Prolotherapy (proliferative therapy)

Also known as ligament and tendon reconstruction therapy, and fibro-osseous injection therapy, is a recognized orthopedic procedure that stimulates the body’s natural healing processes to strengthen joints of spine and limbs weakened by traumatic or over-use injury.

When ligaments or tendon attachments are stretched , torn, or fragmented, joints become hypermobile and painful. Traditional approaches with surgery and anti-inflammatory drugs often fail to stabilized the joint and relieve this pain permanently.

Prolotherapy creates a healing inflammatory reaction that stimulates injured tissue cellular repair mechanisms and activates body’s production of stem cells and growth factors that are shuttles to the site of injury.

Prolotherapy, with its unique ability to directly address the cause of the instability, can repair the weakened sites and produce new fibrous tissues, resulting in permanent stabilization of the joint.

Back on the tennis court!

I have been playing tennis since I was about 8 years old. Unfortunately I suffered a severe elbow injury, which damaged tendons and ligaments in my inner, lower right elbow. At the time, the only real option to treat such an injury was with surgery that involved a long recovery period. I visited a renown elbow specialist in NYC at the Hospital for Special Surgery, who told me to treat it conservatively and get more PT before even considering the surgical route. At that point I decided I would not have the surgery, and resigned to the fact that I would probably never play tennis again.

Fast forward almost 15 years where I start my treatment regimen for my elbow with Dr. Kaplan. I first had the Tenex procedure done, followed by PRP therapy, and finally a few treatments of prolotherapy. I combined those treatments with about 12 sessions of physical therapy, and I am thrilled to say that I am back on the tennis court playing about 3 hours/week at a solid 4.0 level, all while being pain free for the first time in 16 years!   Granted, I am about 15 lbs. heavier, and 16 years older, so I don’t quite move as well as I did back in 1999, but the important thing is I am back out there thanks to the successful treatment I received from Dr. Kaplan!



Guy Sadkin, Williamsville

2017-11-06T09:27:36+00:00
I have been playing tennis since I was about 8 years old. Unfortunately I suffered a severe elbow injury, which damaged tendons and ligaments in my inner, lower right elbow. At the time, the only real option to treat such an injury was with surgery that involved a long recovery period. I visited a renown elbow specialist in NYC at the Hospital for Special Surgery, who told me to treat it conservatively and get more PT before even considering the surgical route. At that point I decided I would not have the surgery, and resigned to the fact that I would probably never play tennis again. Fast forward almost 15 years where I start my treatment regimen for my elbow with Dr. Kaplan. I first had the Tenex procedure done, followed by PRP therapy, and finally a few treatments of prolotherapy. I combined those treatments with about 12 sessions of physical therapy, and I am thrilled to say that I am back on the tennis court playing about 3 hours/week at a solid 4.0 level, all while being pain free for the first time in 16 years!   Granted, I am about 15 lbs. heavier, and 16 years older, so I don’t quite move as well as I did back in 1999, but the important thing is I am back out there thanks to the successful treatment I received from Dr. Kaplan! Guy Sadkin, Williamsville

4 years of arthritic thumb pain.


Over the past four years my arthritic thumb joint has gotten progressively more painful and weakened. I had purchased all the splints recommended with little relief from the pain. NSAIDS were not having much of an affect. I had constant pain in my thumb. It was the one thing that made me feel my age. Yoga positions that I once enjoyed became more and more difficult. Riding my bike was not without discomfort. Even driving highlighted the pain that I had from this degenerating joint. Tightening and loosening lids were problematic. The joint was swollen and tender to touch.

It is like years have been erased since I had my last prolotherapy injection. The swelling and pain has disappeared. I am able to easily do the downward dog yoga position without any discomfort and I no longer ask for assistance with opening jars. I cannot recall the last time I grimaced at the wheel of the car while driving wishing the pain in my thumb joint would go away. It is difficult to imagine all the pain that I once had now that it is gone. I have highly recommended Dr. Kaplan’s Osteopathic Wellness program to friends who suffer from arthritis. I have tremendous respect for Dr. Kaplan and his commitment to wellness. I have been more than pleased with the care and surprised by the generous amount of time that he is able to commit to his patients.

2017-11-06T09:28:16+00:00
Over the past four years my arthritic thumb joint has gotten progressively more painful and weakened. I had purchased all the splints recommended with little relief from the pain. NSAIDS were not having much of an affect. I had constant pain in my thumb. It was the one thing that made me feel my age. Yoga positions that I once enjoyed became more and more difficult. Riding my bike was not without discomfort. Even driving highlighted the pain that I had from this degenerating joint. Tightening and loosening lids were problematic. The joint was swollen and tender to touch. It is like years have been erased since I had my last prolotherapy injection. The swelling and pain has disappeared. I am able to easily do the downward dog yoga position without any discomfort and I no longer ask for assistance with opening jars. I cannot recall the last time I grimaced at the wheel of the car while driving wishing the pain in my thumb joint would go away. It is difficult to imagine all the pain that I once had now that it is gone. I have highly recommended Dr. Kaplan’s Osteopathic Wellness program to friends who suffer from arthritis. I have tremendous respect for Dr. Kaplan and his commitment to wellness. I have been more than pleased with the care and surprised by the generous amount of time that he is able to commit to his patients.

Believer in Prolotherapy


I’ve had back issues for more than 30 years. The pain has at times contributed to poor sleep. I’ve had such intense pain that I was pretty much nonfunctional. Before meeting Dr. Kaplan, I’d been to many doctors. I was x-rayed and sent out to get an MRI. The physiatrist gave me epidural cortisone injections and said that if that did not work that I would need surgery. The treatment was good for about one week. I was not yet sold on surgery. Additionally, I’ve been going to a chiropractor for many years of back adjustments. One day he told me that my problem was not a chiropractic issue. I gave up my home-improvement contractor’s license and resigned myself to being in pain.

Then I met Dr. Kaplan. After three Prolo Therapy treatments, I’m thrilled to report that I feel substantially better. The chronic pain is gone. My back feels stable for the first time in many years. Additionally, Dr. Kaplan’s bed-side manor, during the injections, was superb. The combination of Dr. Kaplan and Prolo Therapy has been the best thing to happen to my back in the past 35 years. I am a believer in Osteopathic Wellness Center of WNY, Dr. Kaplan and Prolo Therapy.



Alan Blanchard


2017-11-06T09:29:01+00:00
I’ve had back issues for more than 30 years. The pain has at times contributed to poor sleep. I’ve had such intense pain that I was pretty much nonfunctional. Before meeting Dr. Kaplan, I’d been to many doctors. I was x-rayed and sent out to get an MRI. The physiatrist gave me epidural cortisone injections and said that if that did not work that I would need surgery. The treatment was good for about one week. I was not yet sold on surgery. Additionally, I’ve been going to a chiropractor for many years of back adjustments. One day he told me that my problem was not a chiropractic issue. I gave up my home-improvement contractor’s license and resigned myself to being in pain. Then I met Dr. Kaplan. After three Prolo Therapy treatments, I’m thrilled to report that I feel substantially better. The chronic pain is gone. My back feels stable for the first time in many years. Additionally, Dr. Kaplan’s bed-side manor, during the injections, was superb. The combination of Dr. Kaplan and Prolo Therapy has been the best thing to happen to my back in the past 35 years. I am a believer in Osteopathic Wellness Center of WNY, Dr. Kaplan and Prolo Therapy. Alan Blanchard

Paul Weber testimonial


Paul Weber testimonial
Torn ribcage ligament.
One and a half years of chest pain.

I was in severe pain. Simple daily tasks were basically impossible. I tried massage therapy, physical therapy and chiropractic care with no relief. My quality of life was severely impacted. I could barely do anything; something as small as helping my wife carry in groceries was painful. It was extremely difficult as I was very active prior to this injury. Dr Kaplan informed me that I had torn a ligament connecting my left ribs to my sternum as a result of repetitive physical work. I received an injection of a concentrated sugar solution into the torn ligament with a procedure called prolotherapy from Dr Kaplan and began to feel immediate relief. I can now do all the physical things I have been avoiding for over a year. This
treatment has changed my life.

Paul Weber.

2017-11-06T09:29:38+00:00
Paul Weber testimonial Torn ribcage ligament. One and a half years of chest pain. I was in severe pain. Simple daily tasks were basically impossible. I tried massage therapy, physical therapy and chiropractic care with no relief. My quality of life was severely impacted. I could barely do anything; something as small as helping my wife carry in groceries was painful. It was extremely difficult as I was very active prior to this injury. Dr Kaplan informed me that I had torn a ligament connecting my left ribs to my sternum as a result of repetitive physical work. I received an injection of a concentrated sugar solution into the torn ligament with a procedure called prolotherapy from Dr Kaplan and began to feel immediate relief. I can now do all the physical things I have been avoiding for over a year. This treatment has changed my life. Paul Weber.

Life improving with each treatment.




In 2013 I was in an accident involving a tractor trailer and suffered from tissue damage to various parts of my body. I had chronic pain in my shoulder, swelling and chronic pain in my ankle, severe pain in the cervical area of my neck and nagging pain in my lower back. After 1 year of physiotherapy it was suggested I seek surgical help.

After only 2 treatments of prolotherapy, my shoulder has improved beyond my expectations. The pain has subsided considerably and I am no longer plagued with the severe aching. Also my range of motion is now 100%. I had a third treatment just yesterday and expect to have no pain soon. On my next visit we are going to address my neck and spinal injuries. I can't begin to describe how the pain affected not only my quality of life but also those around me. I feel very grateful to have found Dr Kaplan and his staff as I see my life improving with each treatment.




Barbara L.


2017-11-06T09:30:09+00:00
In 2013 I was in an accident involving a tractor trailer and suffered from tissue damage to various parts of my body. I had chronic pain in my shoulder, swelling and chronic pain in my ankle, severe pain in the cervical area of my neck and nagging pain in my lower back. After 1 year of physiotherapy it was suggested I seek surgical help. After only 2 treatments of prolotherapy, my shoulder has improved beyond my expectations. The pain has subsided considerably and I am no longer plagued with the severe aching. Also my range of motion is now 100%. I had a third treatment just yesterday and expect to have no pain soon. On my next visit we are going to address my neck and spinal injuries. I can't begin to describe how the pain affected not only my quality of life but also those around me. I feel very grateful to have found Dr Kaplan and his staff as I see my life improving with each treatment. Barbara L.

Diagnosed and treated when others couldn’t.


Dr. Kaplan is a gifted doctor! Dr. Kaplan gave me a prolotherapy treatment on my wrist after I tore ligaments in a fall.

Prior visits to a hand specialist were ineffective and no options for treatment were offered except 2 rounds of X-rays (which kept coming back "still not broken") and the instruction to return in a month if it still wasn't better!

Dr. Kaplan performed an ultrasound and was able to diagnose the tear. And after a prolotherapy treatment, I am finally getting better!



Ellen S.


2017-11-06T09:30:59+00:00
Dr. Kaplan is a gifted doctor! Dr. Kaplan gave me a prolotherapy treatment on my wrist after I tore ligaments in a fall. Prior visits to a hand specialist were ineffective and no options for treatment were offered except 2 rounds of X-rays (which kept coming back "still not broken") and the instruction to return in a month if it still wasn't better! Dr. Kaplan performed an ultrasound and was able to diagnose the tear. And after a prolotherapy treatment, I am finally getting better! Ellen S.

Saved my trip to Europe.




A shout out to my favorite Dr!

Dr. Kaplan is the one that helped me to recover from my injury last spring.  Last visit was the day before my trip to Europe.  If I hadn't received such good care, I know my trip would have been affected!

This year as I start my journey to great health. Once again, Dr Kaplan is helping me through some heel issues so that I can keep going! I cannot recommend this practice highly enough!!!!!




Sharon S.


2017-11-06T09:33:59+00:00
A shout out to my favorite Dr! Dr. Kaplan is the one that helped me to recover from my injury last spring.  Last visit was the day before my trip to Europe.  If I hadn't received such good care, I know my trip would have been affected! This year as I start my journey to great health. Once again, Dr Kaplan is helping me through some heel issues so that I can keep going! I cannot recommend this practice highly enough!!!!! Sharon S.

Prolotherapy Helped My Severe Sciatic Pain

May 30, 2018

Prolotherapy has truly been a success story for me. I had severe sciatic pain in my right calf. Standing or walking caused excruciating pain! On the pain scale, it was certainly a 10. I had never heard of prolotherapy before I’d gone to see Dr. Kaplan, and after having a neurosurgeon tell me that I needed surgery to fuse and cage vertebrae, I’d decided to try a more conservative approach first. After only three prolotherapy sessions, I am 100% pain free and have remained pain free for about 2 years. It would certainly be worth the time to consult with Dr. Kaplan. His staff is wonderful! Always pleasant and helpful. I highly recommend Dr. Kaplan for pain management.

Deborah A.

2018-07-04T12:13:04+00:00

Deborah A.

May 30, 2018 Prolotherapy has truly been a success story for me. I had severe sciatic pain in my right calf. Standing or walking caused excruciating pain! On the pain scale, it was certainly a 10. I had never heard of prolotherapy before I’d gone to see Dr. Kaplan, and after having a neurosurgeon tell me that I needed surgery to fuse and cage vertebrae, I’d decided to try a more conservative approach first. After only three prolotherapy sessions, I am 100% pain free and have remained pain free for about 2 years. It would certainly be worth the time to consult with Dr. Kaplan. His staff is wonderful! Always pleasant and helpful. I highly recommend Dr. Kaplan for pain management.

Prolotherapy for Chronic Pain

As a lifelong trades person, I have developed chronic pain from repetitive overuse. Dr. Speciale has accurately diagnosed my conditions and then successfully treated them using comprehensive Prolotherapy! Thank you to all the good folks at OWM Buffalo!

Gary S.

2018-07-04T12:27:14+00:00

Gary S.

As a lifelong trades person, I have developed chronic pain from repetitive overuse. Dr. Speciale has accurately diagnosed my conditions and then successfully treated them using comprehensive Prolotherapy! Thank you to all the good folks at OWM Buffalo!

Prolotherapy for Disc Issues

I have had disc issues in my neck for over 20 years. I have tried PT throughout the years, massage therapy, muscle relaxers, trigger point injections and chiropractic. My neck and upper trapezius ache all the time. Working on a computer, cutting the grass, working out – even simple sit-ups, and sleeping are difficult. I limit what I do to help alleviate pain and discomfort.

I had one prolotherapy treatment with Dr. Kaplan and I was amazed at how good I felt. I had forgotten what it felt like not to be in pain or constant discomfort. Dr. Kaplan explained everything he did prior to doing it. He was kind and compassionate during the treatment, and the office called to check on me the next day.

Rene S.

2018-07-04T12:30:35+00:00

Rene S.

I have had disc issues in my neck for over 20 years. I have tried PT throughout the years, massage therapy, muscle relaxers, trigger point injections and chiropractic. My neck and upper trapezius ache all the time. Working on a computer, cutting the grass, working out – even simple sit-ups, and sleeping are difficult. I limit what I do to help alleviate pain and discomfort. I had one prolotherapy treatment with Dr. Kaplan and I was amazed at how good I felt. I had forgotten what it felt like not to be in pain or constant discomfort. Dr. Kaplan explained everything he did prior to doing it. He was kind and compassionate during the treatment, and the office called to check on me the next day.

Prolotherapy for Back and Hip Pain

I had back and hip pain. My lower extremities were painful and weak. Back pain in the spine was at an 8+ on a scale of 1 – 10. I had trouble walking more than 10 feet without stopping to rest. Pain in my hip was at 10+, and my upper back was very weak. Chiropractic, physical therapy and medications didn’t alleviate anything. My activities of daily living went downhill. No gardening, sitting or standing for any length of time. My sleeping pattern was awful. Depression was increasing and energy was decreasing. I didn’t want to leave the house and life was horrible.

I’ve just had my second prolotherapy treatment on the lower back and now I’m able to walk without limping. I’m very thrilled with what little I have had as far as treatments so far. I’m looking forward to more treatments for my entire spine. I can’t wait!!

I am so excited to continue my treatment here at OWM Buffalo. Everyone here is fabulous. No one could ask for anything or anyone better. My entire experience has been without question, the BEST treatment and experience I’ve ever had. The entire staff is a prayer being answered! There are no words to define what all of them have done for me except “Angels”!

Lynda L.

2018-07-04T12:33:45+00:00

Lynda L.

I had back and hip pain. My lower extremities were painful and weak. Back pain in the spine was at an 8+ on a scale of 1 – 10. I had trouble walking more than 10 feet without stopping to rest. Pain in my hip was at 10+, and my upper back was very weak. Chiropractic, physical therapy and medications didn’t alleviate anything. My activities of daily living went downhill. No gardening, sitting or standing for any length of time. My sleeping pattern was awful. Depression was increasing and energy was decreasing. I didn’t want to leave the house and life was horrible. I’ve just had my second prolotherapy treatment on the lower back and now I’m able to walk without limping. I’m very thrilled with what little I have had as far as treatments so far. I’m looking forward to more treatments for my entire spine. I can’t wait!! I am so excited to continue my treatment here at OWM Buffalo. Everyone here is fabulous. No one could ask for anything or anyone better. My entire experience has been without question, the BEST treatment and experience I’ve ever had. The entire staff is a prayer being answered! There are no words to define what all of them have done for me except “Angels”!
With a precise injection of a mild irritant solution directly on the site of the torn or stretched ligament or tendon, prolotherapy creates a mild, controlled injury that stimulates the body’s natural healing mechanisms to lay down new tissue on the weakened area. The mild inflammatory response that is created by the injection encourages growth of new ligament or tendon fibers, resulting in a tightening of the weakened structure. Additional treatments repeat this process, allowing a gradual buildup of tissue to restore the original strength to the area. Injection of varicose veins and other similar abnormalities creates a mild inflammatory response causing them to contract so that they become smaller or even vanish.
The prolotherapy injections contain anesthetic agents and natural substances which stimulate the healing response. There are numerous substances, and each treating physician tailors the selection of substance according to the patient’s need.
Any pain involving an injection will vary according to the structure to be treated, the choice of solution, and the skill of the physician administering the injection. The treatment may result in mild swelling and stiffness. The mild discomfort passes fairly rapidly and can be reduced with pain relievers such as Tylenol. Anti-inflammatory drugs, such as aspirin and ibuprofen, should not be used for pain relief because their action suppresses the desired inflammatory process produced by the injection.
Each patient must be evaluated thoroughly with patient history, physical exam, X-ray exam, and full laboratory work up before treatment will be administered. With this information, your physician can evaluate your potential success with this therapy. Success depends on factors which include the history of damage to the patient, the patient’s overall health and ability to heal, and any underlying nutritional deficiencies that would impede the healing process.
Physicians who administer this form of therapy are trained by The American Osteopathic Association of Prolotherapy Regenerative Medicine. Postgraduate training is a prerequisite before treating any patient with a medical orthopedic problem, vein problem, or other condition which might benefit from prolotherapy.
This form of therapy can be used to treat dislocation of the joints, knee pain, shoulder pain, Temporal Mandibular Joint dysfunction, Carpal Tunnel Syndrome, and disc problems at any level of the spine. The therapy affects only the area treated and does not cause any problem in any other area. Spider veins, abnormal or bulging veins and other similar conditions can be treated on the legs, feet, hands, arms, breast, face, and most other areas.
The treatments should be administered every one, two, or three weeks, as determined by your treating physician. Vein treatments are usually scheduled four or more weeks apart.
The anticipated rate of success depends on a number of variables, including the patient’s history and ability to heal, and the type of solution used. In patients with low back pain with hypermobility, 85% to 95% of patienst treated experience remission of pain with this form of therapy. In comparison, the Journal of Bone and Joint Therapy reports on a 52% improvement in patients treated surgically for disc involvement. Varicose veins can usually be 90% to 100% eliminated. Spider veins can usually be improved 70% to 90%.

Prolotherapy/sclerotherapy has been used successfully as early as 500 B.C. when Roman soldiers with shoulder joint dislocations were treated with hot branding irons to help fuse the torn ligaments in the shoulder joint. Advances in medicines greatly improved on this process, and led to the modern techniques of strengthening the fibrous tissue rather than producing scarring to fuse tissues. In 1926, a group of physicians met with great success using injection therapy to treat hernias and hemorrhoids. Earl Gedney, D.O., a well-known Orthopedist, decreased his surgical practice and began to inject joints with these newer injectible medicines in the 1940s and 1950s. Also, in 1950, George Stuart Hackett, M.D., wrote a book on injection therapy. His work is still used today in training physicians. In the years since this early work, techniques and medications have advanced to move from a scarring or fusing effect to a strengthening effect, which restores the weakened joint to its original level of stability, without loss of flexibility and function.

Hippocrates described vein sclerotherapy around 400 B.C. using “slender instruments of iron” to treat varicose veins causing vein ulcers. Injection sclerotherapy of veins was first reported in 1623, and modern forms of injection sclerotherapy for varicose veins and similar diseases has been performed since the early 1900’s. Refinements and clinical study over the past few decades have dramatically improved our understanding of vein sclerotherapy, and improved the results.

Prolotherapy is an injection of a solution that creates microscopic injury to the tissue injected and stimulates body’s immune system to heal the injured region. Prolotherapy solutions vary. High concentration dextrose (sugar solution) and PRP (platelet rich plasma) are frequently used alone or in combination.

Knee Osteoarthritis

In a Journal of Complimentary Medicine in 2012, Dr Rabago and others published results of benefits of Prolotherapy injections containing Dextrose (concentrated sugar solution) for moderate to advanced osteoarthritis of the knee. The outcomes were compared to saline (sterile water) and physical therapy alone.  The results were far superior for Prolotherapy in reduction of pain and improvement of function when compared to the other two interventions.

 

Spine

Dr Yeland and others published a study on benefits of Prolotherapy for chronic low back pain in a 2004 publication of the Spine journal.

Patients had on the average fourteen years of pain. Prolotherapy injections consisted of Dextrose/ Lidocaine and were compared to Saline alone. There was 50% improvement in both pain and function in the Prolotherapy group.

In 2014 at an annual Prolotherapy conference, Dr Young Kim, a Korean orthopedic spine surgeon reported his experience with 24 patients with severe cervical and low back pain and spinal nerve compression. He used a combination of PRP and Prolotherapy. He also reported greater then 50% improvement of pain and function.

In many cases there was a significant reduction of spinal cord compression after treatment: