RADIO SHOW TRANSCRIPTS
WHIPLASH

Taking the surgery out of pain, this is the Dr. Marc Darrow Show, changing the treatment of chronic pain.

Dr. Darrow is the medical director of Joint Rehabilitation and Sports Medicine Center in Los Angeles. He is dedicated from keeping you from unnecessary surgery for joint problems.

Dr. Gene: My name is Dr. Gene and I have the privilege of co-hosting the Dr. Marc Darrow show with Dr. Darrow.

Dr. Darrow is a board certified physiatrist, he specializes in physical medicine and rehabilitation. He is the medical director of Joint Rehabilitation and Sports Medicine Center in West Los Angeles.

Dr. Darrow's focus of his practice is on musculo-skeletal injury. He is terrific in pain management. As an avid sports enthusiast, Dr. Darrow discovered Prolotherapy after an injury on the golf course which caused him to suffer the kind of chronic pain that afflicts millions of Americans. And a skeptical Dr. Darrow became a believer in the therapeutic healing powers of Prolotherapy and trigger point injections, only after one treatment, since then he has devoted his practice to Prolotherapy, a little known natural therapy that is really revolutionizing the way we treat chronic pain. As always Dr. Darrow it is a pleasure talking to you this Saturday morning.

Dr. Darrow: I had Prolotherapy on my back this morning, I fell down the stairs about six weeks ago and fell on the back of my ribs and the back of my pelvis and it sort of loosened everything up and it brought back an old injury that I had when I was a gymnast and fell on my tail bone. I had been healed with Prolotherapy once before and this is my third set of Prolotherapy injections for this injury and I am ready to go back out on the golf course.

Dr. Gene: You know with the traditional medicine using the MRI or any type of soft tissue x- ray. In your opinion is there a down side risk to using these techniques as the basis of surgery?

Dr. Darrow: I have had bad back pains that went down into my legs where I actually had to limp around for a couple of days and I never got an MRI. Now why didn't I? Because I don't believe in them, I believe that they are a useful backup but not as a primary diagnosis. Now if I had a herniated disc, in my low back where the pain was, a surgeon would have told me to have a surgery to clean up the disc. But what we find in the people that come into our clinic is that they have sprains in the ligaments and this sprain can "pretend" that it is a herniated disc that the person has. Many people have disc problems, they have no pain, but if they get a sprain in their back and then they get and MRI, the doctors often think that it is the disc problem causing pain and they recommend surgery to fix it and it doesn't work.

Dr. Gene: What you are saying is that there is a lot of referable pain.

Dr. Darrow: There is pain that can come from the back down the legs, from the neck down the arms, that has absolutely nothing to do with the disc even if there is a disc problem. Most of the pain comes from Trigger Points, which was popularized by Dr. Travell and Simon who worked with Presidents Kennedy and Johnson. What we find is that the trigger point injections work very adequately when some one has an acute or new injury, to help relax the muscles. But what we find down the road the problem becomes chronic.
The other night we had a caller who said she had 25 years of back pain healed by Prolotherapy, and she said she was healed after only eight treatments. We hear that everyday, people getting better, and it makes us excited and enthusiastic about this pain treatment.

Dr. Gene: Now you mentioned trigger point injections, tender point injections, and then there is Prolotherapy injections.

Dr. Darrow: What the dextrose does is start a very small inflammatory response in the body. Inflammation kicks up the immune system, the immune system brings up fibroblasts which are small cells that produce collagen. Wherever we put that small needle, we will be stimulating collagen growth (Studies have shown ligaments actually get 50% thicker and their strength becomes 200-400% stronger.) Typically a person needs to get injected two to four times to show improvement, and if it is a really bad injury, we may have to inject up to eight times over a period of a couple of months as it does take collagen a couple of months to grow.

Prolotherapy helped me personally after numerous chronic injuries and a failed surgery. It is a valuable weapon that can help people with chronic pain.

CALLER: MY question is, I was in an accident and sustained injuries in the neck area, can you explain whiplash to me?

Dr. Darrow: One of the biggest problems is that people drive with their head restraints too low. SO when they are rear-ended, your head is thrown back violently. Your car keeps moving forward, your neck is kind of in an S-shape, and then when your head comes forward when your car stops, there is a sheer force on the vertebrae that can actually tear the vertebral end plates where the vertebrae attach to the discs and tear ligaments and sometimes you can't see this on X- rays or MRIs it is very subtle thing that can happen, certainly x-rays don't show it at all.

So it is an injury to the structures that hold up the head and that can be the ligaments, the parts of the muscles that attach to the bones, it can be the discs themselves, you can get disc herniation like that. And there are so many different side effects that can come from this, neck pain to headaches, some people get allergy type symptoms, they get GI complaints where there stomach is inflamed, anxiety problems, even depression. Some people even get Fibromyalgia which is just a syndrome, people get widespread pain. Fibromyalgia can be set off by a car accident.

Many times doctors do not find what they call objective findings, when they look at diagnostic studies, they don't find anything at all, except that these people have a lot of misery.

Whiplash throughout the years has been laughed at by a lot of doctors. In the 19th century when people rode on the railways, they use to bounce against each other (because of the coupling system) and they use to wind up with whiplash, they called it Railway spine and they laughed at that.

What we are finding now is that even with low speed type car accidents, about 30-60% of these people end up with long lasting injuries, and about 35-50% of them never recover.

Dr. Gene: In whiplash, doesn't it take a week to develop. Would you suggest that instead of taking painkillers or get Prolotherapy?

Dr. Darrow: Well neither of those actually, NSAIDS block the inflammation, the natural healing process, I would not do Prolotherapy for about 3-4 weeks after the injury to see how much natural healing takes place on its own without my interference. People usually stay inflamed for a few weeks, if the inflammation doesn't go away then we use Prolotherapy techniques to help reinflame the area, get more blood flow to the area and create a healing situation.

Dr. Gene: Is this a type of pain that fluctuates with whiplash?

Dr. Darrow: Everybody has different effects, there are many types of risk factors for whiplash, one is being female. More females get injured more than men because I believe it is due to the fact that the musculature around the neck is smaller and not as strong in females so they get more of a whip. Age is also important, the older a person is the more of a chance of getting a whiplash with lasting disability, previous medical history with neck pain is also a factor, position in the vehicle is very important if some one has their head turned that is a different type of whiplash. Another thing is awareness, being prepared for the crash. If someone sees the car coming in the rearview mirror, they tighten up and that actually helps prevent whiplash, if some one is unprepared, their neck is very loose and there is more of a whip like injury.

Dr. Gene: What about the aging process, of just hurting more after working out or playing tennis. I use to play tennis very often when I was young and nothing hurt the day after if I haven't played in sometime, everything just hurts. I wonder would Prolotherapy help.

Dr. Darrow: The question about aging is very important, we are made up of 90% collagen which holds a lot of the water in our system, and as we age, the collagen dries out and breaks down and there isn't as much supportive tissue as there was when we were kids. I remember when I was a kid I got hurt every day. But none of those injuries ever seemed to last, two or three days later I was fine. But what I am finding now in my older years is that when I am injured it stays longer. And sometimes some of these things I had as a kid are coming back. Because it wasn't like there was a total recovery of a healing, it was probably a partial healing but there was enough extra tissue around to handle it and there was no pain. At this age, as I notice a few wrinkles on my face, this is also happening to ligaments, tendons, joints are wearing down just like an automobile gives out after a while. We are in a new age now where we are leaning that No Pain, No Gain is not the way to go, because our bodies are pieces of machinery in a sense with a spirit in side of them and we have to protect them and be very judicious about the sports we do as we age because in our older years it is important not to do the same sport more than two days in a row or the same exercise, it is better to let that area heal itself.

Neck Pain and Whiplash Links