Prolotherapy in Bellevue and Seattle
This non-surgical procedure relieves chronic pain with an injection that promotes the natural healing of injured tissues and joints. The limited blood supply and poor healing properties of ligaments, cartilage and tendons may make treatment necessary after injury. Prolotherapy is not a treatment for all issues; a careful pre operative consultation is required to determine if a patient will benefit from prolotherapy versus one of many dozens of other treatment options available from Dr. Attaman.
Beware of practitioners (many are not even physicians) who suggest you need 5-20 sessions of prolotherapy; these are universally people with no training in the usage of image guidance, and most have no other tools available to treat you. In general, prolotherapy properly performed under image guidance should require no more than 1-3 treatments.
Can It Help Me?
Conditions aided by prolotherapy include whiplash, chronic lower back pain, sacroiliac joint pain, joint problems such as chronic tendonitis and sprained ligaments and tendons.
Injecting the Solution
A mixture of concentrated dextrose, glycerin, and low concentration phenol (PDG solution) is injected into and around the injured tissues. PDG is the strongest of the prolotherapy injection solutions in common use. It creates a stronger and more efficacious inflammatory reaction than using dextrose alone. The injection tricks the body into responding as if a new injury has occurred.
This injection is performed by Dr. Attaman using image guidance such as ultrasound or X-ray. This enhances safety, accuracy, and efficacy many times over prolotherapy done without image guidance. It is particularly critical that x-ray image guidance be used for prolotherapy injections performed in the spine; a misplaced needle in the spine may result in nerve injury, paralysis, and even death. Dr. Attaman is one of the few board certified Interventional Pain Management physicians in the country who performs prolotherapy injections in the spine using fluoroscopic X-ray guidance.
Dr. Attaman received extensive training under the late renaissance man Dr. Thomas Dorman, a leader of the “West Coast” school of prolotherapy. This school of prolotherapy was developed by Dr. Milne Ongley after completing his training with the late James Cyriax. This is considered the most advanced and efficacious school of prolotherapy, in which a very detailed biomechanical evaluation is carried out prior to prolotherapy; it is not enough to identify the damaged tissue, rather the entire “kinetic chain” of the patient must be evaluated prior to identifying which structures need to be treated to optimize function. One may think of this as an engineer evaluating problems with a suspension bridge; while only a few cables may be damaged, those few cables can propagate fault along the entire structure. This was labeled as “tensegrity” by architect Buckminster Fuller.
The second vital component to the “West Coast” school of prolotherapy is the integration of manual therapy into the Prolotherapy session prior to injection. As a board certified Osteopathic Physician, Dr. Attaman applies hands on Osteopathic Manipulative Medicine of the structures in poor alignment immediately prior to Prolotherapy. This is particularly important when performing Prolotherapy in the spine to ensure normal “alignment” prior to injection.
This detailed pre-operative biomechanical assessment of the patient’s kinetic chain and pre-operative manipulative medicine is unique to the “West Coast” school of Prolotherapy and not an integral part of the form of Prolotherapy taught by Drs. Hemwall and Hackett. It is Dr. Attaman’s experience that the “West Coast” school of prolotherapy is much more efficacious.
How It Works
This attracts cells that specialize in repairing damaged tissue. These cells include fibroblasts, which create the collagen used to strengthen and rebuild any damaged tissue.
Prolotherapy patients are able to go home the same day, and should avoid taking any anti-inflammatory pain medications (aspirin, ibuprofen and naproxen). Full recovery from inflammation usually occurs within one week of the procedure. Additional treatments may be required to ensure complete healing of the injured tissues.