Tuesday, July 07, 2020

Modern medicine has achieved so many advances in treating diseases. Antibiotics have saved millions from disease. Advanced diagnostic techniques enable detection of many diseases in their early stages when they are much easier to treat. Surgical techniques such as tumor resection, transplants and cardiac surgery have saved many lives. While the focus of medicine is on treating disease and symptoms, alternative medicine focuses on finding strategies that treat the underlying cause of disease and maintaining health and wellness. I don’t like the name alternative medicine because it implies that it is something different as if something different is needed. I prefer the term wellness medicine because my approach is to optimize a person’s wellness. While we think of seeking a physician when we are sick, wellness is something to strive for whether sick or healthy.

The mainstream approach of treating injuries is that injured tissue is causing inflammation so the key is stopping that inflammation. One can take oral anti-inflammatory medication, such as ibuprofen (Advil, Motrin) or naproxen (Aleve). This will reduce pain but may also inhibit healing that leads to long-term relief. A more powerful anti-inflammatory approach is cortisone or steroid injection, which can provide relief that is often short-term. Unfortunately, steroids have side effects including immune suppression and may lead to wearing away of tissue, so these steroid injections are usually limited to three per year.

A wellness approach to treating injuries is using regenerative techniques to help build tissues such as ligaments, tendons and joints. Regenerative treatments were considered “alternative” for many years. Prolotherapy has been around since 1950 but has not been part of the mainstream approach to treating injuries and arthritis. However, there is level 1 evidence that establishes prolotherapy as an effective treatment for tendonitis and arthritis. Prolotherapy is an example of a treatment that was practiced as an alternative treatment in the community setting that is now being used in academic centers as its efficacy has been established.

There has also been recent emergence of other regenerative treatments including platelet-rich plasma (PRP) injections that are derived from the patient’s own blood. The growth factors present in this plasma provide tremendous power to regenerate tissue. Many of my patients have benefited from these treatments. The idea of regenerative treatments was once considered an “alternative” treatment and in the near future is likely to be part of the mainstream approach to injuries and arthritis. This is because regenerative treatments work well with almost no negative effects, so it just makes more sense. The underlying cause of the pain or injury is weakening tissue, and these treatments help strengthen the tissue; in other words, prolotherapy and PRP treat the underlying cause of injuries and arthritis.

Another aspect that distinguishes alternative medicine is the emphasis on wellness with a holistic approach. Rather than looking at the symptoms of a disease or lab values, there is an emphasis to look at underlying causes of the disease. For instance, a high cholesterol level is considered a risk factor for heart disease. However, lowering that cholesterol with medication leads to a marginal risk reduction at best. From a holistic perspective, looking at the underlying causes of high cholesterol and correcting those causes can lead to dramatic improvement of health with significant risk-reduction for cardiac disease. An elevated cholesterol generally indicates poor metabolism. This can be occurring from increased visceral fat, from lack of fitness or from hormone deficiencies or from a combination of all of these. A holistic approach includes strategizing to reduce visceral fat, working on improving fitness and correcting hormone deficiencies. While many physicians understand that these strategies are valuable, it is very hard to implement these in the standard medical setting. These strategies are best implemented in an “alternative” medicine setting where there is more of an emphasis on lifestyle and nutrition. As these strategies can help significant improvement in health and wellness, this may become the standard medical approach in the future.

Treating inflammation with an alternative approach can help reduce the need for multiple medications that have numerous side effects. Rather than suppressing inflammation with medications, an alternative approach includes modifying diet to reduce inflammatory foods. These will vary for different patients and include gluten, soy, dairy and sugar. For some, this may include all grains. While these dietary changes can sometimes be challenging, the positive feedback of feeling better helps one take on the challenge.

There are many supplements such as turmeric and vitamin D that may positively modulate the immune response. Low-dose naltrexone is another “alternative” low-side-effect compounded medication that can dramatically reduce symptoms of autoimmune disease such as rheumatoid arthritis, lupus, colitis and Crohn’s disease. As evidence continues to grow, I expect low-dose naltrexone to transition from alternative to mainstream. This rational approach of diet modification and supplements is another example of affecting the underlying cause of the inflammation and improving overall health, while reducing the need for medications.

A key theme is that alternative treatments are borne out of a holistic approach that looks for the cause of underlying health problems. Instead of blasting the problem with a medication that may have significant side effects, correcting the cause of the problem will lead to true healing. With this approach, instead of side effects there will be overall improvement of health. I hear many of my colleagues express surprise that alternative medicine is so popular. Based on how well patients feel with this alternative approach, working at treating the underlying cause by improving lifestyle, taking nutritional supplements or optimizing hormones, it is surprising to me that there are still those who do not take advantage of this approach. In other words, I look forward to alternative medicine becoming even more popular and eventually becoming the mainstream approach to health care, with a focus on long-term good health and wellness.

By Dr. Warren Slaten, M.D.

Dr. Slaten is a pain wellness physician in Ridgewood. For more than 20 years, he has been practicing regenerative techniques with great skill and an open mind. Check out his website at www.njprp.com