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Prolotherapy

What is Prolotherapy?

Prolotherapy (proliferative therapy), ligament reconstruction therapy, and fibro-osseous injection therapy, is a recognized orthopedic procedure that stimulates the body’s natural healing processes to strengthen joints weakened by traumatic or an over-use injury. When tendons are stretched, injured and/ or torn, they become hypermobile and painful. Traditional approaches with surgery and anti-inflammatory drugs often fail to stabilize the joint and relieve this pain permanently. Prolotherapy, with its unique ability to directly address the cause of the instability, can repair the weakened sites and produce new fibrous tissues, resulting in lasting stabilization of the joint.

 

How does Prolotherapy work?
  

With a precise injection of a mild irritant solution directly on the site of the torn or stretched ligaments, muscles and/or tendons, prolotherapy creates a mild, controlled injury that stimulates the body’s natural healing mechanisms to lay down new tissue on the weakened area. The mild inflammatory response that is created by the injection encourages growth of new fibrous , collagen rich tissue, resulting in a tightening of the weakened structure. Additional treatments repeat this process, allowing a gradual buildup of tissue to restore the original strength to the area.

 

Is the Prolotherapy treatment painful?

Any pain involving an injection will vary according to the structure to be treated, the choice of solution, and the skill of the physician administering the injection. The treatment may result in mild swelling and stiffness. The mild discomfort passes fairly rapidly and can be reduced with pain relievers such as Tylenol. Anti-inflammatory drugs, such as aspirin and ibuprofen, should not be used for pain relief because their action suppresses the desired inflammatory process produced by the injection.

 

What’s the rate of success in treatment?

The anticipated rate of success depends on a number of variables, including the patient’s history and ability to heal, and the type of solution used. In patients with low back pain with hypermobility, 85% to 95% of patients treated experience remission of pain with this form of therapy. In comparison, the Journal of Bone and Joint Therapy reports a 52% improvement in patients treated surgically for disc involvement.

References:
Bertrand H, Reeves KD. Dextrose Prolotherapy versus Control Injections in Painful Rotator Cuff Tendinopathy. Arch Phys Med Rehabil 2015 Aug 21. pii;S0003-9993(15)01091-6.doi:10.1016/j.apmr.2015.08.412.

Distel LM, et al. Prolotherapy: A Clinical Review of its Role in Treating Chronic Musculoskeletal Pain. Biologics Supplement.2011;3:S78-S81.

Rabago D et al. Dextrose Prolotherapy for Knee Osteoarthritis: a randomized controlled trial: ANN FAM MED; 2013:11:229-237.
Ravin, MD “Wound healing and tissue repair” Principles of Prolotherapy, 2008.