The Hackett Hemwall Foundation
2532 Balden Street,
Madison, WI 53705 USA
www.HackettHemwall.org
The Hackett Hemwall Foundation is a not-for-profit organization that brings Prolotherapy to underserved areas all around the globe, as well serves as the premier training ground for those physicians wanting to learn Prolotherapy.
In 1969, Dr. Gus Hemwall, a surgeon in private practice in Chicago, established a foundation dedicated to providing medical care to needy people around the world. He named the foundation after his mentor, Dr. George Hackett, who was a pioneer in the area of Prolotherapy and one of the first physicians to perform the treatment in the United States. Prolotherapy is often considered a new therapy, but documentation shows that a very similar therapy was performed as early as 400 BC. Although initially known as the Hackett Foundation, the organization was eventually renamed in honor of Dr. Hemwall and his wife, Helen, who dedicated their lives to helping others in many ways. Their lives serve as models for those of us who follow in their footsteps. With its many classes, conferences, and clinical experiences, the foundation provides medical professionals with an opportunity to further their training and education. Another objective of the Hackett Hemwall Foundation involves research concerning the effectiveness of certain medical procedures such as Prolotherapy, which is used as a treatment for chronic pain, and vein sclerosing, which is used to help patients with varicose veins. Jeffrey J. Patterson, DO, professor at the University of Wisconsin School of Medicine and Public Health, Department of Family Medicine, is the foundation’s director. Together, the members of the Hackett Hemwall Foundation dedicate their time and services to provide high-quality medical treatment to people around the world who are otherwise unable to afford medical care. Since the foundation’s beginning, each year, the director has organized a trip to a third world country.
If you are a doctor who desires to improve your Prolotherapy skills or add it to your current skill list, give the Hackett-Hemwall Foundation a call. Don’t miss their upcoming training seminar in October in Madison, WI. Check out their website for more information!
Letter from a physician subscriber of JOP: Why can’t conventional medicine find your pain? Pain is often misunderstood and mismanaged in traditional medical settings.
While many of us hurt or have hurt to various degrees during our lifetime, there is no traditional test to ‘quantify’ our pain, nor does the series of happy and sad faces to describe our pain level aid in finding adequate relief from our symptoms.
What we have lost in medicine is our ability to examine the patient, correlate the examination with the patient’s symptoms, and lastly consider the diagnostic tests. Instead, we as patients enter the system of pain treatment, done almost as a mass production protocol involving first a trial of anti-inflammatory medication and then physical therapy. If these ‘conservative’ measures fail to provide relief, it’s off to see the surgeon, where the decision is made to have either surgery or pain management.
As a physician, I never wanted to manage pain, nor would want, as a patient, to have my pain managed. Having suffered with pain myself, I could not even imagine living the rest of my life in chronic pain. So why are we so far off the mark with treatment of pain? I think that the answer lies in two important factors. First, we are overly reliant on diagnostic tests. Secondly, we have lost the art of physical examination.
Take, for instance, the case of lower back pain. It is one of the most common causes of pain and disability in the world, but often misunderstood. Why? Because most cases are due to musculoskeletal conditions such as sacroiliac joint dysfunction, pyriformis syndrome, or facet joint arthropathy. Such problems are not seen on MRI, CT, or X-rays, thus a clinician without expertise in curing these conditions will not be able to effectively manage them.
Even though we have access to the greatest diagnostic tests in the world, we as physicians need to use our clinical judgment to determine their significance. For example, the majority of healthy people who do not have any back pain at all will have degenerative, bulging, or herniated discs in their lumbar spine. But if you do have pain, the job of your physician is to determine the relevance of your test results. It is not a black and white issue in what may be causing your pain.
So how do we determine what the best treatment courses are for our patients? First we must listen to our patients and ask the right questions—where is the pain, where does it travel, is there any numbness or weakness? What makes it better and what makes it worse? Are there any ominous signs like loss of bowel and bladder function, fever, chills, weight loss, and so on. From our questions alone, the skilled physician should be able to determine 85% of the diagnosis, and then confirm it with physical examination.
The examination is key to determine and confirm the root cause of pain, and unfortunately it is becoming a lost art. Many of my patients have told me they were recommended to undergo surgery with either a very brief exam or no exam at all. I find this to be a disservice to patient care that can only lead to bad outcomes. The physical exam is not without its faults, and to be reliable must be performed with experienced hands. Palpation of ligaments, tendons, and joints is a skill and an innate gift to those that possess the ability to acquire its skill. Skilled hands have the ability to determine damaged, weak, and painful joints from those that are normal. This critical tool allows us to incorporate all of the information about a patient’s condition and formulate a treatment plan.
There is no one size fits all formula to treat a pain condition. However, most pain and sports injury conditions are curable, in the right hands, with reconstructive and regenerative treatments such as Prolotherapy. I found my way to a complete cure after suffering for over 10 years, and I wish you the best in finding your solution, as it exists. If not then hold on tight as we are working on new solutions and treatment options to cure pain and arthritis, all without ever going under the knife.
Feel free to email us at JOP with your comments, ideas, suggestions, or success stories! We’d love to hear from you!
S.G., MD
This email received by Caring Medical in Oak Park, IL describes what many people are facing. They feel hopeless, discouraged, broke, and at the end of their ropes. Here at Journal of Prolotherapy, we are trying to get the word out – that there IS hope – and that hope is found in Prolotherapy. You need not live a life of chronic pain, stronger pain medications, loss of work, inability to exercise, and the like…
Take a look at this email from a potential patient writing to Ross Hauser, MD, Medical Director of Caring Medical in Oak Park, IL:
Dear Dr. Hauser,
My life has been a nightmare since 2001. I used to run, play racquetball three times a week and weight train regularly. Some type of injury happened to me in 2001 in which I had severe groin, adductor and hamstring pain. I have had so many different doctors tell me it is hopeless to repair whatever structural damage has been done. Over these past several years I can barely exercise much at all as this brings constant pain to the hamstring adductor area. I have gained over 30 pounds of body fat and life is just miserable at this point.
I had sports hernia surgery 18 months ago in hopes of eliminating some of the symptoms. This was not the solution at all. I started to recover slightly and then as soon as I began vigorous workouts the pain and problems returned.
After reading some of your information I am suspecting I may have the hamstring tendinopothy at the attachment point of the hamstring to the glute and bone area slightly inside the inner thigh under the buttock of the left side.
I am currently working with a physical therapist for the I don’t know how many times it has been.
Is there any way the therapist and I can pinpoint if this is the exact problem?
Life without exercise is almost unbearable. I need help…
Best Regards,
TJ in Wi
Yes, TJ – there is hope – and that hope is Prolotherapy. Unfortunately, physical therapy and exercise is not going to cure the underlying problem – which is most likely ligament weakness and instability. The only treatment we know to cure that is PROLOTHERAPY – using the Hackett-Hemwall method. Patients are seen every 4-6 weeks for on average of 3-6 visits.
Dr. Hauser’s clinic information: Caring Medical & Rehabilitation Services, Oak Park, IL www.caringmedical.com; 708-848-7789
The latest issue of the Journal of Prolotherapy has just been received from the printer and will be in the mail to all of its subscribers next week. In this issue, we are happy to feature the publication of this ground-breaking study on the use of Prolotherapy as a first line treatment for meniscal tears and degeneration.
The title of the article published in the July 2010 issue of The Journal of Prolotherapy is The Case for Utilizing Prolotherapy as First-Line Treatment for Meniscal Pathology: A Retrospective Study Shows Prolotherapy is Effective in the Treatment of MRI-Documented Meniscal Tears and Degeneration.
Meniscus injuries are a common cause of knee pain, accounting for one sixth of knee surgeries. Tears are the most common form of meniscal injuries, and have poor healing ability primarily because less than 25% of the menisci receive a direct blood supply. While surgical treatments have ranged from total to partial meniscectomy, meniscal repair and even meniscus transplantation, all have a high long-term failure rate with the recurrence of symptoms including pain, instability, locking, and re-injury. READ MORE…
If you have been told you need surgery for a meniscal tear, think about getting Prolotherapy instead of surgery. To learn more about Prolotherapy click here.
Pain simply put is just the body’s response telling you that you have some tissue that is breaking down. The same thing happens to an athlete who is in the heat of competition. When the muscles start hurting, it is just a sign that you are working really hard. It also reveals that tissue is breaking down, which is especially important to those who are athletes. The goal of Prolotherapy is to build the tissue back up.
| Here are 10 tips to know that you are a good Prolotherapy candidate. |
| 1. My pain is from a ligament or tendon injury. 2. My pain is from degenerative arthritis and I have maintained good range of motion (greater than 75% of normal). 3. I take only a little or no pain medication for my pain. 4. Beside the pain, I am healthy. 5. I have clicking in the joint that is hurting. 6. Certain activities increase the pain. 7. Muscle spasms are definitely part of my pain. 8. My pain is better with rest. 9. My MRI/x-rays did not show anything. 10. My sensation is normal (I can feel everything). |
While the above 10 tips are not guarantees that Prolotherapy is going to cure you of your pain, remember that cure is the goal. Prolotherapy candidates often possess many, if not all, of the above 10 criterion.
Not possessing all 10 criterion, does not exclude you from being a good Prolotherapy candidate. For the person with poor range of motion (less than 75% of normal) or an abnormal MRI, it may be that Prolotherapy is still a great treatment. In those situations, we recommend you make an appointment with a Prolotherapist for an evaluation.
We do Prolotherapy because it works. It makes sense that the body heals by the process of Inflammation. Prolotherapy stimulates the body to repair those painful injured areas. It does not shut that down. If you have a pain or injury that you would like evaluated, please make an appointment today. We look forward to hearing from you!
If you are looking for a prolotherapy physician or if you are a physician who would like to be listed, please see www.getprolo.com.
Ross Hauser, MD, Marion Hauser, MS, RD, and Patricia Holian, RN recently released an article on treating wrist pain with Hackett-Hemwall dextrose Prolotherapy published in Practical Pain Management.
The articulation afforded the hand and the upper extremity by the wrist is essential for mobility, strength, and dexterity that most patients need to function in their daily lives. Interestingly enough, primary care physicians frequently see patients in their offices with complaints of wrist pain. The causes of wrist pain are typically related to overuse, as well as repetitive and high impact injuries that may be work or sports related. These injuries often start as an acute tendonitis or ligament sprain and, if not effectively treated, can result in chronic pain due to the formation of degenerative arthritis. Symptoms are frequently gradual at first—with mild aching but full range of motion—and then typically progress to more acute pain along with impaired movement of the hand and upper extremity.
While prolotherapy is commonly taught and used for unresolved wrist pain, no study has been done to date related to effectiveness. This observational study’s purpose was to evaluate the effectiveness of Hackett-Hemwall dextrose prolotherapy—not only on unresolved wrist pain but on quality of life measures, and its ability to reduce or eliminate the need for pain medications.
To read the full article, click here.
Every medical procedure has risks – but so does living with chronic pain!
Let’s look at some of the risks when a person lives with chronic pain.
Risks associated with living with chronic pain:
- Being miserable
- Going into financial ruin because of an inability to work
- Having incredible stress
- Not sleeping
- Ruined overall health
- Marriage collapse
- Developing additional health problems due to toll the pain is taking on the body
- The collapse of the family
- Never being able to enjoy sports again
- Loosing the ability to be independent
- Never running again
- Never being able to take long walks
- Possible addiction to pain medications
- Decreased ability to travel due to restrictions in movement
- Increased weight due to immobility
The risks of living with chronic pain are enormous. I did not talk about just losing the ability to enjoy life. The ability to enjoy life is being lost every day a person suffers from pain. Chronic pain often leads to host of other medical conditions including depression, anxiety, sleeplessness, chronic fatigue, hormonal deficiencies and many others. The psychological toll it takes on the person and their family and friends is enormous. So what is the person to do?
The person can opt for a host of treatments including chiropractic manipulation, physiotherapy, osteopathy, acupuncture, hypnosis, herbs, vitamins, exercise, massage, electrical stimulation, pain pills, surgery, arthroscopy, cortisone shots, trigger point shots, nerve blocks and many others. All treatments have potential benefits and potential risks.
Prolotherapy, like all invasive medical procedures carries risks. Here are some of the risks:
- Bleeding in the area
- Bruising in the area
- Increased pain
- Swelling
- Stiffness
- Joint effusion
- Infection
- Puncture of the lung
- Spinal headache
- Nerve Injury
- Tendon/Ligament Injury
Because Prolotherapy causes inflammation, the person will often note some bruising, pain, stiffness and swelling in the area after receiving Prolotherapy. Typically this lasts 1 to 7 days. On rare occasions it lasts longer. Lasting longer is not necessarily bad, some people just inflame more easily. Since the treatment works by inflammation, lingering pain after Prolotherapy can be a sign of healing. If the pain is severe after Prolotherapy, then call the office where the Prolotherapy was done. Prolotherapy should not cause excessive, severe pain. Severe pain after Prolotherapy, especially accompanied by a fever, could indicate an infection. Infection after Prolotherapy is the most serious risk that we have seen.
The risk of infection after Prolotherapy is between 1 and 1000 to 1 and 10,000 procedures. The most common infection with Prolotherapy is an infection in the skin. This type of infection typically responds to an antibiotic taken by mouth. If a joint or blood infection results, then intravenous antibiotics will typically be needed for six weeks.
Since some of the risks with Prolotherapy relate to the actual technique done, it is important to go to a clinic with a lot of experience. Surely a doctor can stick a needle into a nerve, ligament, or tendon and cause injury. A doctor can stick the needle into the lung when doing the thoracic vertebrae or ribs. A doctor could also stick the needle into the spinal canal when doing any area of the spine and cause a cerebrospinal fluid leak. This is known as a spinal headache (which is a headache when you sit up). The risks of these side effects are rare, but do occur.
In the entire history of Caring Medical, I know of one patient who had a puncture of the lung who needed hospitalization. She refused to go to the hospital after I recognized the problem because someone had to take care of her dog. One of my staff volunteered to watch her dog, and this patient was in the hospital for only two days. She continued to be a client of Caring Medical.
I have taken care of numerous customers from around the country who come to Caring Medical because they have experienced a puncture of the lung from another office. None of these clients had a puncture of the lung after I did the Prolotherapy. But I did tell the clients that just because they received a puncture of the lung in the past, does not mean the technique of Prolotherapy was bad. Everyone’s anatomy is different. Surely if a lung rides high (above first rib) or if a nerve is in an unusual spot, these structures can be hit even though the Prolotherapy technique was good.
There are risks associated with everything you put into your body. All you have to do is look up any of the risks for any of the anti-inflammatory medications (even over-the-counter medications) and realize even taking them can cause serious risks. For me, I have had numerous Prolotherapy sessions and have treated many family members and friends. I understand that every procedure has risks, but so does not having the procedures. Compared to surgery, Prolotherapy in my opinion is much safer, and in most instances, a better option, with far less risks. I desire not to have chronic pain. I understand living with pain carries its own risk. For me, the potential benefits of Prolotherapy far outweigh the risks. If you continue to suffer with chronic pain or a painful condition is limiting your ability to do the things you want to do, I recommend that you seriously consider Prolotherapy.
Content provided by Dr. Ross Hauser, MD and Caring Medical and Rehabilitation Services in Oak Park, IL.
Osteoarthritis, the most common form of arthritis, is a degenerative condition that results in the deterioration of cartilage tissues that support the weight-bearing joints in the body. The condition, also called degenerative arthritis or degenerative joint disease, is closely linked to the aging process and consists of outgrowth of bone, bone spurs and soft cysts on the affected joints and bones. It affects 20 million Americans, primarily women and adults over age 45.
How does osteoarthritis develop?
It is important to note that, although associated with old age, osteoarthritis and degenerative joint disease are not simply a result of the aging process, nor are they a result of general wear and tear on the joints as some believe. These conditions almost always begin as a ligament weakness resulting from injury.
Joints are composed of two bones covered with articular cartilage, which allows the joint to glide, and ligaments, which hold the two bones together. Healthy articular cartilage and ligaments enable the bones to glide evenly over one another. If the ligaments become weak, the bones will glide in an uneven manner. One area of the bone will bear additional weight on the articular cartilage when the joint is stressed. This uneven distribution of joint stress creates an even greater strain on the weakened ligament. Eventually all ligaments of the joint become lax and the joint becomes more and more unstable. As a result, articular cartilage breakdown occurs, causing a grinding or crunching noise when the joint is moved—as well as pain!
When ligaments can no longer stabilize a joint, muscles and tendons will tense, often increasing a person’s pain. When these soft tissues can no longer do the stabilizing work, the bony surfaces rub against each other.
As the condition develops, the bone around the affected joint thickens, and bony growths called osteophytes form. If the synovial tissue that lines the joint capsule becomes inflamed, fluid may accumulate within the joint. This causes pain and swelling in the joints and decreases their mobility. In later stages of the disease, decreased amounts of cartilage in the joints hinder movement.
Although natural medicine specialists see a clear link between ligament injury and the onset of osteoarthritis, conventional medical practitioners cannot reach consensus on a cause of osteoarthritis. They identify certain factors that may increase the risk of developing the disorder, including repeated strenuous activity or reoccurring injury, excessive weight gain, and possibly heredity.
What are the symptoms of osteoarthritis?
Symptoms of osteoarthritis may include pain and tenderness in a joint that worsens with activity and is relieved by rest; stiffness after long periods of rest; discomfort in a joint before or during a change in weather; bony lumps on the middle or end joints of the fingers or the base of the thumb; loss of joint flexibility; swelling and tenderness around the joint; restricted joint movement; creaking or cracking of joints and bones; and referred pain in areas remote from the site of damage but on the same nerve pathway as the affected joint.
Conventional medical treatments may help relieve the symptoms of osteoarthritis but they do not address the root of the problem. By strengthening structural weaknesses in the body, as natural medicine therapies like Prolotherapy do, osteoarthritis pain may be alleviated permanently.
have you tried conventional treatments for osteoarthritis without success? Would you like an alternative to the traditional recommendations? Give us your comments.
Prolotherapy
Prolotherapy is a simple, natural technique that stimulates the body to repair the painful area when the natural healing process needs a little assistance.That’s all the body needs, the rest it can take care of on it’s own. In most cases, commonly prescribed anti-inflammatory medications and more drastic measures like surgery and joint replacement may not help, and often hinder or even prevent the healing process. The basic mechanism of Prolotherapy is simple. A substance is injected into the affected ligaments or tendons, which leads to local inflammation. The localized inflammation triggers a wound healing cascade, resulting in the deposition of new collagen, the material that ligaments and tendons are made of. New collagen shrinks as it matures. The shrinking collagen tightens the ligament that was injected and makes it stronger. Prolotherapy has the potential of being 100 percent effective at eliminating and chronic pain due to ligament and tendon weakness, but depends upon the technique of the individual Prolotherapist. The most important aspect is injecting enough of the solution into the injured and weakened area. If this is done, the likelihood of success is excellent.
Prolotherapy involves the treatment of two specific kinds of tissue: tendons and ligaments. A tendon attaches a muscle to the bone and involves movement of the joint. A ligament connects two bones and is involved in the stability of the joint. A strain is defined as a stretched or injured tendon; a sprain, a stretched or injured ligament. Once these structures are injured, the immune system is stimulated to repair the injured area. Because ligaments and tendons generally have a poor blood supply, incomplete healing is common after injury.This incomplete healing results in these normally taut, strong bands of fibrous or connective tissue becoming relaxed and weak. The relaxed and inefficient ligament or tendon then becomes the source of chronic pain and weakness.
The greatest stresses to the ligaments and tendons are where they attach to the bone, the fibro-osseous junction. The most sensitive structures that produce pain are the periosteum (covering of the bone) and the ligaments. It is important to note that in the scale of pain sensitivity (which part of the body hurts more when injured), the periosteum ranks first, followed by ligaments, tendons, fascia (the connective tissue that surrounds muscle), and finally muscle. Cartilage contains no sensory nerve endings. If you are told that your cartilage is the cause of your pain, you have been misinformed; the cartilage cannot hurt because they contain no pain sensing nerves. If there is cartilage damage, the ligaments are typically the structures that hurt. Ligaments are weakest where they attach to bone. The periosteum is the most sensitive area to pain and the ligaments second. It is now easy to understand why this area hurts so much. This is where the Prolotherapy injections occur, and thus eliminate the chronic pain of many conditions including arthritis, mechanical low back pain, degenerative disc disease, cartilage injury, and sports injuries.
Prolotherapy works by exactly the same process that the human body naturally uses to stimulate the body’s healing system, a process called inflammation. The technique involves the injection of a proliferant (a mild irritant solution) that causes an inflammatory response which “turns on” the healing process. The growth of new ligament and tendon tissue is then stimulated. The ligaments and tendons produced after Prolotherapy appear much the same as normal tissues, except that they are thicker, stronger, and contain fibers of varying thickness, testifying to the new and ongoing creation of tissue. The ligament and tendon tissue which forms as a result of Prolotherapy is thicker and stronger than normal tissue, up to 40% stronger in some cases!
Tell us your experiences with Prolotherapy – we’d love to hear from you!
| Authors: Ross A. Hauser, MD, Marion A. Hauser, MS, RD, Nicole M. Baird, CHFP, & Danielle J. Martin |
Thirty-four patients with average musculoskeletal pain duration of 27 months who were told by their medical doctor/surgeon that surgery was needed, including 20 joint replacements and nine arthroscopic procedures, were treated with Hackett-Hemwall dextrose Prolotherapy in lieu of surgery. Patients were followed prospectively and asked questions regarding levels of pain, stiffness, and other physical and psychological symptoms, as well as questions related to activities of daily living before and after their last Prolotherapy treatment.
In this study, Prolotherapy caused a statistically significant improvement in their pain and stiffness. The average starting level of pain was 7.6 and stiffness 7.2, but after Prolotherapy they decreased to 1.3 and 2.5 respectively. Ninety-one percent of patients felt Prolotherapy gave them 50% or greater pain relief, and 71% felt the pain relief was greater than 75%. Upon interview, an average of 10 months after their last Prolotherapy session, this study revealed improvement in patients’ quality of life parameters in addition to pain and stiffness including depression, anxiety, medication usage, as well as range of motion, sleep and exercise ability. Seventy-nine percent felt they had enough pain relief with Prolotherapy that they will not now or in the future need surgery. Four of the remaining seven patients noted 50% or greater pain relief from the Prolotherapy and plan on getting more Prolotherapy in the future.
In this study, Prolotherapy was able to eliminate the need for surgery realistically in 31 out of 34 patients. If Prolotherapy could eliminate 80% of musculoskeletal surgeries in the United States, this procedure alone could make a tremendous dent in cost savings to Medicare, private insurers, and patients. This does not include the money that is lost from productivity and additional expenses that accompany surgery such as future or revision surgeries, rehabilitation, physiotherapy, medications, or disability (from continued pain). Prolotherapy does not have the risks associated with surgery. Often patients can immediately return to work after receiving Prolotherapy. Since results with Prolotherapy are often permanent, no future treatments are needed. These are reasons enough for patients to consider a Prolotherapy evaluation before undergoing a musculoskeletal surgery.
As this pilot study found such significant improvements in these participants with chronic musculoskeletal pain who were told that surgery was needed, further studies under more controlled circumstances, with larger patient populations, should be done.
Journal of Prolotherapy. 2010;(2)1:272-281.
KEYWORDS: alternative to knee replacement, alternative to surgery, arthroscopy, joint replacement, Prolotherapy.
To read the full article:
http://www.prolotherapy.org/prolotherapy/alternative-to-surgery-introduction
