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What is Prolotherapy?

by Mila McManus, MD

Prolotherapy is a non-surgical treatment used to stimulate growth factors in the human body and thus promote the body’s natural healing process. It is also known as regenerative injection therapy or proliferation therapy. Growth factors are complex proteins that help repair body tissues.  Prolotherapy is also thought to encourage collagen repair which is a protein essential to connective tissue that holds our skeletal structure together.

Conditions that may benefit from prolotherapy treatment include:

  • Damaged tendons, muscles, or ligaments
  • Arthritis of the knees, hips, or fingers
  • Chronically painful musculoskeletal conditions
  • Degenerative disc disease
  • Fibromyalgia
  • Certain types of headaches
  • Lax or unstable joints

Prolotherapy involves injecting typically a sugar or salt solution into or around a joint or other parts of the body to stimulate the body to repair itself.  Usually a dextrose, glucose, or saline is used.  Injections are repeated at 3 to 4 weeks intervals for a total of 3 to 6 sessions. If suboptimal improvement is the result, treatment with PRP (platelet-rich plasma) or Wharton’s jelly may be recommended.  Wharton’s Jelly is derived from umbilical cord and contains stem cells, fibroblasts, and other types of cells and structural material.  Several studies have shown that a series of injections have resulted in improvements in pain, function, and stiffness, often resulting in the avoidance of more invasive and complex surgical procedures.

Prolotherapy is available at TWIHW. Ask one of our medical providers if prolotherapy is right for you, or call (281) 298-6742 and speak to a wellness consultant today.




By |2021-10-05T16:48:59-05:00October 7th, 2021|General|

Stem Cells-The Future of Medicine or Dangerous Science?

by Mila McManus MD

I began learning about the miracles of stem cell therapy several years ago at a functional medicine conference. I saw pictures of scarred heart tissue from a heart attack that disappeared after the injection of stem cells.  It was quite amazing. I didn’t pay much attention to the potential applications in the real world until some information landed in my lap a few years later. Since then, I’ve been doing a lot of research, watching a docuseries and other videos, reading books, studies and articles feverishly, attending lectures at conferences, and sharing notes with colleagues.  Today I’m presenting some details about what stem cells are and what they do, as well as the risks, benefits, uses, and controversy.

Definition of stem cells:

Stem cells are the cells in our bodies that act as our raw materials.  They can self-renew, meaning that they can create more new stem cells, or they can differentiate into (i.e., turn into) other types of cells, such as blood cells, bone, muscle, and organ tissues.

Types of stem cells:

There are 2 main types of stem cells.

  • Hematopoietic stem cells give rise to all types of blood cells
  • Mesenchymal stem cells (MSCs) form bone, muscle, fat, heart tissue, etc.

Where stem cells are sourced from:

  • Bone marrow
  • Adipose (i.e., fat) tissue
  • Embryos (illegal in the US)
  • Umbilical cord blood or tissue
  • Amniotic membrane and fluid
  • Menstrual blood/tissue

Couple of fascinating facts about stem cells

  • Doubling time (i.e., how long it takes for stem cells to replicate themselves) slows as we age. In a fetus, stem cells double every 24 hours.  In a 35 year-old, they double every 48 hrs.  In a 65 year-old, they double every 60-72 hours. This means that, at the end of 30 days, 1 fetal stem cell will become 1 billion cells, and 1 stem cell from the 35 year-old will become only 32, 000 cells, and 1 stem cell from a 65 year-old will yield a dismal 200 cells.
  • The number of stem cells declines with age.  In newborns, 1 out of every 10,000 cells is a stem cell.   In an 80 year old, 1 in every 2 million cells is a stem cell (see graph)

Benefits of stem cells:

  • Reduce inflammation
  • Modulate the immune system (strengthen it when/where weak, and dampen overactivity)
  • Anti-microbial
  • Regenerate tissues
  • Anti-aging due to ability to repair damaged tissue
  • Stimulate angiogenesis (i.e., formation of new blood vessels, which then carry oxygen and other nutrients to tissues for healing and optimal function)
  • Stimulate your own stem cells to work better and harder

Risks of stem cell therapy:

  • Infection (extremely rare. You are at risk from infection any time you have any type of injection with a needle)
  • Lack of benefit for various possible reasons
  • Growth of unwanted tissues
  • Transient fever or flu-like symptoms

Various applications for which stem cells have been used and/or studied

  • Cancer treatment
  • Chronic inflammation (e.g., autoimmune disease, fibromyalgia)
  • Arthritis in various joints
  • Healing of torn ligaments and tendons
  • Neurodegenerative diseases (e.g., Alzheimers, Parkinsons, stroke, etc)
  • Aesthetic procedures (e.g., improving skin appearance, facilitates better results with face lifts)
  • Autism
  • Diabetes
  • Emphysema
  • Wound care
  • Spinal cord injuries
  • Heart disease, heart failure

The Controversy surrounding stem cells:

  • There are currently thousands of ongoing studies using stem cell therapy for various diseases
  • Big Pharma wants its piece of the pie
  • Large universities are fighting for patents to get their piece of the pie
  • Researchers are working on manipulating stem cells to become patentable drugs
  • Embryonic stem cells are controversial in their own right and are illegal in the US. They are still used in other countries
  • Story of people going blind with stem cells-this was about 3 patients undergoing experimental injections of stem cells directly into their eyes.  The theory is that it was a chemical preservative in the stem cells that caused the blindness, and not the stem cells themselves
  • Tumor growth with stem cells—has been only with use of embryonic stem cells
  • They are NOT FDA approved (they are natural, and therefore not under the jurisdiction of the FDA)
  • Most uses of stem cells are considered ‘off label’
  • Yours vs theirs argument: Proponents of “autologous adipose” derived stem cells (i.e., cells obtained from your own fat tissue) argue that it’s better to use your own cells than those of another person (e.g., umbilical cord from a healthy full-term newborn) because you run the risk of contracting a communicable disease, particularly one that hasn’t even been discovered. While that’s a valid theoretical risk, it’s important to note that 1) no such infection has ever been reported, and 2) umbilical cords are obtained only from healthy, full-term, prescreened newborns and mothers.  Furthermore, the tissue banks test for infectious agents beyond what blood banks do for blood transfusions.  The argument on the allogeneic side (using other people’s cells) is that MSCs lose activity and potency with age, so why use old dysfunctional cells when you can use young, active, and robust cells.  Studies have proven, in vitro, that younger MSCs work better than older ones.
  • Injection of expanded cells is not legal in the US (yet).  Expansion means that cells are obtained and then cultured for several days to increase the volume of cells by orders of magnitude (e.g., from millions to billions). One can culture the cells in the US, but then the patient must travel to another country to have those cells injected or infused.
  • According to Dr Neil Riordan (published in 2017), “over 40 studies published on the use of mesenchymal stem cells (MSCs) in a wide range of chronic and acute health conditions have been found to have no serious adverse reactions. In particular, there have been no adverse events reported with the use of umbilical cord mesenchymal stem cells, which appear to have the highest safety profile among the four most commonly used MSC types: bone marrow, fat tissue, menstrual blood, or umbilical cord.”
  • Dr. Riordan also stated in his book that in 2012 a meta-analysis was conducted that included 8 randomized controlled trials of patients receiving MSC treatment for a range of disease conditions. The only adverse reaction that the analysis detected was transient fever. They found NO evidence of cancer, immune reaction, organ system complications, toxicity, infection, or death.

If you’d like to learn more about regenerative medicine, call us at 281-298-6742.


Stem Cell Therapy: A Rising Tide by Dr Neil Riordan

The Healing Miracle docuseries




By |2023-01-23T14:58:17-05:00June 2nd, 2019|General|

Regenerative Orthopedic Options

By Shaun Lehmann, MD  prp, prolotherapy, and stem cells
Edited by Mila McManus MD


The body is designed to heal itself. As we age, our bodies start to lose the ability to focus a sustained healing response to musculoskeletal injuries. Injuries can occur from multiple sources including trauma, repetitive stresses, or medications. The body’s healing response can also be diminished due to nutritional deficiencies, hormone deficiencies, and genetic conditions.
The field of Orthopedic Medicine is rapidly changing to now include many regenerative options aimed at improving our ability to heal. We are now learning that some of the traditional ways that we have been treating musculoskeletal pain and injuries may actually be causing problems by negatively affecting the body’s ability to heal itself. Steroid injections, for example, are now showing in research to decrease the local stem cell counts and could actually damage cartilage. NSAIDS (non-steroidal anti-inflammatory drugs) also have been shown to accelerate cartilage loss.
Regenerative medicine aims to accelerate our natural ability to heal after injury occurs. The goal of regenerative therapy is to optimize the cellular environment by stimulating growth factors and repair cells.

Some of these treatments include:
Point of Care Therapies (same day procedures)

Nutritional Growth Factor Stimulation

  • Prolotherapy
  • Ozone Therapy

Personal Cell Therapy (Autologous)

  • Platelet Rich Plasma (aka PRP)
  • Bone Marrow Aspirate
  • Fat derived Mesenchymal cells – or VSF “vascular stromal fraction:”

Donation cellular therapy (Allogeneic)

  • Umbilical Allograft Cells
  • Amniotic growth factors
  • Placental growth factors

Cultured Cellular Therapies (not a same day procedure… takes weeks to grow)

Nutritional stimulation treatments such as Prolotherapy and Ozone therapy aim to focus the body’s healing energies on the location that needs repaired. They aim to wake up the body’s local healing mechanisms by refocusing and restarting the healing process. These treatments can work well as long as the body is healthy, and the repair mechanisms are in working order.

Personal cellular therapies do the same as above; however, they also bring extra cellular workers to the job site. These treatments are usually deemed stronger than Prolotherapy and Ozone and are deemed relatively safe since the workers are your own cells.

Donation cellular therapies are from a donor person, are more potent than Personal cellular therapies, and are tested for safety (e.g., viruses such as HIV, hepatitis); however, the tissues are not tested for every potential infectious disease, so there may be some theoretical risk.

Cultured Cellular Therapies are not legal to use in the U.S. at this time, but it is legal to process and store these stem cells in the United States. One has to travel to another country to have the stem cells injected or infused. Cultured stem cells can be either Personal (autologous) or Donated (allogeneic).

There is a large body of research done on the efficacy of Prolotherapy and Platelet Rich Plasma, but more is still needed. Stem cells show so much promise that they are said to be “the future of medicine”.

By |2019-02-22T08:55:43-05:00January 30th, 2019|Articles, General|