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PROLOTHERAPY

What is prolotherapy?

Prolotherapy is a medical procedure that stimulates the body to heal torn and injured ligaments and tendons. Ligaments are the fibrous bands that connect bone to bone. Tendons are the fibers that attach muscle to bone. When ligaments and tendons are injured, they can produce pain at the site and also patterns of radiating pain. For example, a torn ligament in the low back can cause an aching pain that radiates down through the leg. Therefore, the site of the injured ligament can usually be identified before the areas that are painful are even examined by the doctor just by the physician's knowledge of referral pain patterns and the patient's complaints.

What does a prolotherapy treatment involve?

Prolotherapy involves injections of a safe and effective solution into the site of the injured ligament or tendon. The solution stimulates the body's own healing activity, causing regrowth of the damaged tissues. Ligaments and tendons are known to have a poor vascular supply making it difficult for the body to repair these areas when they are injured. Prolotherapy causes inflammation at the injured area. Inflammation signals the body to send whatever is necessary to heal the injured area. Thus, the body sends cells to breakdown the damaged tissues and cells needed to repair the injury. The results are permanent.

Why is prolotherapy a better alternative than conventional methods such as anti-inflammatory medications and steroids?

Anti-inflammatory medicines such as ibuprofen, naproxen sodium, cortisone, prednisone and aspirin inhibit the body's inflammatory response. When the body suffers from an injury, a signal is sent out by the release of prostaglandins that signal the body to increase blood flow to the injured area. This increased blood flow allows for the components necessary for healing to be brought to the site of injury. Anti-inflammatory medicines stop the release of prostaglandins and inhibit the healing of the injured tissues. These medications will also stop the healing effects of prolotherapy and cannot be taken before or during the treatment process.

What does the prolotherapy solution contain in it?

The solution used in prolotherapy is a combination of sugar water (dextrose 50%) and anesthetics such as lidocaine and marcaine. The dextrose causes irritation. The body senses this and is then stimulated to repair injured tissues. The anesthetics provide the patient with an almost immediate relief of the pain giving the patient confirmation that the ligament or tendon was indeed the origin of the problem.

What can be expected after a prolotherapy treatment?

Relief of pain is typically experienced due to the anesthetic in the solution. When the anesthetic wears off, the patient may experience some mild aching pain. This will resolve in 1-2 days. During that time Tylenol may be used. Improvement of pain symptoms can be expected after this time. The amount of relief can vary depending on the degree of injury and the person's innate ability to heal.

How many treatments are required?

It is usually necessary to repeat the procedure from 1 to 8 times. This varies by individual due to the extent of the injury and the person's healing abilities. Treatments are given every 3-4 weeks. During the 3rd week after a treatment, the body is at its peak of the healing process. Inflammation has resolved, but because the injury is not yet completely healed, the pain may return to a lesser degree. Therefore, repeating the procedure in the 3rd week resolves the symptoms and bumps up the healing signals to the body.

Are there any contraindications to the procedure?

People with allergies to corn may not tolerate the dextrose in the solution. Alternatives may be used such as sodium morrhuate, an extract of cod liver oil. The dextrose in the solution will not affect blood sugar levels and is therefore safe to use in individuals with diabetes. For people with intolerance to lidocaine, this component of the solution may be eliminated.

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