Chad: The vast majority, well in excess of 85% of those patients have actually had a ligament or tendon problem as the source of their pain. 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. Two different things, so I would almost think about it as, “You’ve got a nerve problem, or you’ve got a ligament/tendon problem.”
Bryan: Okay, so this young man comes to you. He’s having this, at this point it’s phantom pain, right? You can’t diagnose it, at this point?
Bryan: Continue the story, where?
Chad: This guy ended up getting medically discharged out of the army. I can’t, who knows, I have no idea how much money the taxpayers spent training this guy, and we had to send him home because he had pain and we couldn’t fix it.
Bryan: He wanted to stay.
Chad: He did, yeah. Traditionally, we would think about that and say, “Oh, he’s got secondary gain. He’s got some reason, he just wants to go play cards on Monday and not go to work.” That’s not the case with these guys. It’s just-
Bryan: You don’t go into this profession wanting to go home.
Chad: That’s right.
Bryan: Put in all the work, through all the stuff that they do.
Chad: There was nothing that I could do for that guy. That’s frustrating, as a physician, as a doctor. My job is to keep those guys in their job. In fact, the medical, the A-Med, Army Medical Department, they’re slogan is, “To conserve the fighting strength.” That’s my job; that’s what I’m supposed to do, and I couldn’t help him. That was very frustrating.
Then a couple, few months later, my commander in 5th group came to me and said, “I need prolotherapy on my elbow.” I was like, “I have no idea what you’re talking about.” Well of course, when a commander says-
Bryan: You better Google it.
Chad: … “I need this,” then your job is now to go find-
Bryan: The WebMD; have you heard of it?
Chad: I have.
Bryan: It’s amazing.
Chad: That’s right.
Bryan: It’s on your phone. You can get an app for it and everything.
Chad: My PA at the time started doing the research and found a guy in the Nashville area, Dr. Martin Johnson. He’s a urologist, and he had back pain so bad that he could no longer operate. He got prolotherapy and that’s, so he saw the benefit. That’s how he started doing it.
Bryan: He saw, he was at a point, just let me understand this guy’s story.
Bryan: He’s at a point, he’s a commander, right?
Chad: A commander comes to me and says, “I need prolotherapy-”
Chad: … “on my elbow.”
Bryan: Because he’s-
Chad: On his own.
Bryan: He’s at a point where this other guy, he couldn’t even have surgery, right?
Chad: Dr. Johnson was a urologist, and he couldn’t perform surgery any longer because his back pain was so bad.
Chad: He got prolotherapy and it fixed his back pain.
Chad: That’s how he got into prolotherapy, and so we sent my commander to this guy, and it fixed his elbow. I was like, “Okay, well that’s-”
Chad: … “that’s interesting,” but didn’t really think much more about it.
Bryan: It’s good.
Chad: Dr. Johnson, 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. He came and spent the day with us. The first thing he did was he sat down, and you got to understand, I was an athletic trainer in college, so I worked with the athletes, and we had tee shirts that said, “Just ice it.” This is regular sports medicine dogma is “rice,” rest, ice, compress, elevate.
Bryan: This is in the 60s, right?
Chad: Or the late 90s.
Bryan: Late 90s, okay, I couldn’t tell.
Chad: This is still modern sports medicine dogma.
Bryan: Medicine has not been good to you.
Chad: Oh my goodness. It’s that rest, ice, compress, elevate, and then working in medicine in the army, we have what we call “ranger candy.” It’s Motrin. You just give it out like candy. It’s good for what ails you.
Bryan: There you go; here you go, buddy.
Chad: These are anti-inflammatory medications, what we call “NSAIDS,” nonsteroidal anti-inflammatory medications. Ice and Motrin, it’s kind of like duct tape. It fixes everything. We’re sitting here listening to this guy and he says, “Don’t use ice after an injury and especially, no matter what you do, don’t ever use anti-inflammatories. I was like, “Okay, are you kidding me?”
Bryan: Is this guy working for the enemy?
Chad: Right. I was like, “You’re either crazy or brilliant.” I don’t know which one.
Bryan: In wartime, we’re going to shoot you if your crazy, right. That’s what you do?
Chad: That’s exactly what we do on a daily basis. Anyway, so that was a very interesting concept for me and I was like, “I don’t buy this.” I shelved it for about 6 months. Multiple patients came in and there were these patients came in, you know retropatellar pain, it’s pain behind the kneecap, common in runners. We don’t have a good solution for that.
Bryan: Runner’s knee?
Chad: Sometimes we’ll try steroids.
Bryan: Is that what they call it?
Chad: Little bit different.
Chad: That’s a little bit different pathology and there is some things we can do for that. With this retropatellar pain, sometimes they’ll try and do physical therapy. Sometimes they’ll do steroids; sometimes they’ll do surgery, but nobody really knows exactly … I mean, there’s no 100% solution for this. He’s talking about these things, and this prolotherapy stuff and so I filed it in the back of my brain. I had this patient came in; she was a young female that ran a lot and had this retropatellar pain.