*Proliferation injection therapy
*Platelet-rich plasma (PRP) therapy
*Regenerative injection therapy
*Sclerosant therapy or sclerotherapy
*And sometimes nonsurgical ligament reconstruction
Prolotherapy is an injection procedure that helps resolve tiny tears or injuries to connective tissue located throughout the musculoskeletal system (ligaments, tendons, muscle fibers, fascia and joint capsules). Often connective tissue becomes injured when it is torn away from a nearby bone. Prolotherapy is most often used in the case of injuries or conditions that cause chronic pain which don’t respond well to other natural therapies or medications (nonsurgical treatments). It has been characterised as an alternative medicine practice.
Prolotherapy involves the injection of an irritant solution into a joint space, weakened ligament, or tendon insertion to relieve pain. Most commonly, hyperosmolar dextrose (a sugar) is the solution used; glycerine, lidocaine (a commonly used local anesthetic), phenol, and sodium morrhuate (a derivative of cod liver oil extract) are other commonly used agents. The injection is administered at joints or at tendons where they connect to bone.
Prolotherapy treatment sessions are generally given every two to six weeks for several months in a series ranging from 3 to 6 or more treatments. Many patients receive treatment at less frequent intervals until treatments are rarely required, if at all.
Prolotherapy uses our body’s own platelets and growth factors to heal damaged tisues
naturally. It is cutting-edge form of regenerative medicines leading the way in helping to treat both acute and cronic injuries, aswell diffucult to resolve joint pain.
The way Prolotherapy Stimulate Healing:
The way that prolotherapy works is by causing a purposeful, mild inflammation response near damaged tissue that helps new fibers to grow. While usually “inflammation” is thought of as a bad (and sometimes painful) thing, it also has important benefits for stimulating repair-work and healing damaged tissue fibers.
Prolotherapy College describes this process as follows:
When ligaments or tendons (connective tissue) are stretched or torn, the joint they are holding destabilizes and can become painful. Prolotherapy, with its unique ability to directly address the cause of the instability, can repair the weakened sites and produce new collagen tissue, resulting in permanent stabilization of the joint.
Essentially through performing a very directed injection to an injury site, prolotherapy tricks the body into repairing an area. In the past, prolotherapy injections contained a mix of substances that helped to dull pain and cause a mild inflammation response, including dextrose, saline, sarapin and procaine.
Recently, platelet-rich plasma (PRP) procedures have been developed that use adult stem cells (from the person being treated) that are removed from the bone marrow or adipose (fat) tissue. These stem cells have the remarkable ability to transform themselves, making them highly valuable for treating many conditions.
*When stem cells are injected into soft tissue that is experiencing tiny tears, “natural healing” takes place near the area of the injection — which really means that new blood vessels and fibers form, helping to tighten, repair and strengthen the damaged joint or tissue.
*Prolotherapy treatment involves a series of injections. Patients receive anywhere from 3–30 injections depending on the severity of their injury. Most people need about 4–10 injections to experience results.
*Injections are administered every 2–3 weeks over the course of several months (usually 3 to 6 months).
*Substance used in “Detroxse Prolotherapy” injections include “natural irritant agents” (such as dextrose or glucose, which are types of sugar molecules, or glycerin and phenol).
*Irritants are often used with a local anesthetic (lidocaine, procaine or marcaine) to help numb the affected area and injection site. Sometimes other substances such as cod liver oil (sodium morrhuate) are also used to regulate inflammation and healing.
*There are certain differences between standard prolotherapy injections (using dextrose for example) and PRP injections.
*PRP Prolotherapy utilizes substances taken directly from the patient’s own body. PRP (or “platelet-rich plasma”) is defined as “autologous blood with concentrations of platelets above baseline levels, which contains at least seven growth factors.” Platelets contain a number of proteins, cytokines and other bioactive factors that initiate and regulate basic aspects of natural wound healing.
A 2015 review found limited evidence that prolotherapy is safe and effective for Achilles tendinopathy, plantar fasciosis, and Osgood Schlatter disease. The quality of the studies was also poor. Another 2015 review assigned a strength of recommendation level A for Achilles tendinopathy, knee osteoarthritis and level B for lateral epicondylosis, Osgood Schlatter disease, and plantar fasciosis. Level A recommendations are based on consistent and good-quality patient-oriented evidence while level B are based on inconsistent or limited-quality patient-oriented evidence. Two 2016 review articles expanded level B strength of recommendations to include low back/sacroiliac pain and rotator cuff tendinopathy. As of 2016 evidence to support the use of prolotherapy in acute pain, myofascial pain or as first-line therapy, could not be determined.
1. Helps Repair Tendons Injuries:
Prolotherapy can increase platelet-derived growth factor expressions that kick off repairment of damaged tendons. A 2010 JAMA study compared two forms of prolotherapy (saline and PRP) for treating tendon injuries and found they had similar effects. Both treatments helped treat chronic Achilles tendinopathy, although some speculate that PRP might be best suited for this kind of injury.
2.Helps Treat Chronic Back & Neck Pain:
According to Spine Health, prolotherapy can help heal small tears and weakened tissue in the back that contribute to inflammation, reduced functioning, bulging discs and back pain. The mechanism by which stem cell therapy helps to treat back pain is by shutting down “ligamentous laxity,” which is the activation of pain receptors in tendon or ligament tissues that send painful nerve signals up the back. (6)
Damaged tissue in tendons or ligaments are sensitive to stretching, compressing and other forms of pressure, so by reducing these tears, prolotherapy helps to eliminate the root source of pain.
Prolotherapy has successfully been used in pain management for common conditions that affect the back including:
*Neck pain due to spine related conditions
*Sciatica/sciatic nerve pain
*Bulging or herniated discs
*Degenerative disc disease
*Rotator cuff injuries extending to the upper back
3. Resolves Shoulder Injuries & Pain:
Prolotherapy have been shown to be effective in the treatment of shoulder injuries and pain, which are often a result of the rotator cuff being overworked (sometimes from not resting enough between workouts). The shoulder is one of the body parts exposed to the most repetitive use, repeated traumas and degeneration, so athletes, laborers and aging adults are most susceptible to shoulder injuries of all kinds.
A 2009 Journal of Prolotherapy study reported that up to 82 percent of patients treated for chronic shoulder pain (also called frozen shoulder) experienced improvements in sleep, exercise ability, anxiety, depression and overall disability. And 39 percent of these patients were told by their medical doctors that there were no other treatment options available for their pain!
4. Treats Elbow & Wrist Tendonitis:
A 2008 report published in Practical Pain Management states that adults who play golf or tennis frequently are some of the more prone to elbows injuries. Prolotherapy is now considered an effective non-surgical treatment option for sport-related injuries. And not only those that affect the elbow (like lateral and medial epicondylitis) but also those causing subsequent pain in the lower back, wrist ligaments or shoulders, plus sprained ankles and other musculoskeletal damage caused by repetitive use and joint degeneration.
5. Treats Injuries to the Hands & Feet:
Prolotherapy is now being used to lower pain associated with common hand injuries experienced by younger and middle-aged adults, such as carpal tunnel syndrome, Skier’s or “Gamekeepers” thumb and “Texting thumb,” which are caused by repetitive use and damage to the ulnar collateral ligament. Recently, doctors have seen a steady increase in injuries triggered from everyday activities like typing, computer mouse use or playing sports.
The thumbs, fingers, hands and feet are also prone to pain caused by osteoarthritis and aging. One study involving over 600 patients with ankle and foot pain that was published in Operative Techniques of Sports found that prolotherapy treatments helped reduce ankle and foot pain associated arthritis, tendon ruptures, plantar fasciitis, misalignments, fractures and ligament injuries.
Prolotherapy side effects can sometimes include:
*Swelling at the injection site
*Increased pain and stiffness
*Signs of an allergic reaction
*Although very rarely, cases of spinal fluid leaks and permanent nerve damage have also been reported
Final Thoughts on Prolotherapy & PRP:
*Prolotherapy/PRP is a type of natural soft tissue/connective tissue treatment that promotes long-term healing without the use of surgery or prescription medications.
*They work by stimulating the body’s ability to repair itself through causing a mild inflammatory response in damaged tissue, which triggers the release of proteins and growth factors to strengthen the weakened area.
*Conditions that can be treated with prolotherapy or PRP include sports injuries, tendonitis, back and neck pain, arthritis, whiplash, joint sprains, degenerative disc disease/osteoarthritis and more.
Disclaimer : The information presented herein is intended for educational purposes only.