Ben Benjamin, training for an ultramarathon in Utah, runs on the Pacific Crest Trail near Grouse Gap. - Photo by Andy Atkinson

New life for old joints

It helped Tiger Woods recover from a devastating knee injury. It saved the career of Pittsburgh Steelers wide receiver Hines Ward. It helped heal the knee of downhill skier Bode Miller, who subsequently won both the World Cup and Olympic gold.

"It" is prolotherapy, an alternative medical treatment that uses the body's own healing systems to regenerate tendons, ligaments and cartilage.

"If the tissues heal back to their normal length and strength, that process is six to eight weeks," says Dr. Allen Thomashefsky. "If that ligament hasn't healed tightly enough, the ankle is going to be loose forever.

Ashland physician Thomashefsky and Medford osteopath Carl Osborne are Southern Oregon's two prolotherapy practitioners.

Whether it's an injured ankle, knee or shoulder, if the healing process is not complete, the eventual result is degenerative arthritis. Competitive athletes are especially prone to this condition because of the punishment they inflict on their joints.

Enter prolotherapy, a simple technique that's been around for more than 60 years but has gained in popularity and medical acceptance over the past decade, thanks to testimonials from star athletes and new medical studies.

"This is the principle: an injury to induce a healing response," explains Thomashefsky.

The induced injury is made by a needle filled with dextrose — sugar water. The needle is injected at the site of the injury. In cases where extra precision is needed in placing the needle, ultrasound is used to pinpoint the injection site.

It's not just athletes who benefit from prolotherapy. Arthritis in seniors can severely limit mobility.

The typical prescription for arthritis of the hip or knee often starts with drugs to curb the pain, then surgery to replace the joint if the condition is severe.

"When you have a patient of that age (80s), first of all, surgery is more risky because they can die in the surgery," cautions Thomashefsky. "The leading cause of death in (elderly) women is a broken hip because they break their hip and then they have surgery, and usually within a year, 50 percent of those women are dead."

Like other medical treatments, prolotherapy does not work 100 percent of the time for 100 percent of patients. The medical literature contains multiple double-blind studies on the efficacy of prolotherapy. The prevailing opinion seems to be that prolotherapy is more effective in curing osteoarthritis than in relieving lower-back pain.

Patients respond differently to treatments, so it's not surprising that 50-something Ashland resident Rhonda Cochrane found that prolotherapy did, in fact, give her long-lasting relief from her lower-back pain.

"I had had back problems for years and had tried a lot of different things for that; my back would go out on me," says Cochrane.

She underwent two courses of prolotherapy treatments with Thomashefsky.

"The next day (after the treatment) I would be doing whatever I wanted — it got better," recalls Cochrane. "Sometimes I'd go in for a maintenance treatment, then I'd be on my way again for another two years. I haven't seen him now for my back for three years, maybe four."

Cochrane has also experienced long-lasting pain relief from tennis elbow and runner's knee. She's sold on prolotherapy, even though it has generally been an out-of-pocket cost for her.

"My health care plan initially did not pay any of it," says Cochrane. "I've changed plans, and now I think some of it is paid for."

Medicare, in particular, does not cover prolotherapy, which is characterized as experimental. A basic prolotherapy treatment and consultation run about $300. If the arthritis is so severe that hip replacement is suggested, prolotherapy may be an alternative that is far cheaper and has a much lower risk. The cost of hip replacement — including surgery, hospital costs and rehabilitation treatments — can exceed $100,000, according to Thomashefsky. Even with generous health coverage, the out-of-pocket cost for a hip replacement far exceeds the cost of prolotherapy.

Aging athletes often put tremendous wear and tear on joints and connective tissues. Among Thomashevsky's clients are several who have extended their racing careers through prolotherapy.

"I've been receiving prolotherapy for more than 12 years, and it's fixed my running injuries," says Ben Benjamin, 63, an Ashland ultramarathoner.

Benjamin has run dozens of ultras since 1997, including 17 races at the 100-mile distance. That's a lot of foot plants, especially for a runner with high arches.

"I've had plantar fasciitis several times and experienced relief quickly," says Benjamin. "Unlike surgery, you can run the next day. I'm a believer."

For more information on prolotherapy, see www.prolotherapy.org.

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