What is Prolotherapy?
Prolotherapy is a regenerative technique that was developed in the 1830’s to address soft tissue injuries. The process has been refined over decades and studied at length, with much promise. Today, prolotherapy has been used to treat common soft tissue injuries and arthritis conditions. The basic theory is that an irritant or stimulant is injected into a space to initiate a healing response from the body. For many years, medical experts sought to extinguish these reactions known as inflammation. Emerging research, however, suggests that inflammation is a pathway to healing. This procedure is often times repeated until complete healing is achieved. The most common negative reactions to treatment include moderate discomfort, redness, and swelling.
Prolotherapy is a renowned orthopedic procedure that stimulates the body’s healing process to strengthen and repair injured and painful joints and connective tissue. When ligaments or tendons are strained or torn, the joint they are holding destabilizes and can become painful. Prolotherapy can repair the deteriorated areas and create new collagen tissue, which can lead to permanent stabilization of the joint. The pain is typically resolved, once the joint is stabilized. Conventional approaches with surgery have more risk and may fail to stabilize the joint and relieve pain, and anti-inflammatory or other pain relievers only act temporarily.
How is Prolotherapy Performed?
The most common injected material to perform prolotherapy is dextrose (medical grade sugar). This substance acts as an irritant and stimulant when injected into various tissues and joints. Prior to treatment, a careful and detailed exam is performed to determine what structures require direct intervention. This exam often times includes the use of ultrasound to give real time information on the condition of various tissues. Once the target tissues are identified, the concentration of prolotherapy is calculated. The dextrose is then injected with a small needle into the target. Most practitioners now use ultrasound to pinpoint the delivery of the prolotherapy. Along with dextrose, an anesthetic may also be used to help determine the pain generator and provide comfort for the patient. After successful treatment, most patients will follow-up in 2 – 4 weeks to monitor progress, reaction, and determine if repeat treatment is needed.
Prolotherapy will lay down new tissue in the deteriorated location by stimulating the body’s natural restorative mechanisms. This process is completed by a direct injection to the injury location, which then “tricks” the body to repair again. The mild inflammatory response, which is created by the injection, encourages growth of new, normal ligament or tendon fibers, resulting in a constriction of the weakened structure. A gradual buildup of tissue to restore the original strength to the area will occur with additional treatments to repeat the process.
Prolotherapy injections include natural substances that stimulate the healing response. The injections also contain local anesthetic agents to help with the pain of the injection. Conventional formulas include ingredients such as saline, dextrose, sarapin, and lidocaine or procaine. In the past few years, newer formulas include Platelet Rich Plasma (PRP) and autologous (from the same person) adult stem cell sources. These sources are typically taken from bone marrow or adipose (fat) tissue. Each treating physician selects the appropriate formula according to the individual patient’s need.
Conditions Related to Prolotherapy
Prolotherapy has been shown to be effective in treating a wide array of common pain conditions. This includes: headaches, jaw pain (temporal mandibular joint), neck pain, back pain, shoulder and forearm pain, hip and knee arthritis, tendonitis in various joints and ankle pain. There is also emerging evidence that prolotherapy is effective at treating chronic pain from neuropathies (i.e. diabetic neuropathy). Because of the low incidence of adverse reaction and relative low cost, prolotherapy is often considered a worthwhile treatment option for most chronic pain conditions.
The areas treated include low back or mid-back pain including:
- Degenerative disc disease
- Sacroiliac joint instability/dysfunction
- Neck pain
- Knee pain
- Knee meniscal tears
- Wrist or hand pain
- Shoulder pain including rotator cuff tears
- Elbow pain including golfers or tennis elbow
- Foot pain including plantar fasciitis
- Ankle pain or instability
- Osteitis pubis
- IT band syndrome
- Piriformis syndrome
- Temporal mandibular joint syndrome (TMJ)
- or other musculoskeletal pain or injury.
It is important to be evaluated by a physician that is trained and experienced in this procedure so that an accurate assessment and treatment plan can be provided, as some areas can be more challenging than others.
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Are you suffering from chronic pain that has not been helped through more conservative therapies? We can help. Clearway brings together healthcare professionals from a range of disciplines who can work together to get you the best treatment plan for your specific needs. Call us for an appointment. We will discuss your condition and the range of treatment options you have available.