At a Glance Prolotherapy involves injecting a sugar (dextrose) solution into damaged ligaments and tendons to trigger a controlled healing response. Evidence is strongest for sacroiliac joint pain and chronic low back pain from ligament laxity, with several RCTs showing meaningful improvement. A typical course runs 4 to 6 sessions spaced 3 to 6 weeks…
Chronic pain management without opioids works best as a mix of active exercise, a psychological therapy such as CBT, and a targeted non-opioid medication or procedure. The CDC's 2022 guideline prefers nonopioid therapies for chronic pain.
At a Glance Shockwave therapy has Level 1 evidence (multiple randomized controlled trials) for plantar fasciitis, one of its strongest indications. Success rates for chronic plantar fasciitis range from 65 to 80 percent across published studies. Most protocols involve 3 to 5 sessions spaced one week apart, with improvement continuing for 8 to 12 weeks…
How ketamine treats chronic pain through NMDA antagonism and central sensitization reversal. Evidence for CRPS (50-80% response), fibromyalgia, neuropathic pain, infusion protocols, and at-home options.
Chronic pain lasts more than three months and comes in three types: nociceptive, neuropathic and nociplastic. This review explains each mechanism, central sensitization, and the evidence for PRP, stem cells, shockwave, HBOT, ketamine, LDN and neurofeedback.
Prolotherapy injects dextrose to trigger a controlled repair response, while PRP injects your own platelets concentrated 3 to 8 times to deliver growth factors directly. PRP has more data for tendons and knee arthritis, prolotherapy for loose ligaments, and both have mixed, cash-pay evidence.
At a Glance Widespread joint pain has a wide differential, from autoimmune conditions (RA, lupus) to infections (Lyme, post-COVID), metabolic causes (thyroid, vitamin D), and structural issues (hypermobility/EDS). The pattern of joint involvement, symmetry, which joints, morning stiffness duration, swelling, narrows the diagnosis significantly. A basic blood workup (CRP, ESR, RF, anti-CCP, ANA, vitamin D,…
At a Glance What it is: Stem cell therapy for back pain uses concentrated regenerative cells, most commonly bone marrow aspirate concentrate (BMAC), injected into damaged spinal structures to promote tissue repair. Conditions treated: Degenerative disc disease, facet joint osteoarthritis, and sacroiliac (SI) joint dysfunction. Evidence level: Early, small clinical trials and case series show…
Stem cell therapy for back pain injects regenerative cells into a degenerated disc or facet joint. No stem cell product is FDA approved for back pain, and small trials show benefit in some patients while larger trials are still settling the question.
At a Glance Osteoarthritis (OA) is driven by mechanical wear and cartilage degradation; rheumatoid arthritis (RA) is an autoimmune disease attacking synovial tissue. The treatments are fundamentally different. Morning stiffness lasting more than 60 minutes strongly suggests RA; OA stiffness typically resolves within 30 minutes of movement. RA requires early DMARD therapy to prevent irreversible…
Arthritis in the hands is usually osteoarthritis, which hits the fingertip joints and thumb base, or rheumatoid arthritis, which inflames the knuckles and wrists of both hands. Hand therapy, splinting, targeted medication and early DMARDs for RA do the most to preserve grip and dexterity.
