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Pain and fatigue are the two leading complaints that patients bring to their physicians and they often go hand in hand. Most pain originates in the connective tissue of the body – bones, joints, ligaments, tendons, intravertebral disks and fascia. A lot of these structures are primarily constructed of the protein collagen. This protein makes up about one third of the proteins in our body.
When we get a whiplash, back strain, shoulder injury, ankle sprain, etc., the connective tissues in the area of injury experiences a greater or lesser amount of tearing or fraying. This is itself a process that occurs as we age, but acute injuries are often the breaking point (acute overload) that leads to the symptoms precipitated by a fall or other event. So often a patient says that they twisted while they were lifting a relatively light object and then their “back went out.” X-rays often reveal degenerative arthritic changes that have developed over many years due to continuing microtears of the collagenous fibers in the region.
Embedded in the collagen fibers are various sensors – modified nerve cells that transmit information related to position of joins, stretching of fibers, temperature, vibration and pressure. Of course, also present in most tissue of the body are nociception (pain) sensors which fire when tissue is torn or cut.
All of this data travels to the brain and integrates in diverse connections throughout that organ. The purpose of all of this actually is to remove the person from harm, encourage rest and guard against further injury. Various processes are initiated locally to start the healing process. Cells in the damaged area releases their contents and the material signals the migration of white blood cells into the area to clean up the debris – the later signal other cells to produce an inflammatory response which is a necessary part of the healing cascade. The inflammation also serves to destroy any microbes that invade the area if the skin barrier has been broken. Finally, specialist cells called fibroblasts home to the injured area and begin to synthesize and lay down collagen fibrils to repair the injured structures.
Normally all these processes go on smoothly and the injury is repaired. However, as in any process, errors can occur. For one, nutritional or hormonal factors can lead to delayed or inadequate healing. Second, aberrant signaling at the site of injury can lead to changes in the muscles spasms and altered proprioception (sensations of position, pressure and vibration) which lead to abnormal three dimensional positioning of the body exerting further abnormal stress at the injury site and beyond. Most importantly, short circuits can occur in the normal networks between the injury, spinal cord and brain leading to chronic pain. If an injury fails to significantly improve after six weeks, many pain specialists diagnose a chronic pain syndrome. Of course, a fracture could take longer to fully mend, but even in that example, non-union can occur and require special treatments.
If a “soft tissue” (connective tissue/fascial structures) doesn’t significantly improve after 4-6 weeks, further diagnostic evaluation and treatment is in order. These cases and ones that become truly chronic and cause symptoms of for months or years, often respond to our pain therapies. We employ the following modalities:
Briefly, these treatments accomplish the following:
Overall, I can confidently state that over 80% of patients that I treat with these methods have significant improvement in their symptoms. For a more detailed description of the therapies, read here.
When we get a whiplash, back strain, shoulder injury, ankle sprain, etc., the connective tissues in the area of injury experiences a greater or lesser amount of tearing or fraying. This is itself a process that occurs as we age, but acute injuries are often the breaking point (acute overload) that leads to the symptoms precipitated by a fall or other event. So often a patient says that they twisted while they were lifting a relatively light object and then their “back went out.” X-rays often reveal degenerative arthritic changes that have developed over many years due to continuing microtears of the collagenous fibers in the region.
Embedded in the collagen fibers are various sensors – modified nerve cells that transmit information related to position of joins, stretching of fibers, temperature, vibration and pressure. Of course, also present in most tissue of the body are nociception (pain) sensors which fire when tissue is torn or cut.
All of this data travels to the brain and integrates in diverse connections throughout that organ. The purpose of all of this actually is to remove the person from harm, encourage rest and guard against further injury. Various processes are initiated locally to start the healing process. Cells in the damaged area releases their contents and the material signals the migration of white blood cells into the area to clean up the debris – the later signal other cells to produce an inflammatory response which is a necessary part of the healing cascade. The inflammation also serves to destroy any microbes that invade the area if the skin barrier has been broken. Finally, specialist cells called fibroblasts home to the injured area and begin to synthesize and lay down collagen fibrils to repair the injured structures.
Normally all these processes go on smoothly and the injury is repaired. However, as in any process, errors can occur. For one, nutritional or hormonal factors can lead to delayed or inadequate healing. Second, aberrant signaling at the site of injury can lead to changes in the muscles spasms and altered proprioception (sensations of position, pressure and vibration) which lead to abnormal three dimensional positioning of the body exerting further abnormal stress at the injury site and beyond. Most importantly, short circuits can occur in the normal networks between the injury, spinal cord and brain leading to chronic pain. If an injury fails to significantly improve after six weeks, many pain specialists diagnose a chronic pain syndrome. Of course, a fracture could take longer to fully mend, but even in that example, non-union can occur and require special treatments.
If a “soft tissue” (connective tissue/fascial structures) doesn’t significantly improve after 4-6 weeks, further diagnostic evaluation and treatment is in order. These cases and ones that become truly chronic and cause symptoms of for months or years, often respond to our pain therapies. We employ the following modalities:
- Prolotherapy
- German Neural Therapy
- Ozone Therapy
Briefly, these treatments accomplish the following:
- Reestablishment of effective circulation to the injected area
- Dampening and elimination of aberrant neural networks that have developed after the injury. This has an analogy in computer science where “resetting” the computer will often get it correctly operating again. Another appropriate analogy is the concept of a computer virus as a cause of deranged electrical impulses routing between injury, the local area surrounding it and the central nervous system. Injections of the local anesthetic procaine can often reset the “computer” and eliminate the “virus”.
- The proliferation (prolo) aspect of the treatment describes the reinitiation of the healing process by stimulating collagen synthesis and the results re-establishment of the structural integrity in the area of injury.
- The injection of ozone into the area of injury has been proven in both animal and human studies to promote healing by increasing the production of growth factors, decrease excessive inflammation by upregulating the production of endogenously reduced antioxidants and improvement of the delivery of healing oxygen to the area. Ozone therapy has been used successfully and routinely to treat pain, infections and injuries for over 50 years around the world.
Overall, I can confidently state that over 80% of patients that I treat with these methods have significant improvement in their symptoms. For a more detailed description of the therapies, read here.
