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New Jersey Prolotherapy
Dr. Silberman specializes in regenerative injections, prolotherapy injection
therapy and neural prolotherapy for back pain, joint, tendon, muscle, nerve,
ligament injuries, degeneration and arthritis, inflammatory conditions, and
chronic pain.  Dr. Silberman trained under one of the pioneers in the field of
prolotherapy and  regenerative medicine, Dr. Brian Shiple, while a fellow at the
Crozer Chester Medical Center Sports Medicine Institute.  

What is prolotherapy, prolo, or neural prolotherapy?
Prolotherapy or prolo is a treatment where a solution, most commonly dextrose, is
injected into cutaneous nerves (neural prolotherapy), injured or degenerative ligament,
tendon, muscle or arthritic joints to stimulate a local inflammatory response. Your body
then induces a healing response through its own production of growth factors and other
nutrients.  
Prolotherapy case reports appear to confirm that prolotherapy does stimulate
tissue growth in tendon (patellar), ligament (anterior talofibular), and meniscus (medial
meniscus) and that this is an organized growth with a return toward a normal appearance
on ultrasound and MRI.

"Prolo" is short for proliferation and is derived from 'proli' which means to regenerate.

Pharmaceutical companies are currently developing growth factors for injection.

Conditions Dr. Silberman may treat with Prolotherapy or Neural Prolotherapy:
Chronic Back Pain
Sacroiliac pain, arthritis
Tennis Elbow (lateral epicondylitis), Tears and Tendonosis
Rotator Cuff Tendonosis and Rotator Cuff Tears
Patella or Quadriceps Tendonosis and Tears (jumper's knee or runner's knee)
Achilles Tendonosis, Achilles Tears
Plantar Fasciitis or Fasciosis (heel pain)
Hamstring tendon tears or insertional high hamstring 'tendonitis'
Hamstring and Quadriceps and Gastrocnemius Calf Muscle Tears
Chronic and Acute ligament sprains
Osteochondral cartilage joint injuries
Osteoarthritis, Lyme arthritis and enthesopathy, Rheumatoid arthritis
Piriformis Syndrome, Buttock Pain
Complex Regional Pain Syndrome

What to expect with prolotherapy or neural prolotherapy?
Your skin will be numbed with lidocaine as for a usual cortisone injection.  A solution of
dextrose will be injected in multiple sites under ultrasound guidance.  A local reaction will
occur whereby you may be sore for a day or so.  Pain medication may be prescribed.  
The process may be repeated every 2 weeks for up to 6 to 8 weeks before evaluation
for success.

What is the cost of prolotherapy or neural prolotherapy?
The cost of one prolotherapy injection therapy is $400 for one joint/tendon/ligament.  
The cost for 2 joint/tendon/ligament is $600. It is not covered by insurance.

Is prolotherapy or neural prolotherapy for everyone?
No.  I have seen many athletes and patients come from other locations treated with
prolotherapy, ozone, stem cells, and/or PRP when they should not have been treated
with these out of pocket treatments.  Be wary of web site testimonials as they do not
constitute science.

Other injection therapies that Dr. Silberman may discuss with you:
Cortisone - covered by insurance
Viscosupplementation (Synvisc) - covered by insurance
PRP or Platelet Rich Plasma Therapy - not covered by insurance
Bone Marrow Aspirate Stem Cell Injection - not covered by insurance
Tenotomy or Percutaneous Needling - covered by insurance
Nerve Blocks - covered by insurance
Botox - sometimes covered by insurance

Links:
Perineural Injection Therapy in the Management of Complex Regional Pain Syndrome: A
Sweet Solution to Pain

Periarticular dextrose prolotherapy instead of intra-articular injection for pain and
functional improvement in knee osteoarthritis

The efficacy of prolotherapy for lateral epicondylosis (tennis elbow)

High-Resolution Ultrasound and Magnetic Resonance Imaging to Document Tissue
Repair After Prolotherapy: A Report of 3 Cases

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