What is Prolotherapy?
Prolotherapy is a nonsurgical treatment used to
strengthen and tighten the ligaments and tendons that hold
bones and muscles in place. Through a series of injections
that stimulate the body's natural healing response,
prolotherapy restores proper joint alignment and relieves
pressure on sensitive tissues. The end result is dramatic
and lasting pain relief.
Prolotherapy Relieves Chronic Pain
If you suffer from back pain, sciatica, unresolved
whiplash, a nagging sports injury, or any type of joint
pain, you could benefit from prolotherapy, also called
regenerative injection therapy.
Prolotherapy relieves musculoskeletal pain by addressing
it at the source: weakness in the ligaments and tendons.
Ligaments and tendons are tough, fibrous bands of tissue
that connect bone to bone, or bone to muscle. They are the
stabilizers of the musculoskeletal system. As long as they
are strong and taut, they keep bones, joints, and muscles
in place, allowing for pain-free smooth movement.
However, when the ligaments and tendons become injured,
weak, or lax, these other structures become unstable and
move out of position. The resulting misalignment impinges
on nerves and blood vessels, damaging tissues and causing
pain. Lasting relief can only be obtained by restoring the
proper alignment to these structures and taking the
pressure off sensitive tissues.
How Does Prolotherapy Work?
Used with permission
from Ross A Hauser, MD,
www.caringmedical.com
First, it is important to
understand what the word prolotherapy itself means.
"Prolo" is short for proliferation, because
the treatment causes the proliferation (growth, formation)
of new ligament tissue in areas where it has become weak.
Ligaments are the
structural "rubber bands" that hold bones to bones
in joints. Ligaments can become weak or injured and may
not heal back to their original strength or endurance.
This is largely because the blood supply to ligaments is
limited, and therefore healing is slow and not always
complete. To further complicate this, ligaments also have
many nerve endings and therefore the person will feel pain
at the areas where the ligaments are damaged or loose.
Tendons are the
name given to tissue which connects muscles to bones,
and in the same manner tendons may also become injured,
and cause pain.
Prolotherapy involves injections of a mildly irritating
solution into the painful area. The irritant, usually a
dextrose-based solution, triggers the body's natural
healing response and causes the proliferation of new
collagen fibers, which are the building blocks of
ligaments and tendons. (The "prolo" in prolotherapy stands
for proliferative.) As tissue growth continues, the
ligaments and tendons become thicker and stronger,
regaining their ability to stabilize the joint and take
the pressure off sensitive nerve endings. Pain subsides,
range of motion returns, and cartilage degeneration slows
down.
Sometimes one treatment is enough to achieve complete pain
relief, but it usually takes several treatments,
administered a week to a few weeks apart, to produce sufficient
collagen growth to relieve pain and restore normal
function.
Used
with permission from Ross A Hauser, MD,
www.caringmedical.com.
Historical review shows
that a version of this technique was first used by
Hippocrates on soldiers with dislocated, torn shoulder
joints. He would stick a hot poker into the joint, and it
would then miraculously heal normally. Of course, we don’t
use hot pokers today, but the principle is similar—get the
body to repair itself, an innate ability that the body
has.
How Does Prolotherapy Compare to Drug Therapy?
The most commonly used drugs for musculoskeletal pain
are prescription or over-the-counter nonsteroidal
anti-inflammatory drugs (NSAIDs). As their name suggests,
NSAIDs relieve joint pain by countering inflammation.
Unfortunately, because inflammation is the first stage of
your body's healing process, these drugs may hinder
recovery. NSAIDs are notorious for their gastrointestinal
side effects and they actually destroy cartilage, the
cushioning material that protects joints. Most important,
NSAIDs do nothing to address the underlying laxity of
ligaments and tendons which is the source of chronic pain.
Used with permission
from Ross A Hauser, MD,
www.caringmedical.com.
For more severe or chronic musculoskeletal pain, doctors
sometimes prescribe corticosteroids. Like NSAIDs,
corticosteroids work by countering inflammation. However,
they also suppress immune function, increasing your
susceptibility to infection and interfering with healing.
Long-term use of these drugs is associated with an
increased risk of high blood pressure, osteoporosis, and
vision problems.
Unlike anti-inflammatory drugs, prolotherapy does not mask
pain. Instead, by correcting the underlying problem, it
eradicates it. This extremely safe therapy has none of the
risks of NSAIDs and corticosteroids, and its only side
effect is mild discomfort during the first few days of
healing.
What Conditions Can be Treated With Prolotherapy?
Prolotherapy is helpful for a wide range of
musculoskeletal conditions in which pain and inflammation
play a role. Here is just a partial list:
Arthritis
Back pain
Fibromyalgia
Headaches
Knee pain
Ligament sprains
Neck pain
Sciatica
Shoulder pain
Tendinitis
Sports Injuries
Carpal Tunnel Syndrome
Degenerated or herniated discs
TMJ
Unresolved whiplash injuries
Used with permission
from Ross A Hauser, MD,
www.caringmedical.com.
Research Studies & Demonstrated Results
George S. Hackett, MD
George Hackett, MD, published the results of a research
study involving 656 patients with chronic low back pain
treated with prolotherapy. The average duration of pain
prior to treatment was 4.5 years, although some patients
had been suffering for as long as 65 years. About half of
the patients had already undergone back surgery without
success. After 12 years of treatment with prolotherapy, 82
percent of Dr. Hackett's patients considered themselves
cured. In other words, their pain had been eradicated and
had not returned. — Hackett, G. Ligament and Tendon
Relaxation Treated by Prolotherapy, 3rd edition.
Springfield, IL: Charles C. Thomas, 1958.
The Lancet Study
In a study published in the prestigious British medical
journal, The Lancet, 81 patients with chronic low
back pain were randomly assigned to receive either
prolotherapy injections or injections of saline (an
inactive placebo). Six months after treatment, 87.5
percent of those who had received prolotherapy were rated
as being more than 50 percent improved, compared to only
39 percent of those in the placebo group. Furthermore,
almost four times as many patients in the prolotherapy
group were completely free of disability as in the placebo
group. — Lancet, 1987; 2(8551): 143-6.
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