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Dr. Cavallino is a physician in Italy who specializes in regenerative medicine and prolotherapy. He is known for his work in advancing prolotherapy techniques and education in Italy and throughout Europe. Based in Italy, he has been instrumental in teaching prolotherapy techniques to medical professionals and helping establish regenerative medicine protocols.

He has contributed to the field through both clinical practice and education, working to integrate American prolotherapy techniques with European medical practices. Dr. Cavallino has been involved in organizing training programs and workshops for physicians interested in learning prolotherapy techniques.

Summary

• Introduction to Dr. Stephen Cavallino and Prolotherapy 0:00
  • Dr. Barrett introduces Dr. Stephen Cavallino, a physician from Italy specializing in prolotherapy and regenerative medicine.
  • Dr. Cavallino has contributed to the development of prolotherapy techniques and trained other physicians worldwide.
  • Dr. Cavallino is the founder of the European School of Prolotherapy, which is accredited and focuses on teaching prolotherapy globally.
  • The discussion will cover indications, dosages, methods of administration, and the physiology of prolotherapy.
• Overview of Prolotherapy 2:28
  • Dr. Cavallino explains that prolotherapy was born about 70 years ago in the United States as an injection therapy to treat chronic pain in the musculoskeletal system.
  • The term "prolo" means proliferation, and it involves deep injections into the connective tissues attached to bones, particularly ligaments.
  • Weak ligaments can cause joint instability, leading to chronic pain. Prolotherapy aims to strengthen these ligaments through injections.
  • The injection solution typically contains dextrose, which causes inflammation and initiates a healing cascade.
• Differences Between Prolotherapy and Glucopuncture 5:46
  • Dr. Barrett asks about the percentage of dextrose used in prolotherapy and how it differs from glucopuncture.
  • Dr. Cavallino explains that glucopuncture uses 5% dextrose or glucose subcutaneously, while prolotherapy uses higher concentrations (10-25%) for deep injections into the enthesis.
  • Higher dextrose concentrations cause more inflammation, which is necessary for prolotherapy to work.
  • The mechanism involves causing microhemorrhaging to increase platelets and growth factors at the injection site.
• Tensegrity and Fascia in Prolotherapy 8:06
  • Dr. Barrett inquires about the concept of fascia tensegrity and its role in prolotherapy.
  • Dr. Cavallino explains that tensegrity involves the tension between points in the body, similar to how a bridge stands.
  • Fascia, which covers muscles, can cause pain if it becomes involved in the tensegrity system.
  • Recent research has shown that dextrose can modulate neuropeptides, providing immediate pain relief in prolotherapy.
• Mechanisms and Clinical Applications of Prolotherapy 10:22
  • Dr. Barrett asks about the process leading to ligament laxity and weakened mechanical integrity.
  • Dr. Cavallino explains that aging and degeneration lead to weakened ligaments, causing joint instability.
  • Prolotherapy with dextrose can tighten ligaments, making joints more stable and reducing pain.
  • The importance of treating the entire tensegrity model of the body is emphasized, as pain can originate from different areas.
• Chemical and Biochemical Effects of Prolotherapy 14:12
  • Dr. Barrett inquires about the chemical denervation effects of dextrose in prolotherapy.
  • Dr. Cavallino explains the biochemical changes in the healing cascade, including the bleeding phase, inflammation phase, and proliferation phase.
  • Dextrose causes neuromodulation, reducing pain, and releasing growth factors from platelets.
  • The importance of not using anti-inflammatory drugs during the inflammation phase is highlighted.
• Administration and Pain Management in Prolotherapy 17:55
  • Dr. Barrett asks about the administration of prolotherapy and pain management during injections.
  • Dr. Cavallino explains that they use a mixture of 1% lidocaine and 1% dextrose for anesthesia during injections.
  • The lidocaine helps make the patient comfortable, and the dextrose ensures the effectiveness of the treatment.
  • The use of ultrasound guidance in prolotherapy is discussed, with a focus on its growing importance in treatment accuracy.
• Deciding on Prolotherapy Concentration 22:33
  • Dr. Barrett asks about the criteria for selecting dextrose concentrations for prolotherapy.
  • Dr. Cavallino explains that 15% dextrose is typically used for extra-articular structures, while 25% is used for intra-articular structures.
  • There is a trend towards using less inflammatory solutions, such as 5% dextrose, which can still be effective.
  • The importance of the needle contacting bone during prolotherapy is emphasized, as it contributes to the inflammatory response.
• Comparing Prolotherapy to Other Regenerative Technologies 22:53
  • Dr. Barrett inquires about the use of dextrose versus other regenerative technologies like PRP and stem cells.
  • Dr. Cavallino explains that dextrose is the first choice for prolotherapy, followed by PRP if necessary.
  • Stem cells are used as a last resort if other treatments are ineffective.
  • The importance of treating the peri-articular structures of the joints rather than the joint itself is emphasized.
• Post-Treatment Care and Patient Management 29:26
  • Dr. Barrett asks about post-treatment care and patient management after prolotherapy.
  • Dr. Cavallino explains that patients should avoid anti-inflammatory drugs and use painkillers and heat for the first few days.
  • Patients should rest gently and avoid strenuous activities for the first week to allow the healing process to take place.
  • The importance of treating the body like a newborn baby during the first week is emphasized.
• The European School of Prolotherapy 40:59
  • Dr. Barrett inquires about the European School of Prolotherapy and its offerings.
  • Dr. Cavallino explains that the school was formed in 2018 to standardize prolotherapy education and training.
  • The school offers courses in basic prolotherapy, neuroprolotherapy, perineural injection treatment, and ultrasound training.
  • The importance of starting with basic training and progressing to more advanced courses is emphasized.
• Upcoming Courses and Future Plans 42:01
  • Dr. Barrett asks about the upcoming courses and future plans for the European School of Prolotherapy.
  • Dr. Cavallino mentions the upcoming courses in February and April 2025, as well as a master class in May in Montenegro.
  • The school also offers missions for doctors who have taken basic courses, providing hands-on training with patients.
  • The importance of practical experience and standardized education in prolotherapy is emphasized.