Prolotherapy

What is Prolotherapy?

Woman runner Prolotherapy, short for proliferation therapy, is a treatment that involves the injection of a solution into a weak or damaged area of the body in order to promote regeneration and repair of tissue. More specifically, a dextrose (sugar) and lidocaine (a common anesthetic) solution is injected near painful or damaged ligaments, tendons, or joints to induce an inflammatory response. Once injected into these areas, these seemingly benign substances promote healing, which is initiated by the body.

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How does prolotherapy work?

Initiating the inflammatory process is thought to cause the production of fibroblasts (the body’s repair cells), which deposits new tissue fibers to repair an injury, ultimately stabilizing the area, restoring function, and diminishing pain. The resulting reduction in pain and improvement of function has the potential to be permanent. Each prolotherapy session is done in-office and takes around 30 minutes from prep to finish.

What Can I Expect at a Prolotherapy Treatment Visit?

Before the procedure can begin, an initial discussion of the risks and benefits of prolotherapy will take place between the patient and provider. Once the patient has a thorough understanding of the procedure and associated risks, consent for the procedure will be obtained before proceeding with the treatment.

For the actual procedure, the patient is positioned on an exam table, and the treatment area is prepped and sterilized. Depending on the origin of the complaint or injury and site location, multiple injections may be needed. In most instances, the area will be anesthetized with lidocaine by a very fine needle, followed by the prolotherapy injection(s). The solution is then injected into the treatment area.

How frequently are injections needed?

Depending on the injury or condition, the healing time is different for everyone, but most people can expect to see results as soon as three to four weeks after their visit. However, this is a regenerative healing process which may take a few weeks to see full results.

When can I expect results after I receive prolotherapy?

The injection site will likely feel sore and achy for the next few days, often resolving 24 to 72 hours post-injection. Refrain from using ice, steroids, or Non-Steroidal Anti-inflammatories (NSAIDS) such as aspirin, ibuprofen (Motrin) or naproxen (Aleve) for one week before and six weeks after your procedure; doing so will only block the intended regenerative response.

To prevent infections, avoid swimming or soaking the injection site in a bath or hot tub for 24 hours post-procedure.

How does prolotherapy differ from steroid injections?

Steroid injections are a commonly used treatment to block inflammation and pain for acute and chronic musculoskeletal conditions but are usually only a temporary solution.

With corticosteroids, you’re blocking inflammation and you’re blocking the pain, but you have a lot of side effects. High blood pressure, high blood sugar, even cosmetic side effects. Steroid injections prevent the body’s normal healing process while masking the pain and, in the long-term, may weaken the joints and ligaments. It might actually be deteriorating the joint.

What are the side-effects of prolotherapy treatment? Is it painful?

Other than mild to moderate discomfort during and after the injection, prolotherapy solutions have minimal side effects like any other injection, such as swelling and bruising. In comparison, steroid injections have been associated with hyperglycemia (high blood sugar), skin discoloration, and hypertension (high blood pressure). Prolotherapy injections are mildly painful, much like a flu shot. You may take medications such as acetaminophen (Tylenol) for soreness that may occur afterward.

Prolotherapy is commonly used for:

Unresolved pain despite the use of Osteopathic Manipulation Therapy (OMT)
Joint instability of the shoulder, elbow, wrist, ankle, and knee
A non-surgical option for joint and back pain
Osteoarthritis of the knee, shoulder and other joints

Commonly used for the treatment of:

Degenerative joint disease
Tendonitis
Sprains & ligament injuries
Hip Pain – arthritis, bursitis
Knee pain – meniscal and ligament tears, Chondromalacia patella
Foot and Ankle pain – plantar fasciitis, sprains, Morton’s neuroma
Low Back Pain/Neck pain
Headaches
Shoulder pain – rotator cuff
Elbow pain – golfer’s & tennis elbow
Hand/Wrist pain – Carpal tunnel

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