06/21/2023    Glen N Robison, DPM

Therapeutic Injections of Dextrose (Elliot Udell, DPM)

Elliot Udell, I have followed your comments on
this platform for many years, and for this one I
cannot stay silent on prolotherapy. The doctor who
started the discussion was asking advice for
treating Interdigital neuromas and the proper
dosage of the % medium used. Here is my experience
with prolotherapy

I have been using prolotherapy for over 10 years,
stabilizing ankles, repairing torn plantar fascia,
tendon and plantar plate tears, and even neuromas.
When given in the right dosage, the right way to
inject and absolutely no anti-Inflammatories such
as Advil or ibuprofen or aspirin and say in the
ankle when it is set properly it is very
effective. I was trained by Kent Pomeroy MD here
in Phoenix AZ who was world renowned before his
passing.

I have treated well over several hundred patients
using prolotherapy (50% dextrose with 1% lidocaine
as my medium of choice) I have treated
professional athletes, college athletes to high
school age students, my success stories with my
patient are no longer a debate but a proven safe
therapeutic treatment for someone who is not a
surgical candidate or someone who does not what
surgery as a first option. And I do not charge
what you are suggesting, not even a fraction of
that.

I am sure you would call my best-selling book “
Healthy Dad, Sick Dad” where I tell patients to
eat blueberries, green beans, and fresh ginger to
help lower blood sugar a “quakery" but tell that
to the many of my patients who have tried the
diabetic diet in the book that has lowered their
blood sugar successfully.

I don’t know why you have so much hatred towards
natural remedies, but I am tired of your lamb
blasting those few of us out there that want a
healthy discussion on other treatment options
other than surgery, and by the way, I am
surgically trained.

Glen N Robison, DPM, Mesa, AZ

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06/23/2023    Allen Jacobs, DPM

Therapeutic Injections of Dextrose (Elliot Udell, DPM)

I know little about prolotherapy, nor do I have
any expertise in holistic medicine. With that
preamble, I find the demands on Dr. Kornfeld to
produce literature defending his use of
prolotherapy both interesting and somewhat
disingenuous. For many years Dr. Ribotsky, as an
example, advocated the use of fillers for the
treatment of various foot lesions. Where was the
literature to support that? Anyone familiar with
the 2023 International Working Group on the
diabetic foot guidelines will note that the
majority of wound care products advocated by
“thought leaders in the diabetic foot” within our
profession, have little, if any studies to support
their use. Yet my colleagues continue utilizing
these modalities.
I am sure that Dr. Kornfeld would not utilize
therapies that he did not feel were in the best
interest of his patient and did not provide
satisfactory outcomes. He would be a fool to do
so. Look at the recent study-based calamity that
occurred with the recent Covid pandemic. How
reliable were those studies in retrospect? Not
everything we do, and I would venture to say the
majority of what we do, is not based on RCTs.
Evidence-based medicine includes the experience of
the practitioner, and the observations of that
practitioner in treating patients. With reference
to selection of therapies, medical or surgical, my
old professor, Dr. Ganley used to ask “how many
bad results can you afford to have limping about
your town?”

I have no doubt that Dr. Kornfeld has seen
satisfactory results with his treatments. The fact
that there are no studies to support the use of a
particular therapy, equates to the fact that the
absence of these studies also tell us that there
is no evidence that these therapies do not work.
As for the placebo effect, how many arthroscopic
surgeries are effective because of the placebo
effect, how many medication‘s we prescribe help as
the result of a placebo effect? How many topical
antifungals for onychomycosis does Dr. Udell
prescribe that have no good studies to support
their use? Let us not be so quick to condemn
anyone or make unreasonable demands on another
practitioner that we do not make upon ourselves in
daily practice.

Allen Jacobs, DPM, St. Louis, MO