Philipose Restorative Prolozone System
Venturis Clinic
7917 N May Ave OKC, OK 73120
(405)848-7246
Dr. Alvin Philipose, DC
The Philipose Restorative Prolozone System (PRPS), is a safe, non-surgical treatment for chronic pain using injections to stimulate healing. It uses various treatments such as prolotherapy, prolozone, ozone, neural therapy, acupuncture, sarapin, chiropractic, spinal decompression, cupping, LaserNeedle Acupuncture and various other natural and restorative treatments which have been used for decades on patients in pain from aging, overuse or injury. Pain from auto accidents, athletic injuries, and arthritic injuries often arise from injury to the soft tissues in the body. These soft tissues which include ligaments, muscles, cartilage, tendons and joint capsules are also called “connective tissues” because they connect to bones, thereby supporting the bony skeleton. The Philipose Restorative Prolozone System causes these connections to be repaired, rebuilt and strengthened. It is for this reason that The Philipose Restorative Prolozone System has also been called ligament reconstructive therapy or stimulated ligament repair.
COMMON INJURIES TREATED with The Philipose Restorative Prolozone System:
• Whiplash Injury to the Neck, Upper Back, Shoulders and Low Back
• Tension and Migraine Headaches
• TMJ Syndrome
• Low Back Pain from Lifting or Work-Related Injuries
• Postural Strain of the Neck and Back
• Overuse Injuries such as Tennis Elbow, Shoulder Tendonitis, Achilles tendonitis
• Carpal Tunnel Syndrome
• Fibromyalgia and Myofascial Pain
• Sacroiliac Joint Disorders
• Muscle Tightness, Strain and Spasm
• Arthritis Pain-Knee, Hands, Neck and Back
• Herniated and Degenerative Discs
• Pinched Nerves and Sciatica
• Weak, Loose, and Unstable Joints (Hypermobility/Subluxations/Dislocations)
• Athletic Injuries, New and Old
These represent soft tissue injuries, which can often become chronically painful. Normally, these injured muscles, tendons, and ligaments go through a repair and healing process, which takes about four to six weeks. But, what happens when the low back pain, neck pain, and headaches from a whiplash injury just will not get better? Or, the athletic injury that continues to cause nagging pain and is preventing you from staying active, especially keeping you from the sport you enjoy the most? What about the pain where you cannot pinpoint a specific injury, but think it may be due to some repetitive tasks at work, or from overdoing it while working around the house. Anti-inflammatories and medication are often given to treat these injuries, but they may actually slow or stop this healing process. When rest and pain medications fail, and usually they do because they only mask or cover up the underlying problem, other types of treatment are often tried. One method of treating these kind of injuries is a specific flexibility and strengthening program, tailored to the individual and the areas of weakness. A physical therapist can administer therapeutic treatment, teach an exercise program, and provide the education to the individual to allow them to follow their program at home, giving them independence in their recovery.
Another type of treatment is manual therapy, in which a therapist uses his hands to break up or release adhesions, muscle spasms and restricted fascia (connective tissue). Acupuncture may only give temporary relief. In a significant number of cases, despite a reasonable treatment plan and consistent effort from the individual, residual pain and dysfunction may persist. Chronic pain is often quite disabling and may affect job performance, recreational activities and activities of daily living. Along the way a doctor may state that “you just have to live with it…there is nothing you can do about it” or say that surgery is the only option. That news is frustrating and discouraging.
The Philipose Restorative Prolozone System WORKS though you may not have heard about
The Philipose Restorative Prolozone System until now, it has been used to treat pain and injuries for more than sixty years and the results have been amazing. In studies conducted on pain patients, up to 85-90% of patients receive good-to-excellent results in pain relief and improved function. We are finding similar statistics in our practice as well. Also, the use of pain medications can be greatly reduced or even eliminated after treatment. This is good news, because pain medications can be costly and have potentially serious side effects with chronic use. But, the best part of all, is that it produces long-lasting relief through stimulating the body’s natural healing response. Most other types of treatment provide only temporary relief. Philipose Restorative Prolozone System is an alternative to surgery in many cases, thereby avoiding dysfunctional scar tissue and lengthy rehabilitation.
HOW DOES The Philipose Restorative Prolozone System WORK?
The Philipose Restorative Prolozone System works on a very simple principle: injecting The Philipose Restorative Prolozone System solution at the sites of pain and weakness stimulates the body’s own healing mechanism to repair and rebuild injured tissue into a stronger, more supportive, less painful tissue than it was before treatment. When injuries to the connective tissues (ligaments, tendons, and muscles) occur, the area may not heal completely, due to poor blood supply to these tissues and from lack of proper treatment. For this reason, ligaments heal very slowly. If left untreated, damaged ligaments become loose, allowing bones in the joint to swing out of alignment causing pain, muscle spasms, and eventually arthritis. The attachment sites or anchor points of ligament to bone are the weak links. Connective tissue cells called fibroblasts are deficient, as seen under microscope. This deficiency of fibroblasts leads to loose ligaments and weakened tissues.
As a result, the normal supportive function of the ligaments, which was present prior to injury, is lost. Therefore, joint stability is reduced. Small pain fibers in these damaged ligaments transmit pain impulses to the brain when stretched. Through a subconscious reflex, the surrounding muscles go into a tight and painful spasm in an attempt to stabilize the joint. This causes the region to feel tight, stiff, achy, burning, tingling, numb, fatigued, and painful. The individual will often notice painful knots in the affected muscles. These muscles become tight and painful as they try to compensate for the weak and damaged underlying tissue structures. The muscle spasms reduce blood flow, causing even more pain. Not only are these symptoms local, but they are often referred (transmitted) through nerve pathways into the legs and feet, arms and hands, and head (headaches). In other words, pain felt in the head, arms, or legs may be due to instability in the neck or back.
For example, weakness or injury to the ligaments in the neck may interfere with the sympathetic (automatic) nervous system, causing a group of symptoms called Barre-Lieu Syndrome. This syndrome consists of one or more of the following: dizziness, visual blurring, loss of balance, ringing in the ears, runny nose, salivation, trouble swallowing, hoarse voice, nausea, vomiting, nervousness and headaches. These symptoms are caused by instability in the neck and can be eliminated by PRPS. Medications and other forms of passive treatment such as ultrasound, ice, heat, massage, acupuncture and manipulation may give minimal lasting benefits because the primary problem, the loose and injured ligaments, are not being addressed. Stretching and strengthening exercises usually can provide some relief from chronic pain, but this is often only temporary. When these exercises have failed to increase the support sufficiently to diminish pain and improve function, the chronic pain cycle ensues. The Philipose Restorative Prolozone System should be initiated as soon as possible, before the problem progresses and becomes widespread. The most basic Philipose Restorative Prolozone System solution contains a naturally occurring sugar (dextrose) derived from corn combined with an anesthetic (lidocaine). Other common, natural substances can also be used effectively such as amino acids, vitamins, and collagen. This solution does not contain cortisone, which is known to decrease inflammation, but will also slow or stop the healing process. Acute pain may be relieved with cortisone, but repeated use causes a weakening of the tissues and chronic pain develops.
THE THREE STAGES OF HEALING
INFLAMMATORY Increased blood flow, swelling and pain. Immune cells remove damaged tissue. Occurs during 1st week
FIBROBLASTIC Swelling and pain begin to subside and new blood vessels form. Tissue repair cells (fibroblasts) form new collagen. Starts at day 2 or 3 and continues for 6 weeks.
MATURATION New blood vessels mature, tissue is stronger and pain subsides. Collagen density and diameter are increased. This continues from week 6 to 18 months after injection.
When the injured tissues are injected with small amounts of the The Philipose Restorative Prolozone System solution, a reaction begins, starting a three-stage healing process (see table above). PRPS initiates the first stage (Inflammation). Stages two (Fibroblastic) and three (Maturation) will then follow automatically. In stage one, the body sends in special cells, which help to clean up the debris and damaged areas. These cells respond as if another injury has occurred resulting in a controlled inflammation and increased blood flow. This process takes a week.
In stage two, the body begins the process of repair and healing. This is accomplished by the addition of tissue repair cells called fibroblasts, which are deficient in the injured tissue. Fibroblasts increase in number at the sites of injection, and over the course of four to six weeks, secrete a substance called collagen, which is a very strong and relatively inelastic substance and the most abundant protein in the body. The new collagen makes the ligaments thicker, denser and strong, providing more support to the joints primarily where the ligaments anchor or attach to bone. The strength of the injected ligaments can increase up to 40% above normal. Stability is increased as pain and muscle spasm decrease.
In stage three, the newly formed tissue continues to mature for one to three years. Improvement, therefore, may continue for up to three years after the last treatment. If, during the three stages of the healing process, anti-inflammatory drugs, ice, compression and/or immobilization are used to reduce pain and inflammation, complete and normal healing will be inhibited. Most people are taught that inflammation is bad and don’t realize that without inflammation, no healing will occur.
So, in essence, The Philipose Restorative Prolozone System strengthens ligaments and decreases pain by stimulating the body’s own repair and healing mechanism to go into action at the areas stimulated. There is no masking of pain as tissues heal naturally and become stronger, without forming scar tissue. It is for this reason that The Philipose Restorative Prolozone System gives long-lasting relief lasting months to years. Several treatments spaced apart by about three to four weeks are usually required to get the full benefit from The Philipose Restorative Prolozone System. Because there are very few doctors who perform The Philipose Restorative Prolozone System, patients typically just accept the pain or have surgery. While surgery has its place, many patients and doctors are not aware that PRPS may relieve their pain and postpone or prevent the surgery they thought they needed. Although research and studies are proving its efficacy, it is at this time considered by most insurance companies to be “alternative”, and is not usually covered.
WHAT ABOUT THE PROCEDURE ITSELF?
The Philipose Restorative Prolozone System is a very safe procedure when performed by a trained and highly skilled physician who has an in-depth knowledge of anatomy and experience using this injection technique. The use of needles involves risks, but complications from The Philipose Restorative Prolozone System are rare.The solutions used have been shown to be safe and, as stated previously, do not contain cortisone. The most common side effect is discomfort due to the injections, as well as temporary soreness, stiffness, and occasional bruising. Although injection discomfort cannot be eliminated, it is well tolerated in most cases. Local anesthetic is used prior to the injections to decrease discomfort. If necessary, pain can also be reduced by the use of prescription oral medications for pain control and sedation taken prior to the treatment. Most patients prefer not to be sedated because it makes them feel groggy and because a driver is required to and from the appointment. Topical freeze sprays or anesthetic cream can also reduce needle discomfort. Depending on the area treated and the number of injections, which are usually just a few for small areas or many for larger areas, one may return to usual activities during the next day or two.
The actual treatment may last anywhere from a few minutes if there is only one site of
tenderness such as the elbow, to thirty minutes, if a large region such as the back and neck are being treated together. The soreness and bruising that may occur following the injections is normal and gradually lessens over several days. Approved prescribed drugs or plain Tylenol may be taken for this discomfort. However, no anti-inflammatory drugs may be taken during the treatment period because these will interfere with the healing process that PRPS initiates. A goal is to get the patient off all pain medications. Specific natural supplements may be recommended to enhance healing and alleviate pain.
CAN the Philipose Restorative Prolozone System CURE EVERYTHING?
Philipose Restorative Prolozone System is not an overnight cure. It cannot “cure” a painful condition, nor always eliminate 100% of one’s pain. There are some areas that the therapist cannot safely reach with a needle. The vast majority of patients who are treated (usually two to ten sessions) will receive at least 50%-75% relief of their pain. Many even report complete resolution. These results are excellent, considering that chronic pain is exceedingly difficult to treat by any means. It is also important to know that PRPS only strengthens tissues. No structures are weakened and no scars are formed. Therefore, no bridges are burned in the process. A good history and a thorough examination are necessary to select the best candidates for PRPS prior to treatment. The motivation to want to get better and complete the necessary treatments is vital. Patience and time are important to obtain the benefits from PRPS. Chronic pain problems do not occur overnight and they do not heal that way either. If the pain is enough to affect one’s life, then PRPS may be indicated.
COMMON QUESTIONS
Do the injections hurt?
The use of a needle is always accompanied by some degree of discomfort. It varies from patient to patient, but is usually well tolerated. It helps to stay very relaxed by not tensing the muscles and focusing on deep breathing. Local anesthetic is used to decrease discomfort.
Are there any risks?
Anytime a needle is used to penetrate the skin into the deeper tissues, there is always the chance that inadvertent puncture of arteries, nerves, spinal fluid or lung tissue may occur. Complications are rare and are greatly minimized by the skill of the well-trained physician. The solutions used in Philipose Restorative Prolozone System are very safe and the amounts used are well within manufacturer’s guidelines. However, since Philipose Restorative Prolozone System is a procedure with some risk to the patient, all patients are asked to read and sign a consent and waiver form prior to the procedure.
Should I eat before I come?
A light meal and plenty of water are recommended about 1-2 hours before the procedure. Water improves cell hydration and lessens the discomfort of the injections, while food diminishes the likelihood of dizziness. Patients report even less discomfort when they drink water right up to the time of the injections.
How many treatments are needed?
Three to six treatments for a given area is about the average needed. A few patients respond quickly to just a treatment or two, but most patients require more to stimulate the healing properly. Some patients who respond slowly may need 10 or more treatments and stronger solutions may be used to improve the response. The longer the duration of the pain and disability and the more severe and widespread it is, the more treatments will be needed to stabilize the joints. After the first session, successive treatments follow at intervals of two to six weeks. Re-assessment of structural healing usually occurs at the fourth session to determine if more treatments are necessary or desired. Staying on a consistent schedule of treatments will decrease the chance that early benefits are lost.
When will benefit from the injections occur?
Philipose Restorative Prolozone System does not result in immediate relief of pain. Some patients report improvement in as little as two weeks following injections, but it is not expected that any significant relief will be obtained until four to six weeks after the first treatment. Some patients report significant improvement in their symptoms after just the first two treatments. Others may not receive much benefit at all until they have had further treatments. As ligament strength and joint stability improve, results become more noticeable with decreased pain and improved function. Improvement may continue for up to three years after the last PRPS treatment.
What can I take for the pain during recovery?
Typically, post-injection stiffness and soreness can be expected and is necessary for the healing process to begin. This will last for the first few days. Heat usually soothes the soreness, but ice will slow the healing PRPS stimulates. No anti-inflammatory (NSAIDs) medications may be used once treatment begins because they interfere with the healing process that the PRPS injections started. An exception to this is for those who take a baby aspirin each day for their heart. Regular use of narcotic drugs should be avoided because they will inhibit the immune system and slow the healing. Tylenol may be used for a short period of time. If you are not sure whether a medication you are taking interferes with your PRPS treatment, bring it to our attention and we will help you out. Remember, it is important to treat the source of the pain through strengthening the damaged areas rather then just cover it up with chronic pain medications. Specific supplements to assist the healing process may be recommended.
Should I exercise following Philipose Restorative Prolozone System? What should I avoid doing?
Controlled exercise and mobilization of the treated area promotes tissue healing and results in faster recovery after the treatment. For this reason, movement and exercise are recommended as soon as possible. The amount will depend on your level of fitness before and on how many areas were treated. Frequent high-velocity chiropractic adjustments should be avoided because they do not allow the joints treatment with PRPS to stabilize. Massage and other similar therapies are compatible with PRPS.
When should I return to work?
In most cases, depending on your job, you may return to work or school the same day as your treatment. If, however, your job places a great deal of stress on the treated area or if you have significant post-injection discomfort, you should not return to work the same day. A few days is recommended before returning to strenuous athletic activity.
What is the chance I will get better? Get worse? How long will it last?
Statistics show that 85-90% of all patients treated with RJT receive at least a 50% benefit when treated between two and ten times. There is no evidence of a condition becoming permanently worse from receiving Philipose Restorative Prolozone System treatments. Also, because actual healing occurs with Philipose Restorative Prolozone System, it is anticipated that long-lasting or even permanent relief of one’s pain can take place. If an area is re-injured, Philipose Restorative Prolozone System treatments may be necessary in the future.
Will my insurance cover RJT?
In most cases it will not be covered, as it still is considered by insurance companies to be an “investigational” or “alternative” type of treatment. We will discuss your particular situation regarding insurance coverage of Philipose Restorative Prolozone System and the fees involved before you proceed with treatment.
INSTRUCTIONS PRIOR TO TREATMENT
• Stop taking all anti-inflammatory medications, except for baby aspirin taken for the heart, including Naproxyn, Ibuprofen, Aleve, Cortisone-like drugs, Relafen, Motrin, Advil, Aspirin products, Vioxx, Celebrex, Nuprin.
IMPORTANT: Try to decrease or quit smoking as it will impair the healing process.
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Bring any old x-rays or radiology studies to your appointment if available.
Please tell us in advance if you are taking blood thinners (e.g. Coumadin) or if you have allergies to fish, corn, sugar, anesthetics, latex or painkillers.
• Eat a light meal one to two hours prior to your treatment, and drink water up to the time of your appointment.
INSTRUCTIONS FOLLOWING TREATMENT
• DO NOT take anti-inflammatory medications after the injections. These drugs will interfere with the healing process that PRPS stimulates.
• You may take Tylenol or other approved medications for relief of injection pain following treatment. You should start taking the recommended daily supplements beginning the day of your treatment.
• You may use heat for soreness (heating pad, warm moist towel, hot shower or bath). However, refrain from the use of ice during the first week as it may impair the healing. Bruises that occur are normal and will gradually disappear.
• After the injected anesthetic has worn off (usually in a few hours), you may have a temporary increase in stiffness and pain. Not only is this expected, but it is also necessary to signal the start of the healing process. This should last only one to three days. Some patients experience episodes of pain during the first two to three weeks after treatment. This is normal and should not cause alarm. Drinking water following treatment will decrease pain and improve cell function.
• Depending on your job and the area treated, you may be advised to reduce your activities after treatment, but as a rule, you are encouraged to return to your usual activities as soon as you feel able.
• The injections you receive do not contain any cortisone or steroid medications. Instead, they may contain some of the following substances: dextrose (corn extract), zinc, calcium, lidocaine, and/or sarapin (anesthetics) and vitamin B-12.
• Philipose Restorative Prolozone System injections are intended to provide you with long-lasting relief of your pain. In many cases your pain will be greatly diminished and not return unless you re-injure yourself. An average of three to six treatment sessions, between two to six weeks apart are usually required to adequately treat the problem and stimulate the healing. More treatments are necessary for difficult problems. Each treatment builds on the previous one and too much time between treatments may slow improvement. Complete relief of pain cannot be guaranteed. Pain relief is usually first noticed at about two to six weeks following the injections. Joint strength and stability will increase with each treatment and continues for one to three years after the last treatment. The process of healing, increasing joint strength and pain relief is gradual and patience is required to realize the benefits of Philipose Restorative Prolozone System.
• You can resume your previous activities as soon as they are tolerated. Avoid high impact activities on the areas treated. You are encouraged to exercise in order to strengthen areas of weakness and for general fitness. The more active and fit you are, the quicker and easier your recovery will be. A physical therapy/exercise program may be prescribed if areas of weakness are found during your examination.
• If you have any problems following the treatment, an increase in your pain or wish to ask questions about PRPS’s, please let us know so we can serve you better.
• You will be asked to periodically provide a written update of your current status so we can track your progress and recovery.
IN SUMMARY
Philipose Restorative Prolozone System is an effective treatment for a multitude of conditions
(refer to page 1). There is no other treatment that replaces Philipose Restorative Prolozone System for strengthening weakened and damaged ligaments. It works by stimulating the body’s own healing process at the sites of injection. Healing occurs slowly but surely, and naturally. Multiple treatments are usually necessary to achieve maximum joint stability and long-lasting pain relief. The goals of the Philipose Restorative Prolozone System are to decrease pain and to improve the person’s overall ability to function at work, at home, and during competitive and recreational activities.
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