Conditions Treated

Conditions Treated

Headache

Headache treatment can be achieved first by finding the source of the headache pain. There may be serious and rare causes like high blood pressure, strokes, and in some cases, brain cancer. Many headaches are due to tension but most headaches, including migraine and trigeminal neuralgia, are due to problems with nerves to the affected area. These nerves supply the ligaments, tendons, and joints of the neck, as well as the skin that covers them and your head.

If you neck is affected, you will have pain in your neck and the back of your head when you move, and prolotherapy to strengthen the ligaments and tendons of your neck and stabilize it will calm the nerves that produce headaches.

If the nerves that supply your head and your forehead are affected, perineural injection therapy, also called neural prolotherapy will give you immediate relief.

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Sacroiliac Pain

If you have pain in your low back, which is worse on one side. If this pain started during or after a pregnancy, or after a fall, You could be suffering from sacroiliac joint subluxation. If you do, your pain will be worse when you are moving, walking, rolling over in bed, or carrying weights. Prolotherapy is an effective treatment for back pain due to sacroiliac subluxation.

If, on the other hand, your pain also occurs out of the blue, when you’re not expecting it, and is made worse when you press on the painful area, you could be suffering from nerve pain in your low back. An excellent treatment for this form of back pain, is perineural injection therapy (neural prolotherapy).

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Neck Pain

Often after an accident, “a whiplash injury”, where your head goes, very suddenly, back and forth, or sideways, you will experience pain in your neck.

If the accident was very severe, or if, with age, the ligaments and tendons of your neck are weak, then, it is likely the ligaments and tendons of your neck were injured. Your neck pain will be felt mostly when you are moving your head. If this is the case, you will need to be treated with prolotherapy.

If your neck pain happens any time, even when you are at rest, then it is most likely due to irritated nerves in your neck and you will be likely to find relief with perineural injection therapy (neural prolotherapy).

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Shoulder Pain

Treatment of shoulder pain with prolotherapy, a series of injections of growth promoting substances has been shown to be effective in stimulating the growth and repair of ligaments and tendons. Injections to the shoulder ligament and tendon insertions strengthen and thicken them. These stronger ligaments and tendons will help restore the strength of your shoulder, help prevent arthritis of the shoulder and help correct the cause of shoulder pain. There have unfortunately not been any “gold standard” studies done to prove the value of prolotherapy in rotator cuff problems. This is why Dr. Bertrand is carrying out such a “gold standard” study, funded by work safe BC and approved by the UBC ethics committee. In a preliminary observational study, 75% of those whose shoulders, were treated with prolotherapy were better after three months (as opposed to 46% after three years with conventional therapy).

Treatment of shoulder pain with perineural injection therapy (neural prolotherapy) is very effective in providing relief, and allowing you to start moving your shoulder again. It is particularly effective for those who suffer from “frozen shoulder”, or shoulder pain associated with neck, chest, or back pain. In these cases, the pain, and difficulty moving the area is due to inflammation of the involved nerves, which supply the area, and perineural injection therapy relieves this inflammation.

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Hip Pain

The commonest cause for hip pain is osteoarthritis of the hip. If you are older, or have a poorly aligned leg or a previous leg injury, and if you find you have difficulty spreading your hip, or flexing it, or turning your foot in or out, and this has gradually, over the years gotten worse, osteoarthritis, is likely. You could also be suffering from tendinitis of the muscles which surround the hip joint. In this case, you would have pain with certain movements of your hip. All of these conditions respond well to prolotherapy.

If, on the other hand, you have pain in your hip when you are not moving, and this pain is going down your leg, the chances are you are suffering from nerve pain. In this case, it is likely your pain will be helped by perineural injection therapy (neural prolotherapy).

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Foot and Toe Pain

  • Pain in the middle of your foot is often due to osteoarthritis or to
  • tendinitis of your peroneus brevis muscle, which attaches on the bone which sticks out on the outside of your midfoot.
Pain in the front of your foot, has a multitude of causes, including

  • Metatarsalgia, when your front arch sags, and there is too much pressure on your metatarsal bones (the ones that join up with your toes). You will have pain underneath your foot, at that junction, when you walk.
  • Morton’s neuroma: when the nerves that goes to your toes is trapped between your metatarsal heads. This will also give you a great deal of pain when you walk but also numbness between your toes.
  • Hallux valgus (a bunion): this happens because of increased pressure on your big toe. When your foot is rolled in (pronated).
  • Hallux rigidus: when you can’t bend your big toe back (you should be able to bend it to 90° with your foot). It is usually a sign of osteoarthritis of the first joint of your big toe.
  • Hammer toes: usually happen when your front arch sags.
Most of these conditions will respond well to prolotherapy, and to orthotics.

The nerves that supply your foot are essential to keeping it in good working order. If they are injured as a result of faulty gait or footwear or excessive exercise, they will contribute to the breakdown of the foot’s structures. This damage will respond readily to treatments of perineural injection therapy (neural prolotherapy).

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Neuropathic Pain

If you have neuropathic pain, it is because your pain is coming directly from your nerves. When this happens,

  • Even light pressure can cause terrible pain.
  • The pain can feel like an electric shock,
  • Or, it can be like a burn, there all the time.
  • At times you can get pins and needles sensations, or numbness or itching.
  • These nerves communicate their discomfort with their neighbors. Sometimes the pain signals starts in one small area and spreads, until it involves a large part of your body.
The three safest treatments are dietary supplements, QR cream, and perineural injections. Neuropathic pain treatment with dietary supplements: if you are diabetic, Alpha lipoic acid and benfothamine have been shown to be effective in relieving the symptoms of neuropathy. Neuropathic pain treatment with Topical agents: QR Cream contains a sugar derivative, which normalizes the function of the painful skin nerves in a matter of minutes. It is painless to apply, and has no side effects, unless you are allergic to one of its components, which is highly unlikely. In Dr. Bertrand’s practice, this cream has provided a great deal of relief for people with painful neuropathies. Unfortunately, it is not yet licensed for sale by Health Canada. It will be tested first on people experiencing pain after a marathon. Neuropathic pain treatment with perieural injection therapy (neural prolotherapy): this treatment is able to relieve neuropathic pain in seconds. Unfortunately, it requires many tiny injections, under the skin, along the course of the painful nerves, as it consists in bathing the nerves in a sugar derived solution. After the first treatment, you are likely to be pain free for anywhere between two hours and four days. You are likely to need between four and 16 weekly treatments before your pain is entirely gone. With each treatment, you need fewer injections and you remain pain-free for longer and longer periods.

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Tennis or Golfers Elbow

Elbow pain usually occurs when you overuse the muscles which attach just above the elbow. Injury to the nerves that supply the skin, as well as the ligaments and tendons of the elbow, can also cause elbow pain. Pain due to loose ligaments or tendons or arthritis only comes when you move the ligaments or tendons or the joints. Nerve pain, on the other hand, can be severe and happen at any time even when you are not moving at all. If you press lightly on an area with nerve pain, the pain gets worse.

Tennis or golfers elbow treatment with prolotherapy. Prolotherapy,injections to the elbow ligament and tendon insertions strengthen and thicken them. Prolotherapy has recently been shown to be extremely effective in the treatment of tennis elbow. Of 24 people suffering from tennis elbow pain from six months to 10 years, 12 got prolotherapy and 12, who got saline injections instead, were the control group. All the treated subjects and none of the controls were better by 16 weeks.

Treatment of elbow pain, with perineural injection therapy (neural prolotherapy). Neural prolotherapy is likely to help if your pain is coming from the nerves that supply your elbow. Nerve pain can be severe even when you are resting and can be made worse by pressing lightly on the affected areas. If this is the kind of pain you have, and you get perineural injection therapy, your pain will disappear in seconds , as you are being injected.

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Achilles Tendonitis

If you have a lot of pain in your heel cord, which gets worse when you walk or you run, and is usually worse when you first get up in the morning, then, you probably have Achilles tendinitis.

A study has shown that doing eccentric loading exercises together with prolotherapy was the most effective way to treat Achilles tendinitis.

Another effective Achilles tendinitis treatment is, perineural injection therapy (neural prolotherapy). A study in New Zealand using perineural injection therapy (neural Prolotherapy) on patients who had ultrasounds every month to the Achilles tendon has shown complete healing of the tendon a few months after the pain is gone.

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The Cycle of Pain

For every cubic milliliter of tissue in your body, there are 8,000 nerve fibers, which are wrapped in an insulating myelin sheath, and 30,000 other “naked” nerve fibers. Among those are the C fibers. Every single group of cells in the body is supplied with these tiny nerve fibers. Their main role is to make sure every cell is functioning optimally.

When there is no injury, they never transmit pain signals. When part of the body is injured, the role of these nerve cells is to kick-start the body’s repair mechanism, to help bring back normal function to the injured body part. They do this by activating their TRPV1 receptor, which transmits sodium and calcium and releases two peptides.

The first peptide released is called substance P, as in pain. If you have pain, you don’t want to move the painful part. This keeps the edges of an injured area together and allows them to heal. Too much movement disrupts the scar formation. The second peptide released is called calcitonin gene related peptide or CGRP. CGRP and substance P cause blood vessels to open up, which will make the injured area red, and to leak, which will cause swelling, the first phase of inflammation. Inflammation is what kick-starts the body’s repair mechanism. CGRP also causes cells to become engorged with calcium, which may lead to calcium deposits in chronically inflamed areas.

A blow, a burn, a cut, are not the only ways of the body can be injured. In order to get to the skin, nerves, which include these tiny C fibers have to cross the fascia, the fibrous covering of muscles. They do this through tiny holes in the fascia, just big enough to let them through. If the fascia is stretched out of shape, these round holes can become slits and squeeze the nerves, injuring them. This often happens in whiplash injuries. When the nerves are injured they swell, causing them to get trapped in the holes that they pass through. This constriction injury can cause ongoing damage to the nerves, which causes the swelling to persist. This is called “self strangulation” and results in a “chronic constriction injury”. Swelling can cause the pressure inside the nerve fibers to increase to the point where they are no longer able to conduct nerve impulses or even repair themselves. Inside the nerve, the injured, swollen C. fibers now have activated TRPV1 receptors, which will remain activated as long as the C fibers are swollen. This may help explain why people who suffer whiplash or sudden jolting injuries have such persistent pain.

It appears that blocking the TRPV1 receptor would be the best way to block the release of substance P and CGRP, and the transmission of pain signals by the C fibers. Sugar (dextrose) has been shown to block the TRPV1 receptor. A solution as low as 5% dextrose blocks the TRPV1 receptor. Amazingly, sugar blocks the TRPV1 receptor almost instantly. Once the TRPV1 receptor is blocked, CGRP and substance P stop being produced, and the painful message which substance P transmits to the brain disappears in a few seconds. The nerve is no longer swollen and easily crosses the small opening in the fascia. It regains its normal function, which is to maintain cell health.

One theory about this condition is that it is caused by nerve inflammation. The tiny nerves involved in inflammation extend even to the surface of the skin. Applying a cream containing dextrose or mannitol will shut down the TRPV1 receptors on these nerves. These receptors release the peptides, substance P and CGRP, which cause pain and inflammation. Using this cream may stop the vicious cycle of pain and inflammation that happens in complex regional pain syndrome. If you have this condition, you can visit Dr. Bertrand and tryQR cream.


Migraine

If you have pounding headaches, usually, on one side of your head that make you feel sick to your stomach and get worse with noise or bright light or when you are active, you are likely to be suffering from migraine headaches.

When you have a migraine headache, the trigeminal nerve, which supplies sensation to the face and the forehead, is what transmits your pain signals to your brain.

A new treatment for migraine headache involves Perineural injection therapy, injections of 5% dextrose or mannitol near your trigeminal nerve can stop the headache in seconds to minutes, no matter how severe the pain, or how long it has lasted. There is no research yet to prove that this treatment can eliminate migraines permanently, but it may be worth trying it. It has virtually no side effects, unlike all of the other migraine treatments. (See Wikipedia, migraine treatment)

QR cream has also been found effective in the treatment of headaches, even migraines.
TMJ

What is TMJ? (Temporomandibular joint pain)

  • jaw pain when you chew
  • jaw pain when you open your mouth wide
  • headaches that start just in front of your ear
There are two, safe, effective TMJ treatments: Prolotherapy to strengthen the ligaments that hold the joint together, and help repair the inside of the joint, and perineural injection therapy (neural prolotherapy).

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Back Pain

One of the most effective treatments for chronic low back pain is perineural injection therapy (neural prolotherapy). If you have suffered from back pain for a long time, there is a very high likelihood that it is at least in part due to swollen nerves supplying the skin of your back. You can usually tell if your pain is coming from the nerves that supply the skin of your back. Nerve pain can be severe even when you are resting and can be made worse by pressing lightly on the affected areas. Many people with chronic back pain have been successfully treated with neural prolotherapy. Because this treatment is very safe, it is worth trying at least once, particularly if your pain has not been helped by other treatments.

Prolotherapy is another treatment for back pain. Prolotherapy, a series of injections of growth promoting substances has been shown to be effective in stimulating the growth and repair of ligaments and tendons that stabilize your spine, thus helping correct the cause of your back pain, and preventing disk herniations and osteoarthritis in your back.

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Chest Pain

Chronic pain in your chest can be due, either to the nerves which supply your chest, or to the junction of the cartilage and the rib. Some of the commonest causes are

  • Costochondritis , which will give you pain and swelling in the top front of your chest, near the breastbone.
  • Sprained rib, usually due to a blow on the chest, which will often give you pain in the back near your spine.
  • Nerve pain, which can be anywhere on the chest. If it is coming from nerves in your neck, the pain will be at the top of the chest on the front, or on the back, often between your shoulder blade and your spine. If it is due to scar tissue, it can be anywhere, but it usually involves the area of the scar.
If you have costochondritis, or a sprained rib, prolotherapy will often help. The main problem with prolotherapy is that prolotherapy injections to the ribs can sometime result in the lungs being punctured. The needle used is tiny, and the problem usually resolves in a few days, but it is still a risk.

If you have nerve pain, you should respond very well to QR cream or perineural injection therapy (nerve blocks).

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Ankle Pain

  • The commonest cause of ankle pain is recurrent sprains, usually with the foot turned in. This will overstretch the ligaments and tendons on the outside of the ankle, and make a future sprain more likely.
  • Another common cause of ankle pain is osteoarthritis of the ankle.
  • If you have pain in one spot, near the middle of the arch of your foot, and if your pain is worse when you point your toe, and turn your foot in, then you have a tendinitis of the tibialis posterior muscle.
All of these conditions respond well to prolotherapy.

Nerve pain, from your ankles usually happens as a result of pain in nerves higher up. You are likely to have pain down your legs, and not just in your ankle. This pain is much worse when you press on the sore area, and can occur at any time, including the middle of the night. Nerve pain will respond well to perineural injection therapy (neural prolotherapy).

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Plantar Fasciitis

Plantar fasciitis, pain on the inside or the front of your heel, responds well to orthotics and prolotherapy. When the nerves that supply the area are involved, the pain can be removed with perineural injection therapy (neural prolotherapy).

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Fibromyalgia

  • If you have chronic pain all over your body,
  • and this pain is made worse by pressure, particularly over 11 of the 18 tender points, which characterize fibromyalgia,
  • chances are you have fibromyalgia, and that it is due to inflamed skin nerves
The 18 tender points are all found where nerves are crossing the thick fibrous covering of your body, through small holes, so they can reach your skin. If these nerves are swollen, as the result of an injury, they may be too big for the small holes they have to cross. When that happens, every time you move, the swollen nerves rub against the walls of the holes and injure themselves more. Because they are injured, they swell, which causes them to injure themselves even more. Injured, swollen, nerves send pain signals to the brain, and are extremely sensitive to even light pressure. Skin nerves communicate with their neighbors. The pain begins to spread as more and more skin nerves swell, and, in turn, get trapped and injured in the holes they have to cross. Eventually, almost all your skin nerves are swollen and injuring themselves on the walls of these holes. Unless something is done to reduce nerve swelling, the vicious cycle of pain persists.

Fibromyalgia treatments

Currently, the conventional thinking about the cause of fibromyalgia is that it is related to depression and that it is “all in your head“. This is why all the treatments suggested involve antidepressants, antiseizure medication, narcotics, and other painkillers such as Tylenol or NSAIDs, and cognitive behavior therapy (a kind of psychotherapy). It is not surprising that chronic pain is associated with depression and anxiety, as the ventral posterior thalamus, the switching station for pain signals in the brain is right beside, and has multiple connections with, the ventral median thalamus, the switching station for depression and anxiety signals in your brain.

A new and very effective fibromyalgia treatment is Perineural injection therapy, also called neural prolotherapy, injections of 5% dextrose or mannitol near your painful skin nerves can stop the pain in seconds, wherever the injections are made, no matter how severe the pain, nor how long it has lasted. This proves that your pain is due to skin nerves, and is not “all in your head”.

Often, just injecting the nerve roots nearest the involved nerve cells will be enough to calm the pain and reduce the swelling of these nerves. Every time you return for another treatment, you need fewer injections, as more and more of the nerves regain their normal size and function. Eventually, your pain may be completely gone.

Because skin nerves are involved in precipitating the pain of fibromyalgia, it is possible that QR cream might help.
Trigeminal Neuralgia

When the trigeminal nerve, which supplies the whole face, including the forehead, the nose, the lips, the cheeks and the jaw, is inflamed, the pain is excruciating. Stabs of pain like lightning strikes can happen every few seconds or minutes and occur with the lightest touch, opening your mouth, eating, speaking, laughing etc., often making your life unbearable.

Two of Dr. Bertrand patients with trigeminal neuralgia got their pain under control using QR cream. As this cream has virtually no side effects, except that it should not be applied near the eyes as it may irritate them, it is worth giving it a try. If even the lightest touch causes pain, the cream can be put on cling wrap and cling wrap can then be applied to the painful area and left there for the cream to absorb through the skin. When Dr. Bertrand gave QR cream to a group of 20 people suffering from trigeminal neuralgia, 15 experienced almost immediate pain relief.

One new treatment for trigeminal neuralgia is Perineural injection therapy. These injections of 5% dextrose or mannitol near your trigeminal nerve can stop the headache in seconds to minutes, no matter how severe the pain, or how long it has lasted. The treatment, which is safe, and does not involve medications or surgery, has to be repeated whenever the headache recurs until the headache is entirely gone.

Other treatments involve the use of anticonvulsant therapy, narcotics, and surgery. (See Wikipedia, trigeminal neuralgia)

Complex Regional Pain Syndrome

If you suffer from

  • Severe pain,
  • Swelling
  • Changes in the skin (the skin can look mottled or purplish, and there may be excessive sweating or dryness).
  • Which started in an arm or a leg, often after an injury (even a small one)
  • and may have spread to another part of the body
  • If the affected limb is gradually losing its ability to function,you may be suffering from complex regional pain syndrome.
Complex regional pain syndrome treatment: Many treatments have been tried and have not been effective. For more information about all these treatments, go to Wikipedia, complex regional pain syndrome.

One theory about this condition is that it is caused by nerve inflammation. The tiny nerves involved in inflammation extend even to the surface of the skin. Applying a cream containing dextrose or mannitol will shut down the TRPV1 receptors on these nerves. These receptors release the peptides, substance P and CGRP, which cause pain and inflammation. Using this cream may stop the vicious cycle of pain and inflammation that happens in complex regional pain syndrome. If you have this condition, you can visit Dr. Bertrand and try the QR cream. See the cycle of pain.
Wrist, Hand and Finger Pain

The commonest causes of wrist, hand and finger pain are

  • Osteoarthritis, which often shows up on x-ray
  • Tendinitis often caused by overuse and made worse by moving or using the wrist or the hand.
  • Carpal tunnel syndrome, which can wake you up at night, with numbness in the fingers.
  • Nerve pain, which occurs at any time and is worse when pressing on the sore area.
  • Wrist, hand and finger pain treatment depends on the cause of the pain.
QR cream is very effective in helping relieve pain involving the wrists the hands or the fingers. It turns off the pain messages that nerves supplying the area send to the brain.

Prolotherapy is particularly effective in relieving the pain of osteoarthritis and tendinitis, as it helps restore normal ligament, tendon and joint function.

Perineural injection therapy (nerve blocks), is effective for carpal tunnel syndrome and nerve pain, as it reduces the inflammation of the involved nerves.

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