fibromyalgia, chronic fatigue syndrome, chronic pain and even cancer.

When Food Causes Inflammation

When Food Causes Inflammation

Conclusion

This was a whirlwind tour through a talk given by Dr. Blatman during the 24th Annual World Congress on Anti-Aging Medicine (Dec. 9-11, 2016) in Las Vegas. What food we eat determines what gut bacteria we harbor, symbiotic ones or toxic ones. This in turn determines which way our health develops. But the content of what we eat is also important. If we consume processed foods we end up consuming way too many omega-6 fatty acids, which cause inflammation, arthritis and heart disease. This is happening in front of our eyes, if we start seeing things the way they are. I was aware of this since the mid 1990’s. In a lecture I attended at a continuing education conference a cardiologist pointed out that inflammation was the determining factor of whether or not our patients would get a heart attack.

Cholesterol concept being replaced by inflammation concept

The lecturer mentioned then that the older cholesterol concept would be replaced by the newer inflammation concept. He was right, but it goes even further! There is the important omega-6 to omega-3 ratio, and fish oil supplementation helps. At the same time it is necessary cutting out processed foods. But there is the newer insight that our bowel flora and red meat consumption can culture toxic bacteria in our own gut. It is in our power to start eating more vegetables and cut out sugar and starchy food. It is time to see chips and French fries not as a “convenience” but a hazard to your health. Food does not have to cause inflammation; right food choices will help us to stay well and live longer.

Incoming search terms:

Nov
26
2016

Chronic Shoulder Pain Treatment

This overview is about chronic shoulder pain treatment. A 71- year old health conscious patient was exercising in a gym. When he used the shoulder machine, he suddenly experienced a stinging pain in his left shoulder. The location of the pain seemed to be in the upper (superior) portion of the trapezius muscle. With this he also felt pain in his left neck.

This was fitness gone wrong! It can happen, that overdoing exercise or lack of judgment can lead to injury. Trainers caution us, when we embark on exercise programs, and yet, it happens! Often the road to recovery is a bumpy stretch, and if the problem persists, it can lead to chronic pain. With this knowledge the patient sought help. The first approach was visiting a

Chiropractor

He sought the help of a chiropractor and had 6 manipulations in the neck and thoracic spine. The spine had good range of motion, but the left shoulder pain in the trapezius muscle stayed.

He found that heat application to the trapezius muscle helped. So he bought an electric heating pad that he applied once or twice a day for pain relief. He also sought the input of his G.P. The doctor offered him a prescription for pain pills.

Pain pills

This was the predictable regimen, but the patient was concerned about the side effects of pain pills, and he declined. He had heard of a supplement, called Lipo (from Trophic). It contains 300 mg of choline bitartrate, 300mg of inositol and 300 mg of methionine in one tablet. At a medical conference he learnt that two Lipos were as effective in relieving the pain as one Motrin. He took two of these pain relievers from the health food store a couple of times per day. He alternated this with the heating pad to control his pain.

Since the condition improved only marginally, he looked at the option of

Prolotherapy

After 5 treatments the chiropractor mentioned  that he likely could not help the patient. The patient decided to try prolotherapy. He had heard that this would be good for chronic musculoskeletal pain. The naturopath whom he saw examined thoroughly and determined that the patient would be a good candidate for 2 to 4 prolotherapy treatments. After one treatment on the left side along the cervical spine and the left trapezius area the pain was reduced by 30% of what it was before. The second prolotherapy treatment was given again to the left side and also to the right side to keep it symmetrical. The naturopathic physician told the patient that he would see him for follow-up in 4 weeks.

Treatment of left should did not improve things

The treatment of the right asymptomatic side did not cause any pain, but the left side started flaring up after the second treatment, causing pain that was almost as bad as the original pain. When the patient returned to the naturopath and told him about the flare-up of pain in his left shoulder, he was told that this is what sometimes happens when treatments are not spaced far enough apart. He felt that this should be observed now and reassessed in 6 months in case there was no progress. It was time to look at other options.

IMS treatments

The chiropractor indicated that he could likely could not remove the pain. Instead he suggested that maybe a physiotherapist trained in intramuscular stimulation treatment (IMS), also known as dry needling could be of help. The patient was waiting for the appointment with the naturopath for prolotherapy when he saw the physiotherapist for IMS treatments. He examined the patient and noticed a persistent trigger point in the upper trapezius muscle, which he thought was causing the chronic pain.

Partial success of intramuscular stimulation treatment (IMS)

Two IMS treatments relieved the pain by about 50%. But about two or three days later the pain came back to about 75% of the original pain after the gym injury. The appointment for the prolotherapy by the naturopath had taken two months to wait for, so he had already had 3 IMS treatments just before the prolotherapy to get some pain relief. The IMS trained physiotherapist thought that perhaps a few more treatments, up to five or six might be able to take the pain away. So the patient continued treatments on a weekly basis.

Ultimate failure of IMS

Unfortunately the hope for pain relief did not materialize. The pain improved to about 30 to 40% of the original pain, but it always came back just 2 or 3 days later. Fortunately for him he could apply the heating pad and the pain would stay away for 3 to 5 hours. It also responded to taking two tablets of the choline bitartrate/inositol/methionine combination that took the residual pain away for several hours. Self-massaging the trigger point also gave some relief.

Recurrence of pain

But occasionally the pain came back with a vengeance and felt like a charley horse. This could suddenly occur in his left shoulder making it difficult to move his left arm. It as particularly bad when he needed an outstretched arm for ballroom dancing. Also, lifting of heavy objects or working out in the gym were difficult to do. Even just holding on to the rails of the treadmill when doing a fast walk on the treadmill for half an hour could lead to a flare up of the left shoulder pain. It is frustrating, when there is only temporary relief, but no real cure, but giving up is no option. Often we find more information on the Internet. What came up was low-dose laser therapy.

Low-dose laser therapy

The patient remembered having heard of low-dose laser therapy that might be useful in treating chronic pain. The physician treated the trigger point in his left shoulder with interstitial low-dose laser therapy. Dr. Weber who is the president of ISLA, the international society for laser applications, specializing in laser treatment, treated him with low-dose laser therapy.  This involved inserting a cannula into his left trapezius muscle close to the trigger point. He injected a small amount of procaine (local anesthetic), then 5 ml of normal saline. This was followed by three low-laser beam treatments for 10 minutes each, first blue, then green and finally yellow color. They were all given interstitially after which the cannula was removed.

Relief of pain with low-dose laser therapy

The surprise was that he felt relief almost instantly. There was still a bit of pain from the interstitial needle for about two days, but the trigger point in the trapezius muscle was no longer there. Finally after 6 months of intermittent pain there was relief of about 50% of the original pain. It was encouraging that this time the pain in that particular trigger point stayed away.

More laser treatment for other trigger points

But there were two other trigger points that were bothering him. After one month he received a second interstitial low dose laser treatment by the naturopath. He was the one who previously treated him with prolotherapy. 2 weeks later the naturopath administered the third laser treatment for yet another trigger point. This continued on for another few months. The pain disappeared, then it crept in slowly again, but at a lower level. It became a quest to eradicate the trigger points! Each time the same low-dose laser treatment targeted the remaining trigger points still palpable. It took a total of 9 interstitial treatments to finally reach the point where all of the pain was gone.

It felt strange: the chronic left shoulder pain had disappeared!

Chronic Shoulder Pain Treatment

Chronic Shoulder Pain Treatment

Conclusion

When pain lasts for more than 3 months, physicians refer to it as “chronic pain”. Often another name, neuropathic pain, is a substitute term that describes difficult to treat pain. By now you may have guessed that I was the patient in this blog.  It was in my interest to rid myself of this pain. I had previously described a similar pain in my lower back that was relieved with just one interstitial low-dose laser treatment at that time and my back has remained pain free since. Shortly after that successful treatment I developed the left shoulder pain from a soft tissue injury in the gym as mentioned. I was fortunate that Dr. Weber could treat me again, this time at his clinic in Lauenförde, Germany on occasion of a Germany trip that I had booked for holiday purposes.

Nine low-dose laser treatments for chronic shoulder pain

I was lucky that my lower back responded to this treatment in the past. The difference was that it took a total of nine low-dose laser treatments for my left shoulder to respond. Before the chronic pain came to a resolution I needed a total of 14 months of treatments!

It occurred to me that a successful outcome of treating pain requires collaboration between patient and therapist. Call it trial and error. In my case it was only the fourth treatment modality, the low-dose laser therapy that worked permanently.

I feel that the chiropractor did his best to ensure there was no nerve root irritation. He told me that his treatment had reached its limits.

IMS treatment and prolotherapy gave only limited relief

The IMS trained physiotherapist treated me before and after the prolotherapy. He told me after a total of 12 visits that he likely could not help me any more.

The naturopath who did the prolotherapy said that he had strengthened the ligaments along the spine on the left side. But he also stated that the trigger point from the gym injury showed no response to prolotherapy.

The final answer came from the treatment by Dr. Weber in Germany and the naturopath in Kelowna using the same Weber system machine with low-dose lasers. I think that this is an under-recognized treatment modality of musculoskeletal injuries, including sports injuries. You can find treatment providers for low-dose laser therapy throughout the US, Canada and Europe.

Persistence required on behalf of the patient, but also regarding the physician

Many physicians and naturopathic physicians use it as part of their pain management methods. The equipment has the FDA approval; Health Canada approved it also and the Medical Devices Directive in Europe approved it as well. Please note that this type of laser (low-dose laser) has nothing to do with laser treatment for cosmetic purposes.

It cannot emphasize enough that chronic pain treatment requires attention to detail. Feedback from the patient to the healthcare provider is necessary. Also, persistence on behalf of the patient is essential to follow through until the chronic pain recedes. It also shows that giving up is not an option!

Incoming search terms:

Aug
06
2016

Pain Treatment

General practitioners see a lot of patients with various pain symptoms for which they seek pain treatment. The underlying conditions might be from an arthritic problem that suddenly becomes symptomatic, or an acute back injury may send pain from the lower back into one of the legs. Others may experience excruciating headaches like migraines or tension type headaches. Often these painful conditions require some immediate pain relievers to treat the pain, but this can turn into a nightmare of drug dependency and may even lead to the development of chronic pain. Here I like to review an article that I found in the June edition of ConsumersReports.org.  In my review I included most of the content, but added a few newer pain treatment modalities.

Acute pain

Here I’m discussing back pain as an example. When a disc bursts in the lower back because the person was lifting an object too heavy to lift, acute pain develops in the lower back. This is often located at the lower lumbar spine level (L5/S1) causing radiating pain into one of the legs.

In a case like this it will often take several weeks before the body can heal this condition.

Chronic pain

It can happen in many cases that the pain will still be there 3 to 6 months down the road. If a disc fragment pushes on the nerve root in the nearby canal through which the nerve root travels, this will cause the muscles supplied by the nerve root to melt away in the leg of the affected side. If nothing is done about this, the acute pain turns into chronic pain, which is much more difficult to resolve. The initial physician may refer the patient to a neurosurgeon who will review the case together with the help of an MRI scan that shows the underlying pathology. The neurosurgeon may determine that a mini discectomy will reduce the pressure onto the nerve root.

Relief of pressure on nerve root from mini discectomy

This surgery may be able to prevent chronic pain from setting in. Once the pressure is relieved, the nerve can start the healing process. It is critical to not miss the point where acute pain crosses over into chronic pain. This happens at around 2 to 3 months into the pain condition. Chronic pain is much more difficult to treat as some of the neurological pain pathways that form after such injuries can persist within the spinal cord or even within the central nervous system, even after successful disc surgery that is done too late. With respect to the example given above, if the patient is operated on too late (1 to 2 years after the injury), the procedure may not be effective in relieving the pain. A chronic pain syndrome has started.

How pain treatment is done

  1. Avoid bed rest

In the past (up to the late 1970’s to mid 1980’s bed rest was the accepted initial mode of treatment. Even though patients often felt some relief of pain initially, this led to muscle atrophy (literally a melting away of muscles) in the muscles that are supporting the spine. These structural changes destabilized the spine and often made the pain more chronic until physiotherapy treatments and active exercises rebuilt the supporting muscles again.

  1. See a physiotherapist

Physiotherapists can use different treatment modalities like traction, a TENS machine, active exercises that all can help to alleviate back pain due to muscle spasm. If there is only a strain, this will often help to resolve your back pain within 4 weeks. But if there is an underlying disc herniation as previously explained, you need to be assessed by a physician in an urgent care center, primary care setting or by an emergency physician in the emergency department of a hospital. When the examination confirms an abnormal reflex from a nerve root compression, a referral to a neurosurgeon or orthopedic surgeon is usually made as previously explained.

  1. Chiropractic treatment

Some people have their backs treated periodically to prevent back troubles. When they get an acute back pain they likely will see the chiropractor again. In cases of a back strain, where one or more muscles are pulled, this approach will be helpful together with some home exercises and swimming to build up muscle strength along the spine. However, in the case of a herniated disc chiropractic adjustments should not be done (physicians say they are “contra-indicated”). Instead the patient should be referred to either a neurosurgeon or an orthopedic surgeon.

  1. Medication for pain

Often physicians prescribe Tylenol with codeine, hydrocodone (Vicodin), oxycodone (OxyContin, Percocet) or morphine for pain relief. All narcotic medication have side-effects; they can cause constipation, can cause vomiting, make you feel dizzy and can lead to falls, particularly in elderly patients. These falls can cause hip fractures and other fractures that complicate the recovery from the original pain. Never exceed the dosage of pain medicine prescribed on the label, and if it does not relieve the pain, see your physician again for a reassessment to rule out any complications.

Depression with back pain

Often people with back pain also have depression. To address this issue your physician may prescribe an antidepressant like duloxetine (Cymbalta), which has been approved by the FDA for treatment of lower back pain. But there are two rare, but important side effects to know about. Cymbalta can cause lowering of blood pressure, which leads to dizziness. This can cause serious falls with the danger of fractures. The other complication is the risk of liver failure.

Side effects of pain treatment

Pain pills can be addicting

While there seems to be an urgency to treat a patient who is in pain with pain medication, the treating physician must not forget that pain medication is potentially addicting and patients often use higher doses than advisable. However, pain medication has a narrow therapeutic window meaning that the toxic levels are not much higher than the drug levels necessary to relieve pain.

Some medications are only marginally effective

There are medications that are only marginally effective, if at all. Glucosamine and chondroitin are used for relief of arthritic pain in osteoarthritis sufferers. They are eliminated by a liver enzyme system that also eliminates blood thinners. If a patient is on blood thinners, the addition of glucosamine and chondroitin can lead to dangerous bleeding. Instead of using glucosamine and chondroitin when you experience pain and inflammation in joints, reduce your activities, but stay as active as you can to avoid your symptoms from getting worse.

Tests for severe migraines

When a patient has a severe migraine headache it is tempting to want to rule out a brain tumor. But a CT scan exposes the patient to dangerously high radiation doses that over time could cause brain cancer or leukemia. There are physical examination methods to rule out a brain tumor. If the findings are positive, an MRI scan can be used to get much more detail of the brain than a CT study would reveal. MRI scans do not have undesirable side effects.

Use gentle movement to remobilize the painful joints

Before you rush into using anti-inflammatory drugs, use gentle movement to remobilize the painful joint, back or limb. Activities like swimming, walking or yoga can reduce pain and allow you to recover from a painful condition according to a Cochrane Library analysis of 61 studies.

Non steroidal anti inflammatory drugs (NSADs)

For more pain relief NSAID (non steroidal anti inflammatory drugs) pain relievers like ibuprofen (Advil) or naproxen (Aleve) for a brief period will also help. The problem with long-term use of NSAIDs is that it can cause kidney damage. With longer use of NSAIDs there is also a danger of stomach bleeding, heart attacks and strokes.

Toxicity with Tylenol

The pain drug acetaminophen (Tylenol) has a narrow therapeutic window and is less effective in pain relief than the NSAIDs. The FDA has recommended as the highest daily dose 4000 mg of acetaminophen. But if you are a heavy drinker or you have liver disease, your daily dose of acetaminophen should not exceed 3250 mg to avoid liver toxicity. Long-term use of acetaminophen can also damage your kidneys, therefore the recommendation to use acetaminophen only for a short period of time (a few days).

Side effects of triptan drugs for migraines

Migraine headache drugs: The newer migraine drugs, called triptans temporarily narrow widened blood vessels. This relieves severe migraines within about 2 hours. However, these medications are not recommended for those with high blood pressure, chest pain, heart disease or circulation problems in the legs, as blood vessel constriction could bring on heart attacks or worsen circulation problems.

Common sense approach to pain treatment

The key for any pain condition is to treat the pain right away to minimize the impact that pain has on you and to prevent developing chronic pain, which is more difficult to treat.

Here are some examples.

Migraine headaches

If you have a migraine headache, use an over-the-counter pain reliever like naproxen or ibuprofen to treat the migraine pain very early. A combination of acetaminophen, aspirin and caffeine (like Excedrin Migraine or a generic copy) will also do. This will stop the release of prostaglandins, which would send pain signals to the brain. Heat packs or cold packs on your head can also help in the treatment of a headache. A 2013 study from Germany has shown that migraine sufferers can get rid of their migraine headaches in 60% by having sex. It sounds like a nice idea, but what they have not considered may be the fact that somebody who has a splitting headache is not feeling like sex at all!

Triptan pills for migraines

If your home remedies did not help, see your physician for one of the triptan pills. Sumatriptan or a similar drug constricts blood vessels to the brain. The doctor will also look for common triggering factors that can bring on a migraine. Weak neck and shoulder muscles may respond to physiotherapy strengthening. In women a condition called estrogen dominance is associated with migraines and can be treated with bioidentical progesterone to balance estrogen and progesterone in the body by elevating progesterone concentration.

Acute lower back pain 

Acute lower back pain usually follows an event where the person lifted something too heavy or injured the back from a fall. The important part is to rule out a fracture. Most of the time there is no underlying fracture, just a muscle strain. A muscle strain usually sorts itself out in time. Stay active as much as possible. But if the back pain does not resolve within a few days, see your physician for more tests. X-rays can delineate structural changes like a fracture. As explained earlier, an MRI scan can rule out a disc herniation. Instead of neurosurgery, further options nowadays are prolotherapy, stem cell therapy or a combination prolotherapy/stem cell therapy. This type of therapy will also work for knee injuries (meniscal or ligamentous tears).

Hip or knee pain

Conventional medicine usually treats osteoarthritis with NSAIDs, but may not warn you about the possibility of gastric erosions that can lead to massive stomach bleeding, heart attacks or strokes when using NSAIDs. It also can lead to kidney damage that can cause sudden kidney failure. The key is to use anti-inflammatory medication only for a few weeks. If arthritis persists, it is wiser to seek the advice of a naturopathic physician for prolotherapy treatment. One or two treatments of prolotherapy can give relief of pain. If prolotherapy does not succeed, it is best to move on to mixed stem cell therapy with bone marrow and mesenchymal stem cells (from fat cells) as well as PRP (platelet rich plasma). This usually leads to complete healing of osteoarthritis and eliminates the need of total knee or total hip replacement.

Neck and shoulder pain

This often develops because of poor posture, shoulder tendinitis or neck muscle spasm. Physiotherapy is often successful treating this. If not the physiotherapist can use intramuscular stimulation (IMS) with acupuncture needles. This may be more successful in interrupting the abnormal neuropathic pain pathways. Alternatively electro acupuncture with a TENS-like device can also be successful. The newest treatment modality is the Weber medical system using a low-dose laser applicator. Prolotherapy can also be used for shoulder and neck problems, if the ligaments are lax. It requires a lot of experience on behalf of the health professional to choose the right treatment protocol for the condition.

Tension headaches

Anxiety, stress and fatigue can all lead to tension headaches. Initially you may want to drink liquids, as dehydration is related to tension headaches. If your headache is still present after one hour, use naproxen or acetaminophen. Take a warm or cold shower and lie down with a cool cloth on your forehead. If you still have a headache, check with your doctor whether it is indeed a tension headache or a migraine. You may have jaw clenching or teeth grinding during your sleep. If your bite seems off, see a dentist. For stress control use relaxation techniques.

Other ways to treat tension headaches

Some suggestions sound mundane enough, but they can be effective: Get enough sleep, get enough exercise, and work on improving your posture. A physician trained in trigger point injections with local anesthetics (often anesthetists or general practitioners) can freeze your suboccipital and supraorbital nerves with lidocaine, which I have seen to work in 60% to 70% of cases in my former practice.

Pain Treatment

Pain Treatment

Conclusion

Pain treatment can be confusing as pain itself can be very multifaceted. The key is to search for the cause of the pain. Then treat pain very quickly. This way it has time within 2 to 3 months to turn into a chronic pain condition. Chronic pain is much more difficult to treat. The physician should treat acute pain successfully. Conventional medicine has to yet learn from naturopathic medicine and alternative medicine practitioners. They use prolotherapy, stem cell therapy, IMS and trigger point injections with local anesthetics.  In addition low-dose laser therapy (Weber medical system) are valuable alternative methods to treat pain. These methods can successfully treat pain conditions. The physician can incorporate them into general medical practice.

Incoming search terms:

Feb
27
2016

Orthopedics Without A Knife

Dr. Fields gave a talk in Las Vegas about orthopedics without a knife. His talk took place at the 23rd Annual World Congress on Anti-Aging Medicine on Dec. 12, 2015 in Las Vegas. Dr. Fields gave a talk entitled “Regenerative orthopedics – non-surgical repair with stem cells/PRP/prolotherapy”. In essence the talk was about alternative treatments to surgeries in orthopedic medicine.

Dr. Peter Fields, MD, DC is a board certified medical physician and chiropractor. He is also the director of the Pacific Prolotherapy & Medical Wellness Center in Santa Monica, CA.

Introduction

Joints, muscles, tendons, ligaments and joint capsules control the movements in joints. Due to injuries and wear and tear these body parts can have a lack of function, which will lead to pain and disorders. The result can be weak, torn or damaged ligaments and tendons, arthritic changes, excessive joint motion, increased pressure, and a decrease in range of motion.

This is the common treatment cycle in medicine

Joint pain prompts you to see the doctor. You are told it is arthritis, and you get non-steroidal anti-inflammatories (NSAID’s). You come back with more pain, and you’ll get a stronger NSAID prescription. Eventually a cortisone injection is given, which helps for a few months, but then the pain reoccurs. The doctor arranges for an MRI scan. A referral to an orthopedic surgeon is likely to be the next step, and an arthroscopy (pinhole surgery) is arranged. In that case, if this does not resolve the pain, surgery like a knee replacement or hip replacement is suggested.

Common sayings when traditional medicine has nothing to offer

You may have heard some of these common sayings before. “Nothing more we can do about it!” -“I suggest you learn to live with it”- “You should never play that sport again!”- “Take these pain medications” and “The only alternative is surgery!”

The problem is, that none of these pieces of advice are really helpful. This type of approach does not treat the cause; it is directed against symptoms.

How to treat the cause?

Prolotherapy

Prolotherapy is a natural, non-surgical method to assist the body to heal torn soft tissues. It works in cases like torn ligaments, damaged tendons, cartilage, menisci or a torn labrum in the shoulder. Hyperosmolar dextrose solution is injected into the injured area. This stimulates the body’s healing forces and the body repairs what is damaged. More information is found here. In essence, prolotherapy fixes the cause, not just the effect; it heals, and it is permanent. Prolotherapy strengthens tissues, relieves pain and increases the range of motion in joints. There is 80 to 85% full pain relief and more than 80% improvement in range of motion. Prolotherapy promotes the healing of torn or damaged ligaments and tendons.

Conditions suitable for treatment with prolotherapy

Suitable conditions for treatment with prolotherapy are sports injuries, muscle tears, arthritis, tendinitis, bursitis, sciatica, TMJ problems, and fibromyalgia. Common areas treated with prolotherapy are the hip, knee, shoulder, ankle, neck, lower back and elbow. Dr. Fields showed MRI scans before and after prolotherapy treatments of ligament injuries within the knee and of shoulder ligament tears before and after treatment. Normally the physician expected these injuries to require surgery. But all that was done was one or two injections (prolotherapy treatments) with reactivation of the affected joint. There were astonishing results shown with MRI’s before and after herniated disc injuries and how they healed in a relatively short time following prolotherapy.

PRP prolotherapy

Platelet rich plasma (PRP) is a tool from regenerative medicine to amplify the healing response in connection with stem cell therapies .  The lab technician takes blood from the patient and subsequently spins it down in a centrifuge. The platelet rich fraction (PRP) contains all of the growth factors, which have the healing power of the blood. The physicians combines this with prolotherapy to make healing even more successful. This is particularly useful for labral tears in shoulders, meniscus tears in knees and other localized injuries.

Stem cell prolotherapy

Stem cell therapy has been the gold standard for repairing more serious problems. Dr. Fields combines stem cell therapy with prolotherapy to treat more serious injuries like end stage arthritis.  This is the case when bone rubs on bone, where conventional orthopedic medicine would offer a joint replacement in the hip or knee. Stem cell prolotherapy can repair any joint that has cartilage damage. A severe meniscus tear in a knee or a severe labrum tear in a shoulder would also be situations where stem cell prolotherapy is superior to surgery or to just using prolotherapy alone.

Here is a description of the procedure

Before the patient’s procedure the physician first harvests bone marrow stem cells by way of a pelvic bone aspirate; secondly the physician obtains mesenchymal stem cells from fatty tissue by aspiration of abdominal fat. A cell separator provides the stem cell fractions. The physician combines both types of stem cells, the bone marrow stem cells and the mesenchymal stem cells from fat as each one has its own strengths. These two stem cell types are more effective in combination to repair whatever tissue needs repair. Thirdly, the lab technician will draw blood from the patient to obtain PRP, which contains the growth factors needed to activate the stem cells to do their job of healing. The last step is that the physician now combines hyperosmolar dextrose (the prolotherapy part) with the stem cell preparation and mixed in PRP and injects this mixture into the injured area.

Conditions that respond to stem cell prolotherapy

This procedure has superior healing power. Before and after MRI scans of all of the major body regions showed impressive results. Several video recorded testimonials  complemented the MRI scans. It is surprising how quickly and completely fairly severe injuries can heal using stem cell prolotherapy. One particularly nasty condition is osteonecrosis of the hip, which can occur as a side effect of chronic cortisone treatment for arthritis, asthma or chronic obstructive lung disease. One or two stem cell prolotherapy treatments will heal this condition because the stem cells build up brand new bone and get rid of the old necrotic bone from the osteonecrosis. Conventional medicine has no answer for this condition. Regenerative orthopedics is successful by using stem cell prolotherapy.

What are the advantages of regenerative orthopedics?

Regenerative orthopedics reduces pain very quickly and it improves function rapidly. Healing occurs naturally, and it strengthens the tissues involved. Particularly complicated lower back pains or lower neck pains (due to degenerative disc disease, facet joint osteoarthritis, spondylolisthesis and significant foraminal stenosis) respond really well to stem cell prolotherapy, getting rid of chronic pain. The speaker showed before and after MRI scans. He also shared testimonials from patients about the various procedures.

End result following stem cell prolotherapy versus conventional surgery

This is quite in contrast to what conventional orthopedics has to offer: discectomy with fusion surgery, where the patient often has scar pain later. With a laminectomy to treat a foraminal stenosis the patient may have limited improvement of the chronic back pain for a couple of months, only to experience new back pain from a subsequent spinal stenosis as a late complication from the prior surgery. The end result with conventional orthopedics is disability, pain and suffering; the end result with regenerative orthopedics is a patient that is well, active, pain free and thankful.

Orthopedics Without A Knife

Orthopedics Without A Knife

Conclusion

There is a form of orthopedics without a knife: regenerative orthopedics. The tools are prolotherapy for minor musculoskeletal problems. Some very conservatively minded physicians still scoff at this, but wrongly so. PRP prolotherapy is suitable for more severe injuries that require more healing power. Stem cell prolotherapy is what the physician uses for the severe cases. All of the healing power (minus the knife) is put to use. Two types of stem cells initiate healing where there is a need for it. The stem cells transform into the cell types that do the repair.

Two types of stem cells needed sometimes

Research has shown in the past that the mesenchymal stem cells alone will not heal cartilage of joints very well, but in combination with bone marrow derived stem cells this heals quite well and efficiently. Healing osteonecrosis and complicated lower neck and lower back problems borders to miraculous healing. Regenerative orthopedics is definitely something to remember should you get into trouble down the road. There are alternatives to the knife!

Jan
23
2016

Life Extended By Several Decades

Have you ever thought about the possibility to prolong your “Freshness Date”? At the 23rd Annual World Congress on Anti-Aging Medicine on Dec. 13, 2015 in Las Vegas the endocrinologist, Dr. Thierry Hertoghe from Belgium gave a talk about “How to extend the human lifespan by 40 years”. Dr. Hertoghe explained that it is possible to extend life by paying attention to the factors that prolong life and combining them as an anti-aging type lifestyle. He made a distinction between

  1. normal aging: up to age 82
  2. healthy aging: up to age 100
  3. anti-aging medicine: up to age 122
  4. reversing aging medicine: much more than 122, perhaps to age 150 or more.

Normal aging (up to age 82)

Life expectancy is on average about 82 years. From the age of 50 to 60 onwards you may encounter problems with increased cholesterol, high blood pressure leading to heart attacks and strokes. Coronary artery by-pass surgery may extend an individual’s life by 10 to 15 years. But hardening of the arteries in the general circulation will eventually cut down the blood supply to vital organs leading to premature death that could have been avoided.

Around the mid 60’s to mid 70’s 12.4% of African Americans or 2.9% Caucasians get Alzheimer’s disease. These figures worsen rapidly with further aging: in their mid 70’s to mid 80’s 32.5 % of African Americans and 9.8% of Caucasians suffer from Alzheimer’s disease. At the age of 85+ years 54% of African Americans and 27% of Caucasians have Alzheimer’s disease. With normal aging Alzheimer’s has already increased, and this trend likely is continuing.

Loss of memory, depression and musculoskeletal pain

Memory loss also leads to a shortened survival curve; people with memory loss live two years less on average than compared to a group with no memory loss.

Add to this loss of life because of depression, common in older age. Compared to a non-depressed group over 2 years of older people the depressed group lived 30% shorter.

Musculoskeletal pain in younger age (18-44) was 38%; the next demographic group aged 45-64 reported 61% of musculoskeletal pains; seniors between 65 and 74 had 68% of musculoskeletal pain, and in the demographic group of 75 and up 71% of persons suffered of musculoskeletal pain. As we will learn later there may be hormone deficiencies behind these neck and back pains. If the patient does not seek treatment, this can lead to falls, fractured hips and premature loss of life. Those who survive accidents often become wheel chair bound and end up in nursing homes.

Patients with rheumatoid arthritis and patients with other disabilities have a lower life expectancy

One specific subgroup of patients with musculoskeletal pain are rheumatoid arthritis sufferers. After 10 years of having rheumatoid arthritis patients will have a survival of only about 50%. With involvement of more than 30 joints  (more severe form of the disease) only about 40% will survive. In other words, rheumatoid arthritis is an important factor for lowering people’s life expectancy.

At an age of 65 to 74 men have 23% of disabilities, while woman have 27.5% disabilities. This increases between the ages of 75 or older to 40% for men and 44.5% for women. At the age of 65 disabled men have a 3.5% higher death rate than the average population; disabled women’s death rate is 2.5% higher than the normal population. In other words, disability kills.

Obesity, and heart disease

Urinary urgency and incontinence leads to a 3.13-fold higher mortality rate than a control group of men who do not have these symptoms.

65% of men and 85% of women above the age of 50 have abdominal obesity. This is not just a harmless condition. There is an association between increased triglyceride levels and increased mortality due to cardiovascular disease and diabetes.

By the age of 65-74 heart disease has a frequency of 32% in men and 23% in women. At the age of 75 years and older this jumps to 44% in men and 32% in women. Once the doctor diagnoses heart disease, it causes a lot of premature deaths: an average person with heart disease lives 10 years shorter than those who do not have heart disease!

Healthy aging (up to age 100)

Improving lifestyle factors increases life expectancy

If we look at normal aging, we realize that all these diseases and disabilities we discussed are eventually killing us. In order to live longer we have to take steps that are known to interfere with some of these factors. For instance, quitting smoking will prevent heart disease, several cancers and chronic obstructive lung disease (emphysema). Positive thinking, social support and transcendental meditation will increase survival by preventing mental illness and depression, which in turn will prevent suicides. A healthy diet such as the Mediterranean diet or the Pegan diet will avoid cardiovascular disease and cut down cancer rates.

Live longer with better diet

One dietary change is called the “polymeal”. It consists of fish, fruit, vegetables, garlic, almonds, a moderate amount of wine and dark chocolate. Compared to the Standard American diet this type of diet would add 9 years for men and 8.1 years for women regarding their life expectancy. For instance, prostate cancer showed a 7-fold increase in a group of men who ate a lot of pickled vegetables, fermented soy products, salted fish and preserved meats, when compared to a control group who did not include these foods. In a group of women who had their meat well done and ate three servings of beef per week, breast cancer risk was 4.62-fold higher compared to women who ate meat done rare or medium rare. Overall cancer and cardiovascular mortality dropped by 35% in a study where 5 or more servings of fruit and vegetables were eaten per day.

Regular exercise and supplements of vitamin C and omega-3

A regular exercise program will strengthen the heart and lungs, keep your weight stable, reduce heart attacks and strokes and reduce the probability to develop cancer. A group of men between 61 and 81 were observed over 12 years and divided into those who did not exercise versus those who walked more than 2 miles per day. The exercising men had 19% less mortality compared to the sessile men. Vitamin C from fruit and vegetables or from taking supplements reduces global mortality from all causes by 46% compared to controls that did not. Similarly taking omega-3 fatty acid supplements (fish oil) daily reduced all cause mortality by 20%.

Dr. Hertoghe calls this “healthy aging” and this would allow you to be able to reach an age of about 100 years.

Anti-aging medicine (up to age 122)

Low thyroid hormones

Dr. Hertoghe told the audience that further attention to anti-aging factors could reduce mortality even further. He found over the years that paying attention to correcting hormonal weaknesses would have profound effects on how old a person becomes. Thyroid hormone replacement has been one of the steps that has helped people to feel more energetic, have less muscle pain, less falls, less fractures and complications. It also translates into longer lives.

One slide showed that a low free T3 level (low thyroid) was associated with a 3.6-fold higher death rate. A low free T3 level is an accurate predictor of cumulative death rate in cardiac patients.

T3 is also important for the maintenance of the immune system, which shows in patients with tuberculosis: the one-year mortality rate from TB in thyroid deficient patients was 75%, while patients with a normal thyroid had a mortality from TB of only 7%.

Replacement of missing sex hormones

Secondly, replacing missing sex hormones can add more life because cardiovascular disease is postponed (less heart attacks, less strokes), there is less cancer and better cancer survival, if a person comes down with cancer. Many statistics were quoted.

One interesting slide showed the longitudinal survival follow-up of congenital dwarfs in comparison with their normal brothers or sisters. Untreated male dwarfs turned only 56 years on average, while their unaffected normal brothers turned 75 years on average (19 years longer). With female dwarfs the difference is even more striking: untreated females dwarfs turned 46 years on average, while their normal sisters turned 80 years on average (a difference of 34 years).

Bioidentical hormone treatment prolongs life, lowers heart attack rates and lowers cancer rates

Another publication showed that the heart attack risk was 3.8-fold higher in a group of patients with hypopituitarism (under function of the pituitary gland), but the treatment group (treated with GH) had a normal rate of heart attacks.

11606 men aged 40 to 79 years were followed for between 6 and 10 years. The group who had the top 25% range of testosterone had a 19% lower mortality rates from heart attacks or cancer.

Older women, particularly aged 100 in Okinawa had 2.3-fold higher testosterone levels than women in the US at age 70. On the other hand 70-year old Okinawan women had 2.7-fold higher estrogen levels than US women.

Bioidentical hormone replacement therapy (BHRT) prior to developing breast cancer showed a 27% longer survival among 984 breast cancer patients in Sweden compared to those without prior hormone treatment.

Lower mortality rates for bioidentical hormone replacement therapy of breast cancer patients

In another group of breast cancer patients (2755 patients) aged 35 to 74 who were treated with bioidentical hormone replacement therapy (BHRT) after their breast cancer diagnosis, 50% had a lower recurrence rate (compared to no-BHRT treatment) and there was a reduction of 66% of mortality from breast cancer compared to controls without BHRT treatment. Another study showed that breast cancer patients would have a mortality rate of 33.3% without hormone treatment. After non-estrogen hormone treatment the mortality rate dropped to 12.5% and to 6% after estrogen/progesterone use. This shows the healing results of the various natural hormones.

Treating the cause rather than the symptoms

A group of 280 men and women around the age of 50 were treated with anti-aging hormone replacement for 2 or more years. In the beginning there were 34% of women and 15% of men with coronary artery disease. There were also 36.4% of women and 34.1% of men with high blood pressure. After replacing all of the missing hormones with bioidentical hormones for more than 2 years, coronary artery disease had dropped to 1.6% of the women and 1.08% of the men; high blood pressure had dropped to 2% of the women and 3% of the men. No drugs, just hormones! Of course, initially the doctors prescribed drugs to stabilize their condition, but they could gradually drop them safely. The reason was that the doctors treated the underlying hormone deficiency. The doctors were treating the cause of the cardiovascular disease rather than only the symptoms.

Low mortality of women on bioidentical hormone replacement

Dr. Hertoghe presented data of 6.38-year follow-up of 286 consecutive patients using anti-aging medicine (replacement of missing hormones with bioidentical hormones). These patients had an overall cancer rate of 2.1%, which compared very favorably to the 3.2% cancer rate among US women. The overall cancer rate was  3.1% in French women and 3.1% in Belgium women on no hormones. This is the type of information that is needed following the Women’s Health Initiative (WHI) that scared women into the false belief that hormones would be “poisonous”.

Synthetic hormone do not fit the hormone receptor

In the WHI synthetic hormones caused cancer and heart attacks; the reason for this was that synthetic hormones are not the identical shape as the natural hormones. But hormones and hormone receptors have to fit like a key into a lock; otherwise they are not effective or even block the natural life prolonging action of the natural hormone. This is why in the WHI study the outcomes were poor. Using bioidentical hormones the doctor can prevent heart attacks and strokes and they are also cancer-protective.

Reversing aging medicine (much more than 122, perhaps to age 150 or more)

General medicine has the goal to make patients as healthy as possible. With reversing aging medicine the goal is to make patients as young as possible. They are at their healthiest and feel younger again.

With anti-aging medicine using a healthy diet, exercise and bioidentical hormone replacement therapy the patients can add 15 years of good life. Add to these organ transplants, if necessary, telomerase activators and stem cell therapy. This can add another 25 years of life expectancy to a total of 40 years.

Growth hormone deficiency

Growth hormone deficiency is the one factor that has been underestimated. The discussion of dwarfs in comparison to their healthy brothers and sisters showed us the following. Growth hormone production can add between 19 and 34 years (average 26.5 years) of life. Dr. Hertoghe has done blood tests (IGF-1) and lately also 24-hour urine metabolite tests of growth hormone on aging patients and found that many are deficient with regard to GH production. These were patients where Dr. Hertoghe already replaced their thyroid hormones, if abnormal and replaced their sex hormones when they were low. But they lost hair, developed old looking faces with wrinkles. In addition, a loss of subcutaneous fatty tissue is giving the face a hollow appearance. They also had muscle and joint pains and thin skin, particularly over the back of their hands.

Replacement of growth hormone

He replaced their missing GH using daily GH self-injection with a tiny needle (similar to diabetes injections). Within 1.5 to 3 years the wrinkles disappeared, the faces started to look younger and patients did feel younger. Their muscle and joint pains had disappeared and their hair grew back. The dosage range is between 0.1mg and 0.3mg, a tiny amount of GH daily. This is not inexpensive, but some health care plans pay for this, as a lack of GH is a true hormone deficiency.

About organ transplants

Often it is a single limiting organ that determines when we die, typically the heart, lungs, brain, liver, kidneys, small bowel, pancreas or bone marrow. Organ transplants can add years of life, but it can be cumbersome to find a suitable donor. One study showed that only 40% to 60% of organ transplants are surviving 8 years after the surgery.

Stem cell therapies are other ways to prolong life. More research will perfect this, but essentially stem cells can provide 220 different cell types for in-vitro organ culture. This can probably be of use in the future to replace malfunctioning organs.

Life Extended By Several Decades

Life Extended By Several Decades

Conclusion

The dream of staying younger for longer can be a reality today. You just need to be willing to discipline yourself and watch what you are eating (Mediterranean type diet). Also, exercise regularly and have a positive psychological attitude. If the outdoor air is poor where you live, you may want to consider moving. Move to a place with good air quality. Sleep well for 7 ½ hours every night and retire not later than 10 to 11PM. You need to be asleep between midnight and 3AM as the growth hormone peak occurs at that time.

Take supplements

Take supplements that contain longevity micronutrients (magnesium, vitamins A, C, D, E, B6, B12, Co-Q-10, selenium, zinc, iron in premenopausal women etc.). Replace all missing hormones with bioidentical ones, like thyroid hormones (T3 and T4), sex hormones, DHEA and GH. Stem cell therapy and telomerase activators for cell rejuvenation will also have more of a place in the future.

Even, if you do only part of this reversing aging program you will slow down aging.

Incoming search terms: