Q: What is
Prolotherapy also know as regenerative injection therapy, sclerotherapy,
(proliferative therapy), ligament reconstruction therapy, and fibro-osseous
injection therapy. It is a recognized orthopedic procedure that stimulates the
body's nature healing processes to strengthen joints weakened by traumatic or
over-use injury. When the joint’s
ligaments or tendon attachments are stretched, torn, or fragmented, they become
hypermobile and painful. Traditional approaches with surgery and
anti-inflammatory drugs often fail to stabilized 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 permanent stabilization of the joint.
Q: How does
Prolotherapy work? A:
With a precise injection of a mild irritant solution directly on the site of
the torn or stretched ligament or tendon, 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 ligament or tendon fibers,
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.
Q: What is in
the solution that is injected? A: The prolotherapy injections contain anesthetic agents (to numb
the region) and natural substances which stimulate the healing response. The
primary agent is glucose, but each treating physician tailors the selection of
substances according to the patients' needs.
Q: Is the
Prolotherapy treatment painful? A: 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.
Prolotherapy help everyone? A: Each patient must be evaluated thoroughly with patient history;
physical exam, imaging study, and full laboratory work up before treatment will
be administered. If you already have labs and studies completed, please bring
them with you to the visit so they will not have to be repeated. With this
information, your physician can evaluate your potential success with this
therapy. Success depends on factors which include the history of damage to the
patient, the patient's overall health and ability to heal, and any underlying
nutritional deficiencies that would impede the healing process.
Q: Who administers Prolotherapy? A: A Physician trained specifically in
cadaver based injection techniques.
Q: What areas
of the body can be treated? A: This form of therapy can be used to treat different joints;
such as knee, hip, ankle, wrist, elbow and shoulder. In addition, the cervical, thoracic and
lumbar spine including the sacroiliac joints can also be treated. Prolotherapy is also successful in the
treatment of carpal tunnel syndrome and temporal mandibular joint dysfunction
Q: How often
do I need these treatments? A: The treatments should be administered as determined by your
treating physician. Frequency and number of overall treatment will depend on
location and severity of injury and your ability to heal. The spine and
extremities average 2-6 sessions.
Q: What's the
rate of success in treatment? A: 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 on a 52% improvement
in patients treated surgically for disc involvement.
Q: Is this
form of therapy really new? A: Prolotherapy has been used successfully as early as 500 B.C.
when Roman soldiers with shoulder joint dislocations were treated with hot
branding irons to help fuse the torn ligaments in the shoulder joint. Advances
in medicines greatly improved on this process, and led to the modern techniques
of strengthening the fibrous tissue rather than producing scarring to fuse
tissues. In 1926, a group of physicians met with great success using injection
therapy to treat hernias and hemorrhoids. Earl Gedney, D.O., a well-known
Orthopedist, decreased his surgical practice and began to inject joints with
these newer injectable medicines in the 1940s and 1950s. Also, in 1950, George
Stuart Hackett, M.D., wrote a book on injection therapy. His work is still used
today in training physicians. In the years since this early work, techniques
and medications have advanced to move from a scarring or fusing effect to a
strengthening effect, which restores the weakened joint to its original level
of stability, without loss of flexibility and function.
compiled from multiple sources including the AAOMED website and The PRinciples
of Prolotherapy by Ravin, Cantieri and Pasquarello.