A natural and effective treatment for chronic pain and arthritis
Prolotherapy stimulates the body’s natural healing process and can be used effectively for chronic pain, strengthening injured tissues, treating musculoskeletal conditions and restoring function. It is a much less invasive alternative to surgery, pain medication and steroid (cortisone) injections.
Prolotherapy is a non-surgical regenerative injection therapy used to repair injured tendons, ligaments and joints. Joints, ligaments and tendons usually have a limited blood supply, meaning that incomplete healing is common after an injury.
These types of injuries can become a chronic source of pain and/or weakness.
Prolotherapy is both natural and non-surgical. It is based on the principle of injecting a mild irritant solution (dextrose) directly into the weak or damaged ligament or tendon (where it attaches to the bone). This irritant solution “tricks the body” into thinking the area is re-injured and this initiates an inflammatory response which promotes the body’s natural tissue/wound healing mechanism to increase blood and nutrient supply to the area. As part of this process, the body recruits connective tissue cells (fibroblasts) into the injured area to lay down new tissue in the weakened areas. This encourages growth of collagen and new ligament and tendon fibers, resulting in a tightening of the weakened structures. The regenerated tendons and ligaments produced after prolotherapy are remodeled by the body in the final stage of healing, resulting in tissue that looks and functions very similarly to the original tissue. Procaine is also added to the dextrose solution injection. Procaine is a short-acting anesthetic that helps to control pain and stop the constant pain signal to the brain. Procaine is also helpful in stopping muscle spasms, increasing muscle strength, helping to break up scar tissue and resetting malfunctioning nerves
Patients can experience mild to moderate discomfort with this treatment, but the discomfort is manageable.
Treatment protocols for prolotherapy vary for each patient based on their individual needs, personal healing ability, immune health, and the severity of the injury. The average person requires 3-6 treatment sessions given at 2-3-week intervals, although many patients report experiencing some relief after 1-2 sessions. More serious or chronic injuries require longer courses of treatment, while proper exercise, overall health status, age, gender, hormones, inflammation, dietary measures, nutritional supplementation, minimal stress, adequate rest/sleep, and physical adjustments are all factors that affect the healing process as well.
Patients who are at risk of reinjuring the area may need to consider a maintenance schedule.
There are no guarantees, but sometimes a stronger therapy such as platelet-rich-plasma (PRP) may be needed to enhance the body’s healing response further.
Prolotherapy is NOT the same as a cortisone injection. Cortisone is used routinely for chronic pain to decrease inflammation and pain for up to 8 weeks, however, cortisone inhibits blood flow to the injured area and suppresses new blood vessel formation, suppresses growth of immune cells and prevents protein synthesis, fibroblast proliferation and ultimately collagen formation. This means that it helps stop the pain temporarily but does not aid the body in producing a healing response. Cortisone also inhibits the release of growth hormone, which further decreases soft tissue and bone repair. Cortisone weakens the collagen (including soft tissue such as ligaments and tendons).
Inflammation is a necessary first step that the body needs in order to start a healing response. If we suppress the inflammation, we inhibit the tissue repair. In contrast, prolotherapy helps direct healing factors that are part of the acute inflammatory process to help HEAL the old injury.
Cortisone injections can have a place when inflammation turns chronic and needs to be contained. Typically, this means that the underlying problem has not been addresses. Chronic inflammation can lead to collateral damage and cortisone injections can help prevent further injury caused by a runaway pathological process. If a doctor has told you that you need cortisone shorts, you should talk to a Naturopathic doctor or Medical doctor to see if prolotherapy is right for you.
Overall, prolotherapy is an extremely safe procedure, compared to surgical interventions or long-term painkiller use. The risks and complication rates for prolotherapy are low but do vary based on the area being treated.
The most common side effects experienced by patients are temporary increases in pain, stiffness, and swelling (12-96 hours after the injection due to the inflammatory response), as well as bleeding or bruising in the area. Extremely rare side effects include flu-like symptoms, infection, nerve injury or allergic reaction.
It is recommended to avoid NSAIDS (non-steroidal anti-inflammatories) during the course of treatment because NSAIDS interfere with the intended inflammatory response and proliferative process.