Prolotherapy is an amazing therapy when applied appropriately to the right condition. This is basically chronic pain from ligamentous tissue. This is very common and the most frequent cause of chronic pain.
Prolo-therapy comes from the word “Prolo” which is short for proliferation. Proliferation means to increase new tissue growth. Prolotherapy is an injection therapy that has multiple uses by promoting healing in injured tissue. The conditions are many and labeled differently by all doctors depending on their specialty. But simply put, it is used for chronic pain, no matter what you have been told the diagnosis is causing the pain. As discussed else where in this web site, ligament injury is by far the most common cause of chronic pain.
Though prolotherapy has a long history using different solutions, the modern injections now commonly contain:
1. “Sugar water” which is lidocaine, marcaine and dextrose, which is what we use.
2. “P2G” which is procaine, phenol and glycerin.
Lidocaine, marcaine and procaine are all pain killers used to ease the injection pain. The other components produce the actual therapeutic effects. Every doctor has his own “special formula” that is added to improve the process, and we are no different.
Prolotherapy stimulates the natural healing response with its inflammatory, hormonal and proliferant (new tissue growth) components. A downside is that the solution must be placed at the site of the injury, which is usually at the ligament and bone junction (sharpey’s fibers or enthesis) for the osmotic pull from the dextrose to work. When placed at the injured site it draws in fibroblasts and growth factors from the surrounding healthy tissue to create a local healing response. This is not a scarring process as is still commonly stated by those not knowledgeable in the process, but disturbs weak cells while promoting growth of healthy cells. Though this is painful it works well when applied by someone with experience. This is a complex process even though we use simple models to help explain it. As we further our research these simple models are increasingly inadequate.
There have been and continue to be quality studies conducted including pre and post injection treatment biopsies of human ligaments which show increased high quality tissue without signs of scarring. This is a major focus of our clinic including contributing to a higher quality of studies and procedure in the future.
Though many doctors now perform this therapy, it is not the therapy that is the key to managing a chronic pain condition patient well. We encourage internet research by the patient but caution you that many internet websites are frequently used for exaggeration of advertising instead of useful education.
We are frequently asked “why doesn’t my doctor do this or know about it”. I don’t know what to say anymore other than a growing number do. We have used this therapy for many years because it produces results and fits into our model of care, which is to promote the natural healing process.