Prolotherapy: The Cure for Chronic Pain
(originally published Dec. 22, 2008 – Suite101.com)
If you’re like most people, you’re probably asking, “What is Prolotherapy?”
Simply enough, Prolotherapy is the injection of an inert solution into a joint to cause inflammation which activates the body to heal itself.
The primary targets of Prolotherapy are tendons and ligaments, though it can also regenerate cartilage. Tendons join bones to muscles, allowing movement of the joint, and ligaments join bones to other bones, allowing stability of the joint. If either of these tissues is injured, then pain, instability, and poor range of motion are often the results.
HOW DOES PROLOTHERAPY WORK?
While most of mainstream medicine works against inflammation by way of anti-inflammatory drugs and cortisone injections, the mechanism by which the body heals is inflammation! Prolotherapy takes advantage of this healing response by creating inflammation at the site of an injury, thus activating the natural healing process.
The therapy is administered by a series of injections into an affected area (usually a joint) at the specific site of injury. Each injection is made up of a water-soluble mixture of inert ingredients such as dextrose, glycerin, phenol, and various minerals. When the mixture is injected into the target area, it causes an inflammatory response whereby the body responds by depositing new collagen onto the affected tissues and thereby healing the injury.
Under normal conditions, tendons and ligaments heal very slowly (if at all) due to poor blood supply to those tissues. By creating inflammation, however, the body is forced to repair itself. In fact, the ligament and tendon tissue formed as a result of Prolotherapy is thicker and stronger than normal tissue by up to 40 percent!
TREATING CHRONIC PAIN AND DISEASE
The greatest stresses to the ligaments and tendons are where they attach to the bone, the fibro-osseous junction. The most sensitive structures that produce pain are the periosteum (the covering of the bone) and the ligaments. Additional pain is caused when surrounding tissues and structures are stressed from the lack of stability in the joint and the muscles struggle to hold everything together.
Prolotherapy is the only non-surgical medical procedure that cures the underlying pain-causing and degenerative conditions rather than simply covering up the symptoms (i.e. the pain itself). Conditions for which Prolotherapy is used include arthritis, mechanical low back pain, degenerative disc disease, cartilage injury, and various sports injuries.
Healing takes place over an extended period of time lasting from four weeks to several months per treatment. The average number of treatments needed to achieve full recovery is 4-8 sessions, though some acute conditions may be cured from as little as a single visit.
Treatments are typically administered once every 4-6 weeks, though athletes may undergo a more rigorous regimen of weekly treatments so as not to miss a season of competition.
FINDING A PROLOTHERAPY DOCTOR
One of the most important aspects of Prolotherapy is finding a doctor who specializes in the practice. Due to the wide range of conditions and locations for which Prolotherapy may be used, not all doctors are as skilled or experienced in its application.
Another important aspect of a Prolotherapy treatment is the volume of injections. For an effective inflammatory response, numerous injections must be given to deliver a high volume of Prolotherapy solution to all associated areas of the injury. As an example, for low back and sacroiliac regions, a typical treatment is 50-100 injections with approximately 10cc of solution per injection!
A good place to start your search for a doctor who offers Prolotherapy is at the Get Prolo website.
One of the best sources for comprehensive information on Prolotherapy, its history, and its methodology is the book Prolo Your Pain Away! by Ross A. Hauser, M.D. and his wife Marion A. Hauser, M.S., R.D., who also own and run Caring Medical, the nationally-recognized clinic in Oak Park, IL.
Since I wrote this article, I now live very close to an excellent osteopath by the name of Dr. Eric Lake, who works with Premier Sports & Spine Rehabilitation. He performs osteopathic adjustment as well as prolotherapy, PRP and similar procedures. I recently had two major tears in one of the muscles of my rotator cuff as well as extensive tendonopathy, all of which have fully resolved. Find Dr. Lake here: