Prolotherapy Information

Marc Darrow, a Los Angeles physician, is one of many doctors in the U.S. who offer an amazing new treatment called Prolotherapy. Its name is derived from the word “proliferation,” and its goal is to stimulate the growth of new tissue, repairing damage to worn-out joints and relieving pain and discomfort.

First, the exact location of the pain is found using an acupuncture needle. Then an injection of diluted dextrose and an anesthetic is given. The anesthetic relieves the pain, while the dextrose stimulates the body’s healing response. It does this by acting as a “shock agent,” drawing water from superficial cells and drying out the site. It induces slight, but controlled inflammation, and the healing process is set in motion.

Dr. Darrow emphasizes that inflammation “means the body is responding to an injury or stress to the joint by sending cellular compounds to the damaged area. It’s your body’s way of getting the healing process started.” Once these cellular compounds have done their job, they are replaced by fibroblasts, which begin repairing the damage and forming granular tissue that will become new collagen. Collagen is a major component of the connective tissue found between tendons and ligaments.

A few clinical studies have already confirmed the benefits of Prolotherapy. Researchers at the Bethany Medical Center in Kansas City observed a decrease in pain and swelling in the arthritic knees and fingers of subjects. And this year, Australian researchers at the University of Queensland saw “significant and sustained reductions in pain and disability” after Prolotherapy had been administered to 110 patients with lower-back pain. In the future we will be devoting a full article to Shoulder Arthritis rehab since Shoulder Arthritis rehab is a large topic.

Dr. Darrow discovered Prolotherapy after having undergone it himself. During his fourth year of residency at UCLA, while suffering pain from an injured wrist, he met Dr. Andrew Kochan, who used Prolotherapy. After a few weeks of injections, Dr. Darrow was healed. He now gets great satisfaction from helping other people live active lives free of pain, without the need for anti-inflammatory painkillers.

The list of notables who have successfully found relief after using Prolotherapy include former Surgeon General C. Everett Koop and baseball legend Ernie Banks.

This simple therapy has the potential to help many older adults walk and move as they did when they were younger, playing tennis again, traveling and shopping without having to rest, and frolicking effortlessly and joyfully with their grandchildren.

Synvisc Alternative

Synisc is a commonly prescribed injection for osteoarthritis of the knee. Recently a new version has been approved by the FDA called Synvisc-One. It is not a drug, but an injection solution processed from rooster combs that seeks to mimic the naturally occurring synovial fluid in the knee. The goal is to help prevent bone on bone complications for approximately six months

Synvisc treatments need to be administered three times, the new Synvisc-One, one time.

Is Synvisc for you?
At our chronic pain speciality clinic in Los Angeles we do not recommend Synvisc. The reason? Synvisc, at best, is a temporary fix to a long-standing problem – Knee deterioration. Even in the best case scenario – the synvisc products are promoted as providing UP TO 6 months pain relief.

If you are going to have injections in the knee, why not consider a treatment that can provide permanent relief?

Osteoarthritis of the knee
Osteoarthritis or “Bone-on-bone” knee problems are the end result of a knee that has broken down and become unstable.

The knee is held together by thick strong bands of connective tissue such as the tendons that hold the supporting muscles to the bone and the ligaments including the ACL (anterior cruciate ligament), that hold the bones together. When these bands become weak and loose (ligament laxity) they cause the knee to become unstable. In this unstable state, the shin and thigh bones come together and begin to wear away at the articular cartilage that covers the bones and the meniscus, the soft pad between the shin and thigh bone.

Over time, the meniscus can get pinched between the bones and an arthroscopy is recommended by some physicians to alleviate the pain by removing the “trapped” tissue. Eventually a knee replacement may be called for.

When we see a patient in this situation we attack the osteoarthritic knee with Prolotherapy. Our goal is not to delay surgery or provide temporarily relief. Our goal is to provide a permanent, non-surgical, non-drug cure to the patient’s pain.

What is Prolotherapy and how does it work?
Prolotherapy is a simple treatment as Dextrose, (sugar in its simplest form) is injected with a mild analgesic such as dentist grade Novocain into the knee area. The injection causes a small controlled inflammation which in itself mimics the body’s natural healing response to injury repair – the creation of collagen. The new collagen repairs the old by attaching itself to the damaged tissue making it denser and stronger and restoring its natural taut state.

Many studies have shown that not only does Prolotherapy strengthen the ligaments and tendons, but more recently that Prolotherapy can regrow articular cartilage and meniscal tissue.

More importantly – theses studies show long-term and often permanent results – far beyond a 6 month expectancy.

If you have knee osteoarthritis and ould like to explore Prolotherapy and/or PRP, finding the right doctor is the first step. Contact Dr. Darrow or call 310-231-7000.

Listen to Dr. Darrow’s Radio Show Archives Online

Radio Show Archives On Line

Degenerative Disc Disease

The aging process brings about degenerative changes to our ligaments, tendons, and cartilage through the desiccation (the drying out) of collagen. Degenerative Disc Disease (DDD) refers to this process occurring in the vertebral discs. It just so happens that the vertebral discs suffers through the most dramatic of age-related changes of all connective tissue related to this process. In DDD, the discs will shrink and collapse bringing the vertebrae closer together and causing greater risk of disc herniation and assorted pain problems.

The typical treatment for Degenerative Disc Disease is heat, rest, physical therapy, and of course, medications—pain relievers and anti-inflammatories. These treatments can not solve the problem of ligament laxity as we have seen Prolotherapy do. Injections to the ligament area, can help restore, tighten, and thicken the ligaments that will stabilize the spine in Degenerative Disc Disease.

The Problem With The Diagnosis
We typically have patients come into our office with big stacks of MRIs, CT Scans and x-rays to confirm the label of Degenerative Disc Disease placed on them by other medical professionals. For example, a woman once came into our office. She had in essence become the living, breathing “embodiment,” of the problem that showed up on her film. When she came in, all she could do was talk about her degenerative disc disease at the L-5, S-1 discs.

This woman had pain in her groin and her back. When we told her we were going to examine her to determine if this was indeed her problem, she had a lot of difficulty comprehending that her pain may not come from her Degenerative Disc Disease at L-5, S-1 because she had already been diagnosed as needing surgery on these two discs. There have been many studies and papers written on the accuracy or correctness of diagnosis based on an MRI reading.

We know from studies that half the people after a certain age show disc problems on film but they reported they had no pain.

So if someone has a diagnosis from an MRI the first thing we do is see if that is REALLY where the pain from your spinal cord injury is coming from. To practice good medicine you need to rely on MRI and X-Rays and scans but you also need to use your hands to find out where the pain is coming from, being careful to gently press on the suspect area causing pain. When the physician’s touch elicits an intense pain spot, known as a trigger point or tender point, then we know this is the spot (to do Prolotherapy). In a future article we will discuss Prolotherapy Injections and the benefits of prolotherapy injections treatment in greater detail.

Disc Herniation
As Degenerative Disc Disease progresses, the pressure exerted on the discs by the squeezing together of the vertebrae can cause the disc’s inner fluid the “nucleus pulposis” to bulge (or herniate) out and through the disc’s outer layer (the annulus fibrosus) and press down on the nerve.

It is estimated that nearly 90% of disc herniations occur in the lower back and in connection with the L5-vertabrae, either between L4 and L5, or, L5 and S1. Read about Dr. Darrow’s back pain

Questions about this article? Contact Doctor Darrow.

Ligament Sprain or Herniated Disc?

Damage to ligaments is estimated to be responsible for up to 70% of all cases of lower back pain. In my clinic, I would estimate these causes to be even higher.

Many people, over the age of 50, have disc problems but don’t even know they have a disc problem because the disc has not been causing them any pain.

But if someone tweaks a ligament in their lower back, usually the iliolumbar ligament, which connects the pelvis to the spine and they have an MRI done and it shows a herniated disc, their doctor is going to want to operate when it is not needed in the many cases I see. That disc may have been herniated for years and had not been causing any pain.

If we palpitated the area above the pelvis, where the iliolumbar ligament is, and it is pretty sore, Prolotherapy could help heal that injury without surgery.

So what does the Prolotherapy do? It strengthens the ligaments, and gets rid of the pain by stabilizing the spine. We also use the MedX exercise machine. The MedX works by strengthening the musculature of the back and increasing its range of motion, both of which have been found to decrease back pain. We would also align the spine with applied kineology. Combined, these treatments usually put us in very good shape.  So if you were in a Los Angeles car accident, or a collision in some other city, and want to try pain relief therapy that can heal the damaged joint, insurance may not cover it.  But if you can prove it was reasonable and necessary expense, your car accident lawyer may be able to recover you money damages to pay for the therapy.

Hip Pain Prolotherapy

Dr. Darrow demonstrates Prolotherapy to the hip

Insurance Information

Darrow Sports & Wellness
11645 Wilshire Blvd
Los Angeles, CA
(310) 231-7000

Payment Information
As a new patient with Dr. Darrow, all consultations will be billed under Darrow Sports & Wellness Institute (DSWI).

DWSI is contracted and considered “in network” with

• Anthem Blue Cross
• Blue Shield
• United Healthcare
• Cigna
• Aetna
• Medicare

Your benefits must be verified prior to your consultation to confirm that we are in fact “in network” with your plan.

All other insurances, except Medicare, are considered “out of network”.

For out of network patients, we will be happy to send a superbill to your insurance company for you and any reimbursement that is allowed will be mailed directly to the primary subscriber on the insurance.

****We also accept Care Credit as an option for payment. This is like having a credit card that we may pay the interest for you. Please speak to a member of the staff for details****

Darrow Sports & Wellness Institute
Pain Management

In some cases you may be treated with services that are considered “investigational” or “medically unnecessary” by your insurance company; treatments such as Prolotherapy, PRP, and any treatments related to Prolotherapy or PRP such as Ultrasound Guided Injections.

Charges for these services will not be submitted to your insurance company since they will not cover them. Diagnostic Ultrasound may be billed to your insurance, as well as Ultrasound guided trigger point or local anesthetic with steroid injections.

Pain Management charges
$295 initial consultation (cash price if insurance doesn’t cover your visit)

Prolotherapy charges
$295 per visit for 1 injection area

$150 per visit for each additional injection area

$50 Guided Ultrasound Injection per area each visit

PRP charges
$800 for first body part

$645 for each additional body part on the same day

Billing can be confusing, especially with all the different plans of the different insurance companies, so be prepared to ask our staff questions about your insurance.

Patients occasionally tell us that they would rather have their insurance pay for surgery rather than the patient pay for Prolotherapy or PRP. The truth is that in most cases a “free surgery” is much more expensive than our treatment. Expenses from surgery can be monetary or non-monetary and include but are not limited to time off work, losing one’s job, side effects such as infection, joint destruction and arthritis over time, permanent disability, physical therapy, and in rare cases, death. I rarely prescribe surgery, since I don’t believe in most cases that it is effective. There are too many studies that show this. If you are having an emergency, please see your surgeon immediately.

A Non-Surgical Option For Your Knee

Over the years we have seen many patients with various knee problems and have found Prolotherapy to be a very effective treatment in not only alleviating pain but also in strengthening the knees by making the ligaments, tendons and other soft tissue stronger within the joint.

Prolotherapy is short for “proliferation therapy,” Proliferation, of course, means “rapid production.” What Prolotherapy rapidly produces is collagen and cartilage. Collagen is a naturally occurring protein in the body that is a necessary element for the formation of new connective tissue that holds the skeletal infrastructure together. These include, tendons, ligaments, muscle fascia and joint capsular tissue.

Prolotherapy helps make collagen through a series of injections, not of collagen, but of mild chemical or natural (such as dextrose-sugar) irritants, that stimulates the immune system’s healing mechanism to produce collagen naturally. Making collagen makes for strengthened and restored joints. Restored and strengthened joints makes for permanent pain relief.

Please watch as a Prolotherapy treatment is applied to the knee. If you are interetsed in making an appointment, call us 1.800.734.2210 or contact us via the web – Contact Dr. Darrow

Carpal Tunnel Syndrome – Tennis Elbow

Discussions from our Radio Show:

CALLER: I had a question, I wanted to know how the doctor felt about repetitive stress injury as the result of computer use.

Dr. Darrow: That is a great question, we have found an epidemic of people who are having repetitive use syndromes of their fingers, wrist and elbows, shoulders, sometimes all of that from computer use. We talk about the proper ergonomics about the proper hand placement around different equipment, the proper distance of the chair to the equipment, the type of chair, etc.

In the office, there are people who are on the computer all day long, they do not have a chance. Doing anything repetitively, they are going to get an overuse syndrome. I see people come into the office sometimes with their arm tucked around their abdomen. They are afraid to touch anything with it because they hurt so bad.

One of the greatest things to watch is to do some Prolotherapy into the area and seeing the tissue that has been worn down, regrow,

The thing that is so unique about this is people are always coming in and telling me, I am already inflamed, why do you want to inflame me anymore and make it worse? And Prolotherapy actually does this, it actually re-inflames the area, brings up more inflammation in a very short period of time, usually 24 hours, which will bring more blood supply to the area, and these fibroblasts and chondroblasts that actually help regrow tissue. It is the chronic low level inflammation that hurts and to get over it we have to increase the inflammation a little bit. The body’s natural healing response is inflammation. Prolotherapy has helped so many people with computer overuse syndromes, not just computer over use, we have musicians and athletes who also get overuse syndrome.

Tennis Elbow for the most part is an overuse syndrome, it occurs usually because the backhand is not performed correctly. Which is to keep the elbow more in an extended position, those beginners or players who do not have proper technique down, will bend the elbow when they are ready to hit the ball and then they will straighten it out. This causes quite a bit of overuse strain.

What we do is inject around the elbow and we are actually thickening up the tendon that attaches to the bone. There was a study done before and after Prolotherapy in the ligaments of the low back which showed a 50% growth of the ligament itself and a 200-400% strength growth. So that is what we are doing, growing more tissue, strengthening the area.

My way of thinking is that it is a very invasive technique, even though it is much less evasive than cutting the area open with a knife, but at the same time, you are typically poking two or three holes the size of a pencil into the tissue, and creating an awful lot of destruction by just entering the area. And I was one of the poor unfortunate souls that had arthroscopic surgery on my shoulder when I was in medical school because my boss at the time did it. And my arm blew up like a balloon and it took about a year for that shoulder to calm down enough to get back the level of pain it was at before the surgery. I later learned about Prolotherapy, injected myself in the shoulder and it healed right up.

Now for the pain the caller has the “lateral epicondylitis” or tennis elbow, pain around the outside of the elbow, typically Prolotherapy will take 4-5 sessions to clean that up. Now if you use the computer a lot, and this action caused the pain in the first place, it will cause it again if you are not careful. Find equipment that is ergonomically suited for you.

Please watch Prolotherapy treatments to the elbow performed by Dr. Darrow.

Prolotherapy Performed On The Elbow (Tennis Elbow)

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