Proliferative therapy, also know as prolotherapy, is a method of injecting an anesthetic and an irritant (usually containing dextrose and fish oil) into joints, ligaments or tendons that are weakened, torn or pulled.
It is a non-surgical method by which ligaments and tendons are repaired, resulting in strengthening of the weakened connective tissue by using the body’s own healing powers.
Prolotherapy is useful in the treatment of:
- Overuse injuries
- Ligament or tendon dysfunction (sprain, strain, and tendonitis)
- Bursitis
- Arthritis
- Degenerative discs
With prolotherapy, an injectate is injected into the lax or torn areas causing a stress inflammation. This inflammation results in the proliferative cells migrating to the weakened area, allowing for growth of new, strengthened tissues, a mechanism by which the body can work toward healing itself.
Several different types of injections
- Chemical irritants,
- Osmotic agents, and
- Particulates
All of the solutions used in prolotherapy are a combination of anesthetic and proliferant so that they provide a dual effect. The anesthetic agent alleviates the "pain" while at the same time the proliferant agent begins to strengthen the ligaments and tendons at the trigger points or tender points.
Most commonly used agents are Osmotic agents, which work by causing cells to lose water, which leads to inflammation and the subsequent stimulation of the healing response. Dextrose 12-25% is the main ingredient in standard prolotherapy solutions.
All joints respond to treatment. In fact, the treatment has also been successful in cases involving almost all types of:
- Knee-joint - Osteoarthritis, post traumatic ligament tear (ACL / PCL / MCL/ LCL)
- Back pain - degenerative disc disease , Myofacial pain
- Shoulder joint arthritis, Rotator cuff tears
- Ankle Joint - sports injury , Osteoarthritis, post traumatic ligament tear
- Unstable joints
- Heel spurs, plantar facitis
- Tennis Elbow
- Golfer's Elbow
When should you consider prolotherapy?
- When you have trouble sleeping on your shoulders due to pain, or if you have shoulder pain when moving or lifting your arm
- If you suffer from joint dislocation
- When a joint is generally worse with activity and better with rest
- When chiropractic adjustments help but do not last
- When you experience grinding, popping, or clicking in a joint
- When muscle relaxants, arthritis medication, cortisone shots or nerve blocks fail to resolve the problem within six weeks
- When surgery has failed
- When a joint is aided by a sling, brace or splint
- If ligament or tendon sprains, or tears have been diagnosed
- If there is a deep aching or pulling pain in the joint
- If you experience shooting pains, tingling or numbness
- If you have musculoskeletal pain:
- Arthritis
- Back pain
- Neck pain
If you have any of the following:
- Fibromyalgia
- Sports injuries
- Unresolved whiplash injuries
- Carpal tunnel syndrome
- Chronic tendonitis, partially torn tendons
- Degenerated or herniated discs
- TMJ
- Sciatica (prolotherapy is not a treatment for sciatica, but for symptoms that mimic the symptoms of sciatica)
- Joint instability
- Post-surgical back and neck pain
This is an individual matter depending on many factors. The goal of prolotherapy is to help each patient optimize return to function through proper therapy and exercise. The maximum benefits are achieved when full strength and endurance are reached and posture is improved.
The degree of ligament/joint laxity and underlying arthritis will impact the number of treatments. In general, we recommend starting with 3-5 sessions of injections performed at three- to four-week intervals. We then recommend waiting three months to determine if further injections are indicated.
Unlike steroid injections, the benefits of prolotherapy evolve gradually, thus patience is encouraged with the healing process; it is beneficial to set reasonable expectations relating to the time frame for healing. The ultimate goal of prolotherapy is to allow each patient to be able to do more physical activity with less pain.
Links : American Association of Orthopedic Medicine
