Dr. Chad Edwards: This is Dr. Chad Edwards and you’re listening to podcast number three of Against the Grain.
Announcer: Welcome to Against the Grain podcast with Dr. Chad Edwards where he challenges the status quo when it comes to medicine. We get into hot topics in the medical field with real stories, from real patients, to help you on your way to a healthy lifestyle. Get ready, because we’re about to go against the grain.
Brian Wilkes: This is Bryan Wilks, here with my good friend and real doctor, Dr. Chad Edwards. Tulsa Prolotherapy
Dr. Edwards: Hey Bryan, how are you today?
Bryan: How are you doing?
Dr. Edwards: Doing very well, and yourself?
Bryan: How’s business over at the Revolution Health & Wellness Clinic?
Dr. Edwards: We’re staying busy. They’re keeping me busy over there.
Bryan: That’s a plug by the way. That’s your green light to tell us their sponsor.
Dr. Edwards: That’s right.
Bryan: So gives us your phone number over there.
Dr. Edwards: Revolution Health & Wellness Clinic, we are your clinic if you are tired of the status quo, tired of making an appointment, going in, spending five minutes with the doctor. Here’s your problem, here’s your pill. You’re tired, fatigued, can’t figure out why, have pain – muscular, skeletal pains, sports injuries, anything like that, we can help you. Call us at 918-935-3636, or visit our website at www.revolutionhealth.org, lot of information up there as well. You can read about a lot of these topics to come in and get your appointment scheduled. Tulsa Prolotherapy
Bryan: That’s awesome. That’s a good plug. You said sports, right?
Dr. Edwards: Yes.
Bryan: I was going to ask you who’s going to win the presidential race, but you’re not going to answer that… you signed an oath.
Dr. Edwards: I quit predicting a long time ago.
Bryan: Yes, so who’s going to win the Super Bowl? What about the National Championship, Alabama OU… So OU or Alabama?
Dr. Edwards: I’m a big 12 fan, so I would love to say OU, but…
Bryan: I’m going with OU.
Dr. Edwards: I will be pleasantly surprised.
Bryan: Yes, I’m a little bit disappointed, but let’s go to our next sponsors, probably are going to drop you after this. Upper Cervical Health Centers. You know these people, right?
Dr. Edwards: Yes. I’ve actually been a patient there.
Bryan: Yes, I hear a lot of good things.
Dr. Edwards: They’re fantastic.
Bryan: Chiropractic center, right? Patients report an incredible rate of recovery in all kinds of categories, right?
Dr. Edwards: 75%, and they’re not just there for your spine, your neck pain, back pain, those kinds of things. They’re looking at overall health, and I’ve seen patients improve, with their blood pressure, their hormones. It’s been amazing in some cases.
Bryan: Awesome. Let me give you their phone number. 918-742-2300, or you can visit their website at www.uppercervicaltulsa.com/newyou . Now let’s get right to it. This is a great topic for athletes out there, I really think that. The topic is needles over knives, but we’re going to talk about something that you’re extremely good at, and having a lot of success in, that I don’t think most people have heard of. How’d you like that, and it’s Tulsa prolotherapy.
Dr. Edwards: Absolutely. In prolotherapy, I’m going to apply that to PRP, or platelet-rich plasma therapy, stem cell…
Bryan: That’s a mouthful.
Dr. Edwards: It is, but it may resonate with some people a little bit better. Tiger Woods had PRP, and Kobe had PRP. There’s been multiple people that have-
Bryan: Multiple well known athletes.
Dr. Edwards: Athletes, right, that have had PRP, a lot of information coming out about stem cells. There’s going to be a lot of overlap with those, so when we say Tulsa prolotherapy, it stands for proliferative, or proliferant therapy. We’re trying to grow new collagen, and we’ll talk a little bit about that, but the procedure is absolutely fantastic. It can help to heal these damaged ligaments and tendons, which we know is a source of a lot of pain. Tulsa Prolotherapy
Bryan: Right. That’s pretty cool. The topic is needles over knives, and for some people, how does this all relate? Literally, a lot of athletes are just people in general. Or former athletes, those of us that played football, even in high school, and are getting older when you have all these injuries, typically go right under the knife. That’s kind of the go-to. “Now I’ve got a problem, I need to drain some fluids. Let’s just cut that open, let’s do this. Let’s just cut it open.” Cut open happy.
Dr. Edwards: When you look at sports sidelines, professional teams, who’s the team doc for Jinx? Who’s the team doc for these kinds of things?
Bryan: You should know this.
Dr. Edwards: Many times it’s an orthopedic surgeon. You know I love my orthopedic surgeon colleagues, however, are they primary care providers, and I would argue that they’re not, they’re surgeons. What I found in my training is that — because I wanted to learn orthopedic medicine very well. I wanted to be very good at sports medicine. What I found is, when I spend a lot of time with my orthopedic surgeon colleagues, that they were doing a lot of orthopedic surgery. I’m not a surgeon, so I don’t want to do surgery. I don’t want to take that patient to surgery. I think there’s a role for that, I think it absolutely has its place- Tulsa Prolotherapy
Bryan: In context, yes.
Dr. Edwards: – but I want your average athletic injury — How many of those actually need, and would benefit, from surgery? And I would argue that we do too much surgery.
Bryan: Let’s back up a little bit. This whole prolotherapy thing, how’d you get started with this?
Dr. Edwards: I’ll just tell you my story about how I got into prolotherapy. I was one of the battalion physicians in fifth special forces group. One of our special operations, the Green Berets, I was a doc for those guys. I’m working with, basically, these high level athletes that are defending our nation.
Bryan: It’s a good way to put it, because they really are.
Dr. Edwards: Absolutely.
Bryan: They’re moving and shaking as much as a tailback for Alabama.
Dr. Edwards: That’s exactly right. Only carrying fives times as much weight.
Bryan: And their life is at risk. Literally.
Bryan: There’s that.
Dr. Edwards: So what those guys do is just absolutely amazing. This guy came to me and he said, “I hurt my back a couple of years ago.” He’s on a special forces team, he’d deployed to Iraq and Afghanistan at least five times, had done everything that we’ve asked him to do. He is a Green Beret, he’s gone through the course. He’s done really everything, he’s at the pinnacle of his career, as far as the special operations goes.
Bryan: Just so our listeners know, you’re his doctor. You’re a military doctor.
Dr. Edwards: That’s correct.
Bryan: So he’s coming to you for specifically.
Dr. Edwards: So he comes and he says, “My back hurts. If you can’t fix my back then I want you to send me home.” Did my evaluation. On the evaluation everything was normal. He could actually do anything. He could do his physical fitness test, he could go do his [unintelligible 00:06:33] marches. He could do everything, but he would pay for it a week, or two weeks, and it was so debilitating to him he was like, “Man, if you can’t fix this, send me home. I can’t continue in this path.”
Bryan: It’s miserable. I think a lot of people experience those kinds of pains.
Dr. Edwards: Absolutely. We got an MRI, which would be the next normal step, and this was back in early 2008. Got an MRI, and the MRI came back normal. So there’s no herniated disks, there’s no evidence of anything torn, dislocated, pushing out, bucking out, no nerves involved, no nothing. I remember having conversations with my other physicians in fifth group, and we wondered is he making it up, because there’s, quote, nothing wrong with him. It’s just like, we talked about the labs and all those things, and you feel bad there’s nothing wrong. Same thing here. Just because you have a normal MRI does not mean that-
Bryan: You’re normal.
Dr. Edwards: – you’re normal. That doesn’t mean that you don’t have pain, we just didn’t ask the right question. I didn’t know prolotherapy at the time, and I didn’t understand ligament tendon pathology, like I understand it today. We ended up medically boarding this guy out of the military. We did a medical discharge and sent him home.
Bryan: Let me just ask you here, the ligament piece that you were just talking about. Explain that.
Dr. Edwards: Ligaments are structures. you can think about the as steel cables, so each strand of the steel cable is composed of a protein called collagen, a very high tensile strength, really strong stuff. Those steel cables, the ligaments, just hold bones to bones, so they’re holding a joint, or holding something together.
Bryan: Kind of like a rubber band that holds it together.
Dr. Edwards: Only rubber bands stretch, and ligaments don’t. Rubber band, but steel cable is how I kind of think of it, because they shouldn’t really stretch. Tendons are the exact same structure, but they hold bones to muscles, so the tendons help us with movement, the ligaments help us with stability. The ligaments and tendons are very densely innervated with nerve fibers, and the nerves have an important role, it’s to give our brain a sensory idea of what’s going on.
Bryan: Something’s wrong.
Dr. Edwards: They can tell you something’s wrong, but they can also tell us where our body is in space, it helps with what we call proprioception. I can close my eyes, and raise my arm, and know my arm’s in the air, and that’s because of the nerves that are within all these structures that give signal to the brain. Those nerves are very sensitive to pressure and stretching. When ligaments, or tendons, get damaged they irritate those nerve fibers. If you think about this steel cable holding up 2,000 pounds, and if you go in and cut one of the little strands in that steel cable, it can’t hold the weight in the same way. It may begin to stretch, even microscopically under that load, but it irritates those nerve fibers, and so it sends a signal to the brain. The brain sometimes doesn’t know how to interpret this, because it’s supposed to give one kind of signal, but it gives a different kind of signal. Sometimes this sensation is interpreted as pain, sometimes it’s a tingling, sometimes it’s this anesthesia type feeling, sometimes it feels unstable. There’s a whole plethora of way that these things will manifest.
Bryan: Let me ask you, when it comes to back pain, knee pain, joint pain. How much of, typically of that type of pain do you see, and in this young soldier, is related to the, either the nerves, the tendons or the ligaments?
Dr. Edwards: So nerves, tendons and ligaments. So let’s define the nerve because most people will think, “Oh, I’ve got a nerve problem in my back”. What they’re generally referring to is they’ve been told or they think or whatever that there is compression of the actual nerve coming out of the spinal chord.
Dr. Edwards: You know, what we call nerve root compression, whether it’s by herniated disc, whether it’s by the bones pushing on it, you know, any number of different things especially this common scenario of “I’ve got pain going down the back of my leg”, and it’s so common that people will say, “I’ve got an impinged nerve or I’ve got a pinched nerve in my back”. And I’ll tell you in the last, since 2008 when I started doing prolotherapy, in late 2008, since that time I’ve had one patient come in, into my clinic, and I can’t speak to the overall statistics, but in my clinic with the patients that I’ve seen, and I do a lot of muscular skeletal medicine, I’ve had one patient, one, that was true nerve root impingement by like a herniated disc and the vast majority, well in excess of 85% of those patients, have actually had a ligament or a tendon problem as the source of their pain. So the nerves that we’re talking about within ligaments and tendons are very, very different than the nerves that we think about of having a pinched nerve.
Dr. Edwards: So two different things. So I would almost think about it as – you got a nerve problem or you got a ligament tendon problem.
Brian: Okay. So this young man comes to you, he’s having this, at this point it’s phantom pain, right? I mean, you can’t diagnose it At this point.
Dr. Edwards: Right.
Brian: So continue the story.
Dr. Edwards: So this guy ended up getting medically discharged out of the army. So I can’t, who knows, I have no idea how much money, you know, the taxpayers spent training this guy and we had to send him home because he had pain and we couldn’t fix it.
Brian: And he wanted to stay.
Dr. Edwards: He did.
Dr. Edwards: Yes. So traditionally we would think about that and say, “Ah, he’s got secondary gain”. He’s got some reason, he just wants to go play cards on Monday and not go to work.
Dr. Edwards: That’s not the case with these guys. It’s just, it’s just not.
Brian: You don’t go into this profession wanting to go home.
Dr. Edwards: That’s right.
Brian: Put in all the work…
Dr. Edwards: That’s right.
Brian: Do all the stuff that they do.
Dr. Edwards: So there was nothing that I could do for that guy and that’s frustrating. As a physician, as a doctor.
Dr. Edwards: My job is to keep those guys in their job. In fact the medical, the AMEDD, Army Medical Department, they’re slogan is ‘To Conserve The Fighting Strength’.
Dr. Edwards: So that’s my job, that’s what I’m supposed to do and I couldn’t help him.
Dr. Edwards: So that was very frustrating. And then, a couple, a few months later my commander in Fifth Group came to me and said, “I need prolotherapy on my elbow”, and I was like, “I have no idea what you’re talking about”. Well of course when a commander says…
Brian: You better Google it.
Dr. Edwards: “I need this”, then your job is now to go find.
Brian: The WebMD. Have you heard of it?
Dr. Edwards: I have.
Brian: It’s amazing.
Dr. Edwards: That’s right.
Brian: It’s on your phone, you can get an app for it, everything.
Dr. Edwards: So my PA at the time started doing the research and found a guy in the Nashville area.
Dr. Edwards: Dr. Mark Johnson, he’s a urologist, and he had back pain so bad that he couldn’t, he could no longer operate. And he got prolotherapy. So he saw the benefit, that’s how he started doing it.
Brian: So he saw, I mean, he was at a point, just help me understand this guy’s story.
Dr. Edwards: Right.
Brian: He’s at a point he’s a commander, right?
Dr. Edwards: So a commander comes to me and says, “I need prolotherapy”.
Dr. Edwards: On my elbow.
Brian: So, because he’s at a point where this other guy couldn’t have, he couldn’t even have surgery, right?
Dr. Edwards: So, Dr. Johnson was a urologist and he couldn’t perform surgery any longer because his back pain was so bad.
Brian: Oh, Okay.
Dr. Edwards: He got prolotherapy and it fixed his back pain.
Dr. Edwards: So that’s how he got into prolotherapy.
Dr. Edwards: And so we sent my commander to the, to this guy and it fixed his elbow. And I was like, “Okay, that’s-“
Brian: Good. [laughs]
Dr. Edwards: That’s interesting but didn’t really think much more about it.
Brian: It’s good.
Dr. Edwards: So Dr. Johnson, you know, being a patriot, wanted to come and talk to us about prolotherapy and what is it and what can it do and all those kinds of things. So he came and spent the day with us.
Brian: Right. Right.
Dr. Edwards: And he, the first thing he did was he sat down, and now you got to understand, I was an athletic trainer in college so worked with the athletes and we had T-shirts that ‘Just Ice It’.
Dr. Edwards: You know. So this is, regular sports medicine dogma is RICE, Rest, Ice, Compress, Elevate.
Brian: This is in the sixties, right?
Dr. Edwards: Or the late nineties.
Brian: Late nineties. Okay. I couldn’t tell.
Dr. Edwards: Yes, it’s, this is still modern sports medicine dogma.
Brian: Medicine has not been good to you. [laughs]
Dr. Edwards: Oh my goodness. So, but it’s that rest, ice, compress, elevate and then, you know, working in medicine in the army, we have what we call ‘Ranger Candy’.
Dr. Edwards: And it’s Motrin, you know. You just give it out like candy.
Dr. Edwards: It’s good for what ails you.
Brian: There you go.
Dr. Edwards: So these are anti-inflammatory medications, what we call NSAIDs.
Dr. Edwards: Nonsteroidal anti-inflammatory medications.
Dr. Edwards: So ice and Motrin, I mean, it’s kind of like duct tape, I mean, it fixes everything, you know.
Dr. Edwards: We’re sitting here listening to this guy and he says, you know, “Don’t use ice after an injury and especially, no matter what you do, don’t ever use anti-inflammatories”. And I was like, “Okay”.
Dr. Edwards: “Are you kidding me?” \
Brian: “Is this guy working for the enemy?”
Dr. Edwards: Right.
Dr. Edwards: And so I was like, “You’re either crazy or brilliant”. I don’t know which one.
Brian: And in war time we’re going to shoot you if you’re crazy, right? That’s what you do? [laughs]
Dr. Edwards: That’s exactly what we do Brian on a daily basis.
Dr. Edwards: Anyway. So that was a very interesting concept for me and I was like, “I don’t buy this”.
Dr. Edwards: So I shelved it.
Dr. Edwards: I shelved it for about six months and, you know, multiple patients came in and there were, these patients came in and one, you know, retropatellar pain, it’s this pain behind the knee cap, common in runners, and we don’t have a good solution for that. Sometimes we’ll try steroids.
Brian: Runner’s Knee?
Dr. Edwards: A little bit different.
Dr. Edwards: That’s a little bit different pathology and there are some things that we can do for that. But, you know, with this retropatellar pain, sometimes they’ll try and do physical therapy, sometimes they’ll do steroids, sometimes they’ll do surgery-
Dr. Edwards: But nobody really knows exactly the, there’s no 100% solution for this. And, so he’s talking about these things and this prolotherapy stuff and so I filed it in the back of my brain and had this patient came in, she was a young female that ran a lot and had this retropatellar pain. And I said, “Well, we’ve kind of maximized what I can do for you. Your options are I can send you to a surgeon, orthopedic surgeon, and let them evaluate you, maybe they’ve got other options or there is this thing that I’ve been looking into and, you know, it may be beneficial, I’ve heard some really good stuff about it and, you know, so we can give that a try”. And she said, “Well shoot! Let’s try it”.
Brian: Needle or knife.
Dr. Edwards: Needle. And she opted for needle. So we did one round of prolotherapy and she came back three weeks later and she was like, “That’s amazing. My knee feels tremendously better”. So we did another round. Basically we made her knee pain go completely away and I had never seen that with that kind of injury before.
Dr. Edwards: So I was like, “Well that’s impressive”. And then I had, but that’s, you know, what we call an interval one, that’s one patient.
Dr. Edwards: Then I had a young lady that she was, you know, around 30, active duty soldier.
Dr. Edwards: Came in to see me for, I was no longer in Fifth Group at this time, came in to see for low back pain, and she actually came in for what’s called a profile. So she wanted a doctor’s note basically that said she didn’t need to do sit-ups. Now she wasn’t trying to get out of doing her job, she hurt and it hurt her too bad to do sit-ups so she wanted a doctor’s note to get out of doing sit-ups. So I said, “Well, you know, again there’s this thing that I’m new to but, you know, if you want to try it let’s do it”, and she said, “Let’s do it”.
Brian: As people listen to this, I want to tell them a little bit about your DNA. When Dr. Edwards says, “I’m looking into something”, that means he goes into some sort of doctor cave for six months with every book on prolotherapy possible to man, right?
And you research. This is his DNA. So, you know, you have two patients at this point but you have a, you’re getting as much knowledge on this prolotherapy as possible.
Dr. Edwards: Absolutely, yes. These, the injection that I did on the first young lady – this is the exact same procedure as the steroid injections that I was trained on. I mean, there’s no difference in that injection.
Brian: Okay. So let’s, before we can talk about that. So prolotherapy…
Dr. Edwards: Yes.
Brian: Is a liquid, right?
Dr. Edwards: Yes.
Brian: That’s injected through a needle.
Dr. Edwards: Yes..
Dr. Edwards: Into these damaged areas.
Dr. Edwards: So in this first patient’s case, it was inside the joint.
Dr. Edwards: In most cases we’re injecting it into the ligament or tendon that’s damaged.
Dr. Edwards: And the only thing it’s doing is stimulating your body to heal itself. So the only thing magical about the solution is stimulating your body to do what it does. Ligaments and tendons are relatively avascular meaning they do not have a good blood supply.
Dr. Edwards: So if you’re going to go for a run, you go running down the street, your muscles need a lot of blood, they need a lot of oxygen, they need a lot nutrients to provide the energy….
Dr. Edwards: That they’re consuming. Ligaments and tendons, being that steel cable analogy, there is no metabolic demand.
Dr. Edwards: They don’t need oxygen, it’s just this steel cable, so there is no energy utilization for them.
Dr. Edwards: So they don’t need a lot of blood supply even during high activities. They don’t need a lot of blood supply until they get injured or damaged.
Dr. Edwards: And now all of a sudden you have, you have this big project in the middle of the forest and you don’t have a highway to get there. You got this winding road, backwards road.
Brian: That’s a great example.
Dr. Edwards: And so you’ve got trucks that are going in there trying to take the stuff in there to heal it but they go a one-lane road and what you need is a super-highway at that point.
Dr. Edwards: But there is no superhighway. So ligaments and tendons are notoriously poor healers. They don’t heal well. Sometimes you heal completely, sometimes you don’t. Sometimes the pain goes away but you haven’t restored 100% normal strength and function of that ligament and tendon. So prolotherapy just goes in and re-stimulates that inflammatory healing process.
Brian: I envision it’s like green, Star Wars type, goo. What is it? What’s it comprised of?
Dr. Edwards: Most of what I use is plain normal dextrose prolotherapy. It’s been around for a long time, it’s very, very safe. I’m actually involved with what’s called the Hackett Hemwall organization, foundation and you can visit them at www.hacketthemwall.org .
Dr. Edwards: I’m the only prolotherapist recommended by the Hackett Hemwall prolotherapy group in Oklahoma.
Dr. Edwards: So the only prolotherapist in Oklahoma that’s on their recommended list of prolotherapists. There’s a process you have to go through in order to be on their recommended list. So most prolotherapists will use plain old normal dextrose prolotherapy. There are other proliferant solutions, they’re different solutions that stimulate the same process.
Dr. Edwards: They may work by a little bit different mechanism but dextrose prolotherapy is, number one, incredibly safe and number two, very effective. So incredibly safe, very effective, we’re going with that. Now, PRP is also a proliferant solution but it’s platelet-rich plasma. So we basically draw the patient’s blood, we run it through this little machine and it magically separates the red blood cells from everything else and it spits out, we actually have to draw it out, but it spits out this platelet-rich plasma. Platelets have growth factors in them that stimulate the inflammatory response. It’s a little more potent than prolotherapy but there’s also an increased cost associated with that. So any of these ligament regeneration injections, whether it’s dextrose prolotherapy, PRP, even stem cell all work by very similar mechanisms.
Dr. Edwards: Stem cell’s a little bit different but, you know, very, very effective at stimulating inflammatory response which is how we heal.
Brian: Yeah. It’s interesting, I read an article and I can’t remember where it was, but the founder of Red Bull, because I read business periodicals, has kind of started some entrepreneurial endeavors or, excuse me, some philanthropy where he, he’s set up a pretty high-tech lab, I forget where it’s at. But he’s trying to tackle some major issues, one being health and he talks about how blood flow, blood flow and oxygen and direct delivery to joints, bones, organs is the, the lack of that oxygen is generally the root cause for a lot of disease.
Dr. Edwards: Sure.
Brian: And a lot of decay.
Dr. Edwards: Sure.
Brian: And so he’s kind of on to a lot of stuff that you’re talking about.
Dr. Edwards: Right.
Brian: And he’s spent a lot of resources doing.
Dr. Edwards: Yes.
Brian: And in fact what you’re describing sounds almost dead center to some of the injection-type stuff that they do in their laboratory.
Dr. Edwards: Right. I mean, this, prolotherapy’s been around since the 1930s.
Dr. Edwards: First case series was published in the 1950s by Dr. Hackett.
Dr. Edwards: And there’s books that you can read and a greater than 85% success rate.
Dr. Edwards: So this is something that works really, really, really well. It’s incredibly safe. The lead physician in the United States in the 1980s was C. Everett Koop, he was the Surgeon General under President Reagan. He was actually a big fan of prolotherapy and he said “The nice thing about prolotherapy if properly done is that it cannot do any harm”.
Dr. Edwards: So when you look at the risks and benefits of something, the, even if it didn’t work, you’re not doing any harm.
Brian: That’s great. You know, I personally know, personally know, again, I’m not paid to do this, right? [Laughs] I have no skin in this game other than to support your endeavor here because I think it’s important. I personally know two people, one is a retired pro athlete and then one is, was a Division One football player that have gone to your clinic, have been through, like you said, every doctor, that the sports world can offer, you know, traditional-based doctor and come out with pain and they’ve gone to prolotherapy and it goes away.
Dr. Edwards: Yes.
Brian: And the amazing thing for people listening is, if I understand it correctly, I have a perfect body so it’s hard for to relate, you know.
Dr. Edwards: That’s right Brian [laughs].
Brian: No actually, you know, when I say that I’m joking around. I just sat on the bench in every sport. So it’s, you don’t get hurt.
Dr. Edwards: So Brian used to be a track athlete.
Dr. Edwards: And did not just sit on the bench.
Brian: Well, I mean, it’s, you know, that’s track. You run in straight line fast. You don’t need prolotherapy. You know what I mean?
Dr. Edwards: I think you still have a record that still standing.
Brian: Oh, let’s not talk about that. Let’s not talk about that.
Dr. Edwards: [Laughs]
Brian: But here’s what I’ll say is for the patient that’s considering options to get rid of their pain and this whole topic of this is ‘Needles Over Knives’, it is literally as easy as call [laughs], call you, right, or someone else that’s in your network that does prolotherapy at the level that you do it, you go in, you assess the situation at length.
Dr. Edwards: Right.
Brian: I assume and it’s an injection, a series of injections.
Dr. Edwards: Correct.
Brian: Literally not a knife involved, not complicated. Would you say it’s painful?
Dr. Edwards: It’s, everyone interprets it differently, everyone perceives it differently.
Dr. Edwards: I’ve got some patients that think it’s incredibly painful, I’ve got some patients that, I literally had a patient said, “I’ve had haircuts that hurt worse than that”. I’ve done prolotherapy on myself. I’ve treated my knee and my ankle.
Dr. Edwards: And my wrist and my foot and there are some injections that aren’t comfortable.
Dr. Edwards: But I tolerated Okay.
Dr. Edwards: I don’t need, you know, sedation, although we, in our clinic we do offer sedation for those that just feel that they can’t deal with-
Brian: That just can’t do it.
Dr. Edwards: Right.
Brian: But Chad, I mean, these are people that are in pain to begin with.
Dr. Edwards: That’s correct.
Dr. Edwards: Yes .
Brian: So it’s not like you’re going in there for– you’re flying to Africa and you need some shots.
Dr. Edwards: Right. And to be clear, the procedure itself is uncomfortable, the injections aren’t comfortable, you know, but it lasts for a second or two-
Dr. Edwards: Each one of them. And sometimes there can be a lot of injections, just depends on what goes on. The physical exam that we perform in the clinic, which is critical to the prolotherapy component, is different than the way I was taught to do a physical exam. We still do some of those normal things but we want to know where are the damaged ligaments and tendons. And so that, the exam that we teach in the Hackett Hemwall Foundation is critical to making sure that you get the right areas. And when you treat the right areas, we can have a really, really nice success.
Brian: Awesome. So how, why is prolotherapy, in your opinion, let’s go back to this topic before we end the show.
Dr. Edwards: Yeas.
Brian: Why is it not more mainstream?
Dr. Edwards: So I think a lot of it goes back to evidence-based medicine. Well, first of all let me back up. The, Medicare, because the solution is a simple, natural solution.
Dr. Edwards: The Medicare considers it a natural therapy.
Brian: Right, so it’s outside of the network of things that are covered by insurance, right?
Dr. Edwards: Well by rule Medicare does not cover natural therapies.
Dr. Edwards: Independent of how effective it is.
Brian: That’s an important fact, “Independent of how effective it is”.
Dr. Edwards: It’s, their ruling is that they do not cover natural therapies.
Brian: That’s, it’s amazing.
Dr. Edwards: Agree or disagree, that’s just the way it is.
Dr. Edwards: So, then the second component of this-
Dr. Edwards: Many insurances will follow the Medicare model.
Dr. Edwards: The second component of this is when you look at the evidence, the research on prolotherapy, it’s mixed and we probably need to have a specific podcast, in fact we will have a podcast, on the research behind prolotherapy because what I saw is a greater than 85% success rate with my patients walking out the door having dramatically improved, if not completely resolved pain and improved function if not return to a completely normal
Dr. Edwards: And many times that’s the case.
Dr. Edwards: So I see this works and you can go to my website, www.revolutionhealth.org, and there are numerous testimonials on there .
Dr. Edwards: None of them are coerced, none of them are paid these are just their stories.
Dr. Edwards: So there are numerous of them for all different body parts, low back, neck, shoulders, elbows, knees, all those things, and it tells their story. So I know this works. Yet when you look at the research, the Cochran Review, and again we’ll, we can talk more about the Cochran Review, but basically they just examine all the data-
Dr. Edwards: And then they’ll say this works or it doesn’t.
Dr. Edwards: And basically they said, “Uh, this doesn’t really work” and there is a reason behind that. But this was part of why I went into functional medicine because the evidence-based medicine, which I was very evidence-based medicine centered previously and it’s telling me it doesn’t work yet my two eyes are telling me that it does, my patients are telling me that it does.
Dr. Edwards: So what’s the problem? There’s a problem in this whole process.
Dr. Edwards: So I started looking at it and I read all the research behind it and the research, the answers are within the research on why it, quote, “doesn’t work”. All of those answers are there and we’ll talk about that.
Dr. Edwards: And there are some other studies that show clearly that there’s really good benefit with it.
Brian: Right. But really all you can speak for or any of us can speak for is our experience, right?
Dr. Edwards: Correct.
Brian: And at your clinic, the average person, where you see ten people with pain in the areas of what? What would you classify the common areas of pain?
Dr. Edwards: The shoulder is our number one area.
Dr. Edwards: Knee and, between knee and lower back are number two.
Dr. Edwards: We can use prolotherapy for some headaches.
Dr. Edwards: Because they’ve got some stuff going on in their neck. So we commonly do necks, we do a lot of tennis elbow, golfer’s elbow as well.
Dr. Edwards: Elbows, we do some wrists, we do ankles if you’ve sprained your ankle and there’s, you got chronic ankle sprains.
Dr. Edwards: You know, prolotherapy is very good for that. We’ve done shin splints, we’ve done sciatica, so that pain going down the back of your leg. In fact I’ve got some just amazing testimony, I was on my website, about one guy that had back pain, and his leg was going numb. He actually had to pick his leg up out of his car, in order to get his leg out. Two rounds of prolotherapy and he was symptom free. Again, he tells the story on the website.
Brian: Yes, like I’ve said, I personally know some people as well. Lifelong pain, not “Mikey Mouse” pain, either. I mean this guys are hardcore grid iron football players that have really benefited from prolotherapy. I should get a commission. This is getting I mean, come on [Laughs].
Dr. Edwards: I never ceased to be amazed of how well it works, in most cases.
Brian: Yes. My original question was all these categories. If you could sum it up, percentage wise, and some categories would work better than others. I don’t know but percentage wise ten patience come to your office, eight of them, nine of them?
Dr. Edwards: Eight to nine of them, yes. 85% it’s what’s been shown over time. Shoulders is probably like 98%.
Brian: One more quick question. Is it reasonable from a cost end point? Because I can’t put it on my insurance, right?
Dr. Edwards: Correct. When you look at potential for surgery time off. One question I would ask is: What is your pain costing you? Look at your prescriptions and time off from work and all those kind of things. It’s incredibly reasonable. The cost of prolotherapy is when you factor in co-pays and deductibles. It is a no-brainer.
Brian: Even risk of surgery. There are certain inherent risk when you go in surgery.
Dr. Edwards: I had a patient that came in with an amputation to her left leg, and I said, “What happened?” she said, “I went in to get an ear replacement, and it got infected”. And that’s rare, but it happens, and it’s real. It’s a real, and a significant life changing complication.
Brian: Actually, is funny that you bring that up. My father, he’s had both knees replaced. On his first knee surgery, in Oklahoma City, and I won’t name the doctor although I should. He got an infection. And it was horrible. We were concerned. I don’t think most people understand that there’s some inherent risk, especially when you go into a hospital these days, of surgery. And I think any doctor would say, “If you could prevent surgery, it’s a great move, if it can help you”.
Dr. Edwards: That’s right. Our gold is not to do surgery, my goal is not to do prolotherapy. My goal is to get people healthy, doing well, optimal, no pain, full function. The question is how do we get there? You want to do it in the most cost effective way, the least invasive with the lower risk.
Brian: Man I got be honest. I always go into these things skeptical, because what do I know about anything? I’m a business guy. But if I had pain, and I don’t, because you don’t get pain if you’re third string on the basketball team. Marshall, this guy that’s working with us here; He’s like six five, just chiseled from granite, and he’s a first stringer. So he could probably use some prolotherapy. Are you convinced Marshall?
Marshall: Yes I’m definitely convinced.
Brian: Are you in? Do you have any pain?
Marshall: I’m in. I currently don’t have pain, I’ve been playing in the Wreck league recently.
Brian: But be honest with you, before we jump here out of the guys. You’re 25 years old?
Marshall: Yes, 25.
Brian: You got a lot of guys that have chronic pain, that you play with?
Marshall: Yes, guys that are in the training room, every single day before practice. Because they have to get stretched out, or they have to manage a certain pain. Whether it’s an ankle, or a knee, or something like that.
Brian: Cool. I think this is something for you athletes. Any athletes that are listening to this, specifically. [unintelligible 00:33:51] if your golf game is messed up.
Dr. Edwards: I want to say on more thing: we have had tremendous success regardless of the findings on MRI. And we’ll have a podcast about MRI as well. Valuable tool, but it is a road map for surgery. That’s what it is. So we have had tremendous success, independent of findings of MRI. So you may have been told that you have a slap leisure in your shoulder, Thorne, ligaments tendency, whatever. We have had tremendous success with a number of those types of injuries. You still may need surgery later on down the road, but we’re not doing anything that’s going to disrupt needing surgery, or getting surgery.
We’re not going to mess it up for the surgeon, to make it more difficult for him. Conversely, if you had surgery first, you can’t undo it. You can’t ever go back and put it back.
Brian: You’re cutting things.
Dr. Edwards: That’s right.
Brian: You’re cutting them out, you’re moving them.
Dr. Edwards: So surgery has its place. But it is when everything else has failed.
Brian: This is great. High school sports gotten so much more competitive, right? And I really hate to see kids get surgery. 18 year old kids having surgery on the sport industry… my gosh. Or any moms and dads, that has to have young kids specifically to your point. I would say, “Don’t start. Knee over knife, don’t start with the knife”. See what you can do in prolotherapy, and I think try some of this alternative things before you start cutting an 18 year knee open [Laughs].
Dr. Edwards: Absolutely. You got that right.
Brian: But here’s one piece of advice — we’re on our way out of here — I’m actually very impress with you knowledge. Not specific to sport prediction though. Feel like if you’re going to be in this prolotherapy game, you got to get boulder on your sport predictions.
Dr. Edwards: You think so?
Dr. Edwards: Yes, that’s not a problem.
Brian: [Laughs] Alright man, thanks. We’ll see you on the next episode.
Dr. Edwards: Alright, thanks Brain.
Announcer: Thank for listening to this week’s podcast with Dr. Chad Edwards. Tune in next week, where we’ll be going Against The Grain.