What is prolotherapy?

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“Time is not a cure for chronic pain, but it can be crucial for improvement. It takes time to change, to recover, and to make progress.”
— Dr. Mel Pohl

Muskuloskeletal conditions are the most common source of chronic pain, and joints in our extremities are all too often the issue. The increasing prevalence of muskuloskeletal conditions has led to an interest in nonsurgical solutions. Prolotherapy is one of these, and has the benefit of having lower risk and a shorter recovery time than what’s needed with surgery.

First, what is prolotherapy?

Prolotherapy involves injecting a dextrose solution into an attachment site of a ligament or tendon. The solution is a mild irritant that causes inflammation at the injection site. This increases blood flow to the area, which allows for an influx of nutrients to the site and stimulates tissue repair. Ligaments and tendons tend to have poor blood supply, so this process stimulates the body to repair damaged tissue. The final result is strengthened tissue and decreased pain!

What can prolotherapy treat?

It’s always best to ask your health practitioner if you’re a good candidate for prolotherapy. Prolotherapy shouldn’t be the first treatment you jump to when treating different muskuloskeletal conditions, but it’s a great option for those who are feeling they have plateaued with their current treatment. Prolotherapy can help treat pain in the shoulders, elbows, wrists, knees, and ankles (depending on what is causing the pain in these areas).

Specific conditions that prolotherapy can help are:

  • Osteoarthritis in the knees

  • Osteoarthritis in the fingers

  • Unresolved sports injuries that include ligament damage

  • Tennis elbow

  • Golfer’s elbow

  • Chronic tendon issues

How many treatments are needed?

A patient’s response to the treatment varies in each case. The average number of treatments is 4 to 6 with treatments spaced out about a month apart.

 

References:

Jahangiri A., Moghaddam F.R., Najafi S.(2014) Hypertonic dextrose versus corticosteroid local injection for the treatment of osteoarthritis in the first carpometacarpal joint: a double-blind randomized clinical trial. Journal of Orthopaedic Science, 19 (5) , pp. 737-743.

Rabago, et al. (2013) Dextrose prolotherapy for knee osteoarthritis: a randomized control trial. Ann Fam Med, 11(3): 229-237.

Scarpone, M., Rabago, D. P., Zgierska, A., Arbogast, G., & Snell, E. (2008). The efficacy of prolotherapy for lateral epicondylosis: a pilot study. Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine, 18(3), 248–254. doi:10.1097/JSM.0b013e318170fc87

How to choose the right sunscreen

You may have heard that you should wear sunscreen everyday, but with so many to choose from how do you know that you are choosing the safest and most effective sunscreen? With summer around the corner, now is a good time to start using sunscreen if you haven’t started already. But where to begin?

The best place to start is to read the list of ingredients. Your skin is your largest organ so it’s important that you protect it and use a product that is safe! The products that you put on your skin can be absorbed into your body and this is no different for sunscreen!

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Here are the top tips you need to know when choosing a sunscreen:


1. Choose a mineral sunscreen.

Try and find a mineral sunscreen that contains zinc oxide and titanium dioxide. These active ingredients create a barrier to protect your skin from the sun and can block both UVA and UVB damage. They are safe, effective and don’t break down in the sun.


2. Avoid oxybenzones

Oxybenzones were found in 2 out of 3 sunscreen products in 2019. They commonly cause allergic reactions and are easily absorbed through the skin. They are potentially a hormone disruptor and may be connected to changes in testosterone levels (Ghazipura, et.al., 2017). These ingredients are also harmful to the environment by decreasing egg production in fish at high concentrations (Coronado, 2008) and by bleaching coral reefs (Danovaro, 2008).


3. Avoid aerosols and use sunscreen creams.

The number of sunscreen sprays are on the rise and these sunscreens can easily be inhaled, which can be harmful.


4. Find a sunscreen with an SPF between 30 and 50.

To properly protect yourself from the sun’s harmful rays, you must wear a sunscreen that has an SPF (sun protection factor). A Sunscreen with an SPF above 50 is not necessary and may mislead customers with a false sense of security (EWG, 2019). It’s important to apply your sunscreen 30 minutes before going into the sun and to keep reapplying throughout the day! There are two types of harmful UV rays:

a. UVA: which can penetrate into the dermis and can lead to premature aging.

b. UVB: will usually burn the superficial layers of the skin.

The SPF value is a better measure of how well a sunscreen shields the skin from UVB rays, rather than UVA rays, so it’s important to look for a sunscreen that offers protection for both.


Are you curious about how your sunscreen rates against others? Click here to see!


References:

  1. Coronado, De Haro, Xin Deng, Rempel, Lavado, Schlenk (2008). Estrogenic activity and reproductive effects of the UV-filter oxybenzone (2-hydroxy-4-methyoxyphenyl- methanone) in fish. Aquatic Toxicology 90(3): 182-187. Retrieved from: https://www.sciencedirect.com/science/article/pii/S0166445X08002798

  2. Danovaro, et. al., (2008) Sunscreens cause coral bleaching by promoting viral infections. Environ Health Perspect 116(4): 441-447. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2291018/

  3. EWG (2019) Environmental Working Group. Retrieved from: https://www.ewg.org/sunscreen/report/executive-summary/

  4. Ghazipura, McGowan, Arslan, Hossain. (2017) Exposure to benzophenone-3 and reproductive toxicity: A systematic review of human and animal studies. Reprod Toxicol 73: 175-183. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/28844799

Is Weight Loss Simply Calories In VS Calories Out?

“It’s just calories in vs calories out.”

While the simplicity of this statement is appealing, there’s a lot more to successful weight loss than decreasing your caloric intake and increasing your exercise to create a caloric deficit. Why doesn’t this theory of simple math hold up?

  1. Not all calories are equal. Fats contain 9 calories/gram and carbohydrates contain only 4 calories/gram, but increasing your carbohydrate intake (especially processed carbs) by 1% increases your risk of obesity, while increasing your fat intake by 1% decreases your obesity risk. Different macronutrients (carbohydrates, fats, proteins) are metabolized differently in the body and set off different chain reactions. Some promote weight gain, while others support weight loss. No single group is strictly good or bad, but processed carbohydrates are more likely to promote fat deposition when eaten in excess.

  2. Your energy expenditure (calories out) isn’t static. Restricting your caloric intake results in a proportional decrease in energy expenditure. This makes you feel cold, tired, and weak, and makes it more likely you’ll regain the weight you do lose.

  3. Your metabolism is also heavily influenced by many hormones. Ignoring a hormonal imbalance and focusing solely on calories alone won’t get you very far.  

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So, if it’s not all about calories, what’s preventing you from losing weight when you’re eating nutrient-rich foods and exercising regularly?

The three of the most common weight loss obstacles I encounter in my practice are: high stress, poor sleep, and eating too frequently.

Prolonged stress increases hormones (namely cortisol) that promote cravings for sugary and fatty foods, and disrupt hormone signalling (of insulin, thyroid, and growth hormones) to increase fat accumulation, especially in the abdomen. Higher cortisol levels also increase your risk of metabolic and cardiovascular disease. Lowering and managing your stress is one of the best things you can do to improve your overall health and support weight loss! Exercise, deep breathing, meditation, and time spent outdoors are all helpful.

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Similarly, lack of sleep can throw a wrench in the works. Even just one week of insufficient sleep can increase fat mass. Over the long term, too little sleep promotes increased hunger, disrupts blood sugar regulation, and promotes loss of muscle-mass rather than fat-mass. So, what’s the magic number? This can vary, but 7 hours nightly is a good rule of thumb.

And finally, when you eat is as important as what you eat. Our bodies rely heavily on insulin to regulate blood sugar levels and fat storage. Eating too frequently – snacking consistently or eating late into the evening – leads to chronically elevated insulin (and eventually insulin resistance) which promotes weight gain and impairs weight loss. Your body needs breaks between meals. Cutting out snacks and fasting overnight for a 12-hour period can be good places to start. Although, certain conditions (eg. diabetes, hypoglycemia, and pregnancy) can require more frequent nutrient intake, so be sure to discuss this with your doctor.

If you’ve been working hard to lose weight with little success, take a look at your stress level, sleep, and meal timing. And if you’d like some additional support, seek out a Naturopathic Doctor, we’re always here to help.

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