Prolotherapy

What is Prolotherapy?

Prolotherapy is a non-surgical treatment option for various musculoskeletal injuries. It is particularly beneficial for patients undergoing surgery or those with chronic injuries unresponsive to standard treatments like physical therapy or steroid injections. Prolotherapy typically has minimal side effects, such as mild soreness or bruising. Most patients tolerate it well and begin to notice relief within days to weeks.

What's involved in Prolotherapy?

Prolotherapy involves a series of injections into the injured area to stimulate the body's healing process. The most common ingredients in prolotherapy are dextrose, a type of simple sugar that stimulates healing, and lidocaine, a temporary anesthetic that numbs the skin and injured tissue. The entire process, including numbing the skin and performing the injections, takes less than 10-20 minutes, depending on the body part. All injections are guided by ultrasound for increased accuracy and efficacy.

How does Prolotherapy work?

Prolotherapy induces temporary, low-grade inflammation to signal the body to focus on the injured area. This inflammation triggers a new healing cascade, bringing fibroblasts (a type of healing cell) to the region. These cells act like glue to thicken and strengthen collagen, the building component of connective tissue such as ligaments and tendons. This process is particularly effective for chronic injuries that have lingered for a long time.

Many patients who consider prolotherapy have previously experienced effective but short-lived relief from steroid injections. Steroids suppress inflammation and reduce pain but do not address underlying instability, causing inflammation to return. Prolotherapy heals damaged cartilage and strengthens fibrous connective tissues, providing more lasting relief.

How long has Prolotherapy been around, and is there scientific evidence of its efficacy?

Prolotherapy has been around for 80 years and is supported by numerous research studies proving its efficacy. However, it is not widely understood or known by most mainstream medical doctors because it is not typically taught in medical schools or residencies.

How quickly does Prolotherapy work?

Prolotherapy is not an instant cure. Healing takes time, with some patients noticing improvement within a week, while others may take a month or longer. Unlike cortisone injections, which provide immediate but temporary relief by reducing inflammation, prolotherapy promotes long-term healing by regenerating tissues. This involves strengthening and thickening the connective tissues (ligaments, tendons, and cartilage) in the injured joint. For example, knee arthritis is often caused by weakening the ligaments that hold the joint in place. Strengthening these structures through prolotherapy can decrease pain and reverse damage caused by the initial imbalance.

Why doesn’t soft tissue healing occur on its own?

Soft tissue does heal naturally, but not always completely. Most everyday injuries are sprains and strains, which are micro-tears in the ligaments and tendons. Problems arise when the body doesn't have enough time to build an adequate response, the injury is too severe, or healing is interrupted by anti-inflammatory medications. Additionally, ligaments and tendons need up to 12 weeks to fully heal due to their poor blood supply.

For example, a basketball player who repeatedly sprains his ankle and relies on rest, ice, and anti-inflammatory medication may develop chronic ankle instability. This condition, characterized by the ankle constantly giving way, can lead to osteoarthritis over time. Similar patterns occur with other sprains and strains throughout the body. The body's healing process is often disrupted by repeated injury, insufficient recovery time, and the use of anti-inflammatory medications, leading to chronic instability and a predisposition to future injuries. Factors like smoking, lack of sleep, and inadequate nutrition can further hinder healing.