Hawaii Center for
Regenerative
Medicine:
808 933 3444
www.prolohawaii.com
The Hawaii Center for Regenerative
Medicine is designed to provide our patients
with advanced non-surgical pain relief to
promote comprehensive, rapid and effective
recovery.
Honolulu Downtown Office Hilo
Office
928 Nuuanu Ave Suite 210 136A
Ululani Street
Dr. Smigel introduces to Hawaii the
amazing, cutting-edge medical treatments
for musculoskeletal problems such as acute
and chronic sports injuries, accident
injuries, cartilage tears, arthritis and nerve
entrapments such as carpal tunnel
syndrome. She treats patients with severe
degeneration of the neck and low back
including those who suffer with intractable
pain despite spinal surgery
She offers traditional pain relief treatments
and therapies, as well as state-of-the-art
Regenerative Treatments, including
Prolotherapy, Platelet Rich Plasma and
Regenerative Cell Therapy. Dr. Liza Smigel
is one of only a few Physiatrists nationally
who is highly trained and experienced in
these innovative, natural approaches to
healing.
As a pioneer in Regenerative Medicine
therapies, Dr. Smigel is well experienced in
Prolotherapy, having been practicing this
for 14 years. She was among the first
physicians in the United States to
experience first hand the miraculous effects
of Neural Prolotherapy. She is considered
to be the most experienced Neural
Prolotherapist in the United States. She
coordinates annual conferences on the Big
Island and Chicago on Neural
Prolotherapy, where approximately 100
International Doctors attend yearly.
She is also one of the pioneering physicians
using Platelet Rich Plasma for orthopedic
problems since its discovery a few decades
ago. She is trained in Adipose and Bone
Marrow Stem Cell Therapy. She has
discovered Dextrose Caudal Epidural for
Treatment of Low back and lower extremity
pain and will be published in the Archives
of Physical Medicine and Rehabilitation.
This coming October 2015. She continues
to network with doctors around the world
in Regenerative Medicine, which is now a
global and rapidly growing field.
The Hawaii Center for Regenerative
Medicine is proud to be the first Oahu
Center for Advanced Regenerative Medicine
Procedures. These procedures offer viable
alternatives for patients with chronic pain
who may be considering surgery.
Dr. Liza Smigel is Board Certified in
Physical Medicine and Rehabilitation and
highly trained in Interventional Pain
Medicine. She has been in private practice
in Hilo since 2002 and opened her practice
in Oahu in 2009. After completing her
PM&R residency at the University of
Illinois, she completed a Musculoskeletal &
Sports Arts Medicine Fellowship at the
University of Texas-Houston. Dr. Smigel has
been a faculty on the Hackett Hemwall
Foundation trips to Honduras, Mexico and
the Philippines, and at the Hackett
Hemwall Patterson Foundation - University
of Wisconsin Conferences. She has been
faculty for the American Academy of
Orthopedic Medicine in Peru, and faculty
for Neural Prolotherapy Conferences all
over the world including United States,
Australia, Italy, New Zealand, Philippines
and Mexico.
Dr. Liza Smigel uses ultrasound guidance to
perform platelet rich plasma. She also uses
fluoroscopic guidance to perform
interventional spine injections in our Hilo
office procedure suite for the care of
patients with acute or chronic spine related
conditions. We take great pride in
combining cutting edge technology with
compassionate care to give our patients an
exceptional orthopedic medicine experience
PROLOTHERAPY
Prolotherapy is injecting dextrose or other
irritant into the damaged area, it
stimulates the tendon, ligament, joint, and
cartilage, causing mild inflammation that
triggers the healing cascade. As a result,
new collagen begins to develop. As this
collagen matures it begins to shrink and
causes the tightening and strengthening of
the tendons or ligaments of the damaged
area.
Neural Prolotherapy (NPT) is one of the
newest exciting advances in Regenerative
Medicine used to treat neuropathic pain in
a variety of musculoskeletal injuries and
various pain conditions. Neural
Prolotherapy was developed and advanced
by Dr. John Lyftogt from New Zealand.
Neural Prolotherapy is the injection of a
medical-grade sugar (either dextrose or
mannitol or glycerol) just below the skin to
promote healing of injured nerves and
restoration of tissue function. This wonder
therapy target specific receptors called
TRPVI that are present in the sensory
nerves. When TRPV1 is over activated,
there is excessive release of neuropeptides
called substance P and CGRP, which
triggers the experience of pain, and with
prolonged release of these neuropeptides,
produces degeneration and disease. NPT
works by down regulating TRPV1 release of
the pain neuropeptides. Subcutaneous
injection to deliver 5% dextrose leads to a
complete freedom of pain within seconds of
injection. The pain goes away almost
immediately. The technique is simple, safe
and very effective. There is cumulative
effect with repeated treatments, and it may
take 3- 6 treatment days before the patient
is fully cured.
Platelet Rich Plasma stimulates bone,
muscle and soft tissue healing. It is another
treatment option in the event of a failed
cortisone injection, or other therapies.
Sports injuries, arthritic joints (knee,
shoulder, hips, ankle, foot), tennis elbow,
rotator cuff tears, low back pain, plantar
fasciitis and all may be effectively treated
with PRP. To prepare Platelet Rich
Plasma, a small amount of blood is taken
from the patient. The blood is then placed
in a centrifuge, which spins and
automatically creates the PRP, which
increases the concentration of platelets and
growth factors to 500%. It is a natural
approach to healing ligament, tendon and
joint injuries. The procedure is less
aggressive and less expensive than surgery. It
allows your body to heal itself using its
own natural resource, your blood. PRP will
heal tissue with minimal or no scarring
and prevent further degeneration of the
tissues. Recovery time from PRP is
minimal, with quicker return to work and
exercise.
Research and clinical data show that PRP
injections are safe with minimal risk of
adverse reaction or complication. Studies
have shown that cortisone injections may
actually weaken tissue. Cortisone shots may
provide temporary relief and stop
inflammation, but may not provide long
term healing. Thus, pain may reoccur
within months. PRP is delivered to the
tissue in its inactivated form. The collagen
in connective tissue activates the platelets,
which then release their cytokines and
growth factors. These chemical messengers
signal genes to augment the healing stage
and activate local regenerative cells. This
causes regenerative cells, which migrate,
from the local blood and bone marrow to
the treatment site. The regenerative cells
then become cartilage, ligament, and
tendon or muscle cells as needed at the
injury site. At the same time, the cytokines
and growth factors downgrade the local
inflammation. They mitigate the internal
war between the bad proteins, which
slowly chew up the joint cartilage in severe
osteoarthritis and the good proteins, which
stop this degeneration. Without this help,
in a typical knee with osteoarthritis, it
takes approximately five years from
symptom onset to knee replacement,
necessary when the cartilage is gone and
the knee joint is bone on bone. The desired
end result of PRP therapy is functional
repair of an injured tendon, muscle or joint
cartilage allowing it to bear greater
mechanical stress during activity without
pain. Patients can see a significant
improvement in symptoms. This may
eliminate the need for more aggressive
treatments such as long-term medication or
surgery, as well as remarkable return of
function.
The use of PRP has expanded across many
medical fields. PRP has been used in
cardiovascular surgery; neurosurgery;
ophthalmology; urology; ear, nose and
throat surgery and cosmetic surgery. The
procedure can be done in a doctor's office
in thirty to sixty minutes and, some
athletes have reported being back to their
game as quickly as two days after the
procedure, although three to ten days of
downtime and six weeks away from
rigorous training is more common.
While responses to treatment will vary, most
people will require from one to three
treatments. There is no limit to the number
of treatments you can have, if the
treatments are spaced appropriately.
STEM CELL THERAPY
Through stem cell therapy, a patient can
take advantage of the body’s ability to heal
itself by using the healthy regenerative cells
that can be found throughout the body.
Laboratory and clinical research have
shown that it is possible to use regenerative
cells to restore and repair damaged or aging
cells and effectively regenerate tissue in the
body. Additionally, stem cell therapy
allows patients to receive orthopedic care on
an outpatient basis.
It is designed for patients with low back
pain due to disc degeneration and joint
pain due to osteoarthritis in the hip, knee,
shoulder, etc.
While stem cell therapy has been used for
decades to treat a variety of diseases, their
application in orthopedic and sports-
related procedures is relatively new. Dr.
Smigel has currently completed training for
this modality and will be providing it to
the Hawaii community.
We take great pride in combining cutting
edge technology with compassionate care to
give our patients an exceptional orthopedic
medicine experience
Insurance companies do not currently cover
these cutting edge treatments, and payment
is due in full at time of visit
For more information about regenerative
medicine, please check
www.prolohawaii.com. Call 808 933
3444 to set an appointment.

HCRM2014

  • 1.
    Hawaii Center for Regenerative Medicine: 808933 3444 www.prolohawaii.com The Hawaii Center for Regenerative Medicine is designed to provide our patients with advanced non-surgical pain relief to promote comprehensive, rapid and effective recovery.
  • 2.
    Honolulu Downtown OfficeHilo Office 928 Nuuanu Ave Suite 210 136A Ululani Street Dr. Smigel introduces to Hawaii the amazing, cutting-edge medical treatments for musculoskeletal problems such as acute and chronic sports injuries, accident injuries, cartilage tears, arthritis and nerve entrapments such as carpal tunnel syndrome. She treats patients with severe degeneration of the neck and low back including those who suffer with intractable pain despite spinal surgery
  • 3.
    She offers traditionalpain relief treatments and therapies, as well as state-of-the-art Regenerative Treatments, including Prolotherapy, Platelet Rich Plasma and Regenerative Cell Therapy. Dr. Liza Smigel is one of only a few Physiatrists nationally who is highly trained and experienced in these innovative, natural approaches to healing. As a pioneer in Regenerative Medicine therapies, Dr. Smigel is well experienced in Prolotherapy, having been practicing this for 14 years. She was among the first physicians in the United States to experience first hand the miraculous effects of Neural Prolotherapy. She is considered to be the most experienced Neural Prolotherapist in the United States. She coordinates annual conferences on the Big Island and Chicago on Neural Prolotherapy, where approximately 100 International Doctors attend yearly.
  • 4.
    She is alsoone of the pioneering physicians using Platelet Rich Plasma for orthopedic problems since its discovery a few decades ago. She is trained in Adipose and Bone Marrow Stem Cell Therapy. She has discovered Dextrose Caudal Epidural for Treatment of Low back and lower extremity pain and will be published in the Archives of Physical Medicine and Rehabilitation. This coming October 2015. She continues to network with doctors around the world in Regenerative Medicine, which is now a global and rapidly growing field. The Hawaii Center for Regenerative Medicine is proud to be the first Oahu Center for Advanced Regenerative Medicine Procedures. These procedures offer viable alternatives for patients with chronic pain who may be considering surgery.
  • 5.
    Dr. Liza Smigelis Board Certified in Physical Medicine and Rehabilitation and highly trained in Interventional Pain Medicine. She has been in private practice in Hilo since 2002 and opened her practice in Oahu in 2009. After completing her PM&R residency at the University of Illinois, she completed a Musculoskeletal & Sports Arts Medicine Fellowship at the University of Texas-Houston. Dr. Smigel has been a faculty on the Hackett Hemwall Foundation trips to Honduras, Mexico and the Philippines, and at the Hackett Hemwall Patterson Foundation - University of Wisconsin Conferences. She has been faculty for the American Academy of
  • 6.
    Orthopedic Medicine inPeru, and faculty for Neural Prolotherapy Conferences all over the world including United States, Australia, Italy, New Zealand, Philippines and Mexico. Dr. Liza Smigel uses ultrasound guidance to perform platelet rich plasma. She also uses fluoroscopic guidance to perform interventional spine injections in our Hilo office procedure suite for the care of patients with acute or chronic spine related conditions. We take great pride in combining cutting edge technology with compassionate care to give our patients an exceptional orthopedic medicine experience PROLOTHERAPY
  • 7.
    Prolotherapy is injectingdextrose or other irritant into the damaged area, it stimulates the tendon, ligament, joint, and cartilage, causing mild inflammation that triggers the healing cascade. As a result, new collagen begins to develop. As this collagen matures it begins to shrink and causes the tightening and strengthening of the tendons or ligaments of the damaged area.
  • 8.
    Neural Prolotherapy (NPT)is one of the newest exciting advances in Regenerative Medicine used to treat neuropathic pain in a variety of musculoskeletal injuries and various pain conditions. Neural Prolotherapy was developed and advanced by Dr. John Lyftogt from New Zealand. Neural Prolotherapy is the injection of a medical-grade sugar (either dextrose or mannitol or glycerol) just below the skin to promote healing of injured nerves and
  • 9.
    restoration of tissuefunction. This wonder therapy target specific receptors called TRPVI that are present in the sensory nerves. When TRPV1 is over activated, there is excessive release of neuropeptides called substance P and CGRP, which triggers the experience of pain, and with prolonged release of these neuropeptides, produces degeneration and disease. NPT works by down regulating TRPV1 release of the pain neuropeptides. Subcutaneous injection to deliver 5% dextrose leads to a complete freedom of pain within seconds of injection. The pain goes away almost immediately. The technique is simple, safe and very effective. There is cumulative effect with repeated treatments, and it may take 3- 6 treatment days before the patient is fully cured.
  • 10.
    Platelet Rich Plasmastimulates bone, muscle and soft tissue healing. It is another treatment option in the event of a failed cortisone injection, or other therapies. Sports injuries, arthritic joints (knee, shoulder, hips, ankle, foot), tennis elbow, rotator cuff tears, low back pain, plantar fasciitis and all may be effectively treated with PRP. To prepare Platelet Rich Plasma, a small amount of blood is taken from the patient. The blood is then placed in a centrifuge, which spins and automatically creates the PRP, which increases the concentration of platelets and growth factors to 500%. It is a natural
  • 11.
    approach to healingligament, tendon and joint injuries. The procedure is less aggressive and less expensive than surgery. It allows your body to heal itself using its own natural resource, your blood. PRP will heal tissue with minimal or no scarring and prevent further degeneration of the tissues. Recovery time from PRP is minimal, with quicker return to work and exercise. Research and clinical data show that PRP injections are safe with minimal risk of adverse reaction or complication. Studies have shown that cortisone injections may actually weaken tissue. Cortisone shots may provide temporary relief and stop inflammation, but may not provide long term healing. Thus, pain may reoccur within months. PRP is delivered to the tissue in its inactivated form. The collagen in connective tissue activates the platelets, which then release their cytokines and
  • 12.
    growth factors. Thesechemical messengers signal genes to augment the healing stage and activate local regenerative cells. This causes regenerative cells, which migrate, from the local blood and bone marrow to the treatment site. The regenerative cells then become cartilage, ligament, and tendon or muscle cells as needed at the injury site. At the same time, the cytokines and growth factors downgrade the local inflammation. They mitigate the internal war between the bad proteins, which slowly chew up the joint cartilage in severe osteoarthritis and the good proteins, which stop this degeneration. Without this help, in a typical knee with osteoarthritis, it takes approximately five years from symptom onset to knee replacement, necessary when the cartilage is gone and the knee joint is bone on bone. The desired end result of PRP therapy is functional repair of an injured tendon, muscle or joint
  • 13.
    cartilage allowing itto bear greater mechanical stress during activity without pain. Patients can see a significant improvement in symptoms. This may eliminate the need for more aggressive treatments such as long-term medication or surgery, as well as remarkable return of function. The use of PRP has expanded across many medical fields. PRP has been used in cardiovascular surgery; neurosurgery; ophthalmology; urology; ear, nose and throat surgery and cosmetic surgery. The procedure can be done in a doctor's office in thirty to sixty minutes and, some athletes have reported being back to their game as quickly as two days after the procedure, although three to ten days of downtime and six weeks away from rigorous training is more common. While responses to treatment will vary, most
  • 14.
    people will requirefrom one to three treatments. There is no limit to the number of treatments you can have, if the treatments are spaced appropriately. STEM CELL THERAPY Through stem cell therapy, a patient can take advantage of the body’s ability to heal itself by using the healthy regenerative cells that can be found throughout the body. Laboratory and clinical research have shown that it is possible to use regenerative cells to restore and repair damaged or aging
  • 15.
    cells and effectivelyregenerate tissue in the body. Additionally, stem cell therapy allows patients to receive orthopedic care on an outpatient basis. It is designed for patients with low back pain due to disc degeneration and joint pain due to osteoarthritis in the hip, knee, shoulder, etc. While stem cell therapy has been used for decades to treat a variety of diseases, their application in orthopedic and sports- related procedures is relatively new. Dr. Smigel has currently completed training for this modality and will be providing it to the Hawaii community. We take great pride in combining cutting edge technology with compassionate care to give our patients an exceptional orthopedic medicine experience Insurance companies do not currently cover these cutting edge treatments, and payment
  • 16.
    is due infull at time of visit For more information about regenerative medicine, please check www.prolohawaii.com. Call 808 933 3444 to set an appointment.