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Re: [John Muir Trail] Anti-inflammatories and altitude sickness

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  • Roleigh Martin
    Actually Prolotherapy, since it s been around since 1955, is newer than most of the anti-inflammatories out there (aspirin being the main exception). I did
    Message 1 of 4 , Mar 23, 2012
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      Actually Prolotherapy, since it's been around since 1955, is newer than most of the anti-inflammatories out there (aspirin being the main exception).  I did not say to avoid anti-inflammatories but to understand the downside to them if you think they will help healing a wounded part of your body.  Using them for altitude adjustment or temporary stiffness from hiking is fine under the constraints you mention.  I bring them on the hike and do use them for those purposes (but again only after asking myself if I really need them)  I gave a Google link about why they're bad when you have something that needs to heal though.  Here is a single paper on them with abundant medical research footnoting. 

      SPORTS INJURIES - NSAIDs: Why We Do Not Recommend Them: NSAIDs Hamper Ligament and Tendon Healing


      In law (something you used to do for a living), the defense has it's side in court.  In Prolotherapy, because there is little profit to be made from it (compared to the surgical methods they so love), the opposing side thinks they've made their case with positions stated decades ago.  Medicare last issued a statement report on it in 1999, nearly 13 years ago.  However, any use of Medline (National Library of Medicine) will show you it is a very hot area of research now, mostly driven by how much more promising the treatment is with one's own stem cells (search pubmed by terms "stem cell injections" versus "prolotherapy") added to the injection mix and the fact so many professional athletes are using it as a front line course of treatment.  When Tiger Woods and Yankee Pitcher Bartolo Colon do prolotherapy, people notice.  Anyway, here is the case for the defense:

      1.  The entire issue of the December 2011 issue of the Journal of Prolotherapy entitled “The Case for Prolotherapy.”  It is available free in PDF form but the printed version is an impressive professional printed copy to present.  Either address Beulah Land Press, 715 Lake St., Suite 600, Oak Park, IL 60301, phone 70-848-5011, fax 708-848-0978 or email bairdn@....  This issue has 976 bibliographic citations.  It is a very impressive document written by a large number of doctors.  Pay special attention to the last (inside) page of this issue, page 848, entitled “Organizations Who Support, Teach, and Promote Prolotherapy”.  Each of these links (nearly all listed above in this document under directories) have supporting pages on Prolotherapy.

      2.  The position paper, Regenerative Injection Therapy  (RIT): Effectiveness and Appropriate Usage, by The Florida Academy of Pain Medicine (FAPM).  This paper as 139 bibliographic citations and also written by a large number of doctors representing an official position paper of a statewide medical society of Pain Medicine doctors in Florida.

      3.  The American Association of Orthopaedic Medicine position paper on Prolotherapy,

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      On Fri, Mar 23, 2012 at 12:01 AM, John Ladd <johnladd@...> wrote:

      On Thu, Mar 22, 2012 at 12:58 PM, Roleigh Martin <roleigh@...> wrote:

      (When I read up about Prolotherapy one of the first things you learn is to avoid as much as possible ever taking NSAID or anti-inflammatory medications.)

      I'd rather use something whose risks are well studied and well understood, as opposed to something which is perhaps promising but relatively under-studied.  I'm not saying that NSAIDs are risk-free, but their benefits exceed their risks for most people most of the time, if they don't exceed recommended dosage. I'm not fully convinced that they will reduce altitude risks, but they work for me in preventing overuse injuries and in speeding recovery when I do have a problem. 

      More on prolotherapy here:

      Good lay summary of NSAID risks here:

      and for a highly technical review of these risks and their management, see

      (Recent, free and from a good journal)

      I'm not saying that prolotherapy won't work or that NSAIDs always will.  But why not go with something much-studied and relatively well understood?

      My personal experience with Naproxen (Aleve) has been quite positive, both as a preventative and for speeding recovery from injury. Ibuprofen apparently has a lower risk profile, and is perhaps better for that reason, but for me Naproxen seems more effective.  

      I think it would be a mistake for people to be scared off from modest use of NSAIDs, particularly if it drives them to less well-studied treatments.

      John Ladd

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