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Prolotherapy

Prolotherapy is a nonsurgical pain treatment that stimulates the body’s natural healing response to fix injured or weakened joints, ligaments and tendons. The weakened areas are injected with a solution that initiates growth of healthy tissue to restore function, mobility, and eliminate pain. Prolotherapy has been practiced in the United States since the 1930’s and endorsed by US former surgeon General C. Everett Koop. It is a very effective treatment for musculoskeletal injuries including arthritis, tendinitis, bursitis, joint instability and more.

Can Prolotherapy Help Your Pain?

Many types of chronic pain are triggered by weakened and damaged ligaments, tendons, muscles, and joints. Prolotherapy aims to correct this problem and often results in permanent pain relief.

What is the solution that is injected?

Prolotherapy solutions contain an anesthetic agent and natural substances. The most commonly used is a mixture of dextrose (corn sugar) and lidocaine with normal saline.

How does prolotherapy work?

By injecting the prolotherapy solution into the injured area, it creates a mild controlled inflammatory response to recruit the body’s natural repair mechanisms and start a healing cascade. This initiates repair and growth of new healthy ligament and tendon fibers. Subsequent treatments repeat this proliferative process, allowing a gradual accumulation of tissue to restore strength and function and eliminate pain.

Is the prolotherapy treatment painful?

Most patients tolerate the procedure well with just local anesthesia (lidocaine). Some prefer no pre-anesthetic treatment. The treatment may result in some discomfort, which can be reduced with pain relievers such as Tylenol after treatment.

How often do I need these treatments?

This is different for each individual. Some people may feel their pain resolved after just one treatment. Many require multiple treatments with an average of 3-6 treatments separated by 2-6 weeks depending on the condition being treated and the response to the treatment.

How will I feel after a prolotherapy treatment?

You can expect to have increased discomfort for three to five days after injection because the solution is causing a healing inflammatory response. This may cause you to feel stiff and sore, like you had the sprain or arthritis flare-up all over again for a few days and is a good sign that you are getting a proper response. You can expect some bruising, local swelling or tenderness at the injection site.

When can I go back to work or playing sports after a treatment?

Some patients prefer to go home and rest after treatment while others carry on with their work or other activities immediately after treatment. Strenuous work or sports may need to be stopped or modified for two or three weeks after injections to give the repaired tissue a chance to mature. The growth pattern of tendons and ligaments should be complete in six weeks after each set of injections.

Is prolotherapy safe?

It is safe when administered by a properly trained prolotherapist. The risks are similar to conventional joint injections. Gustav Hemwall, M.D., one of the pioneers for Prolotherapy, treated more than ten thousand patients with more than four million injections without incident. At Acuprolo Institute our doctors have extensive experience in prolotherapy and train doctors from around the world how to do this amazing technique.

How effective is prolotherapy?

Prolotherapy is very effective. There is extensive research to support the use of prolotherapy for multiple musculoskeletal conditions. The rate of success depends on multiple factors including patient’s other medical conditions, their ability to heal, age, and nutritional intake.

How is prolotherapy different from steroid injections?

Steroids produce temporary pain relief and inhibit inflammation (the body’s natural healing mechanism). In the long run, steroids cause tissue breakdown and multiple adverse effects. Prolotherapy does just the opposite with minimal side effects.

When would you use prolotherapy versus platelet rich plasma (PRP) or stem cells?

The goal of regenerative injections such as prolotherapy, PRP or stem cell treatment, is to stimulate a healing inflammatory cascade. In general, if a patient gets the desired 2-3 days of inflammation (stiffness, soreness, local pain) after prolotherapy, they do not need a stronger stimulant like PRP or stem cells. Prolotherapy is much more cost effective and less invasive (does not require processing of blood or cellular tissue).

Why should you consider Prolotherapy?

Prolotherapy uses a natural substance (corn sugar) to stimulate your body to heal on its own. It aims to fix the cause of the pain and not just temporarily mask the pain such as the case with pain medications that have lots of side effects. Prolotherapy is less invasive than surgery with shorter recovery time. In some instances prolotherapy is more effective than surgery.

Will my insurance cover for prolotherapy?

Is prolotherapy evidence based medicine?

Absolutely yes! Over the past decade there have been increasing number of Level I randomized controlled trials to support the use of prolotherapy for multiple conditions, such as osteoarthritis of the knee, rotator cuff injury, lateral epicondylitis (tennis elbow), osteoarthritis of the hands/fingers, plantar fasciitis, Achilles tendinopathy, Osgood Schlatter disease and many more. There are meta-analysis and systematic reviews, which is the highest level of clinical evidence, that support the use of prolotherapy for osteoarthritis of the knee and lateral epicondylosis (tennis elbow).