Prolotherapy can repair the weakened sites, produce new fibrous tissues and stabilize joints, all without a loss of flexibility and function.
When ligaments or tendon attachments are stretched, torn or fragmented, joints can become hyper-mobile and painful. Traditional approaches of surgery and anti-inflammatory drugs often fail to stabilized the joint and relieve this pain permanently.
History of Prolotherapy
Ligament injection therapy — the precursor of prolotherapy — has been used successfully as early as 500 B.C., when Roman soldiers with shoulder joint dislocations were treated with hot branding irons to help fuse torn ligaments. Hippocrates also used this type of treatment on Olympic javelin throwers who occasionally dislocated their shoulders. It was used to treat hernias before modern surgical techniques became available.
How Prolotherapy Works
A physician trained by the American Association of Orthopaedic Medicine (AAOM) precisely injects a nonsteroidal anesthetic solution (typically water and glucose or dextrose) directly into the ligament where it attaches to the bone. The process creates a localized inflammation in the weak areas. Nutrients, blood and various cells called fibroblasts flood into the area to rebuild the ligament, aided by the body’s natural healing mechanisms.
The process encourages growth of new ligament or tendon fibers, resulting in a tightening of the weakened structure to its original strength. A typical prolotherapy treatment takes three to six injections over a three- to six-month period.
The treatment is useful for many different types of musculoskeletal pain, including:
- Arthritis
- Back pain
- Neck pain
- Fibromyalgia
- Sports injuries
- Unresolved whiplash injuries
- Carpal tunnel syndrome
- Chronic tendonitis
- Partially torn tendons, ligaments and cartilage
- Degenerated or herniated discs
- TMJ
- Sciatica
The Success Rate of Prolotherapy
The rate of success depends on several variables, including the patient’s history and ability to heal. Up to 95% of patients suffering from low-back pain with hyper-mobility experience remission of pain with this form of therapy. In comparison, the Journal of Bone and Joint Therapy reports a 52% improvement in patients treated surgically for disc involvement.
However, a review of five studies involving 366 participants concluded that prolotherapy alone was ineffective in treating chronic low-back pain. But when combined with other treatments, such as spinal manipulation and exercise, prolotherapy can improve chronic low-back pain.
According to the Mayo Clinic, more research is needed to clarify what role, if any, prolotherapy plays in the treatment of chronic low-back pain. Meanwhile, highly invasive treatment techniques, such as surgery and other traditional modes of treatment for ligament wear-and-tear, are not fully successful.
Recent research continues to show that ligaments and tendons treated with prolotherapy increase in size and strength, and quicken the healing time for a ligament injury without surgery.
When Prolotherapy Might Not Work
The most common reasons why a person may not attain 100% improvement with prolotherapy are because of:
- An inadequate (depressed) immune system
- Nutritional deficiencies
- Hormonal deficiencies
Often, the wrong area is being treated, as in the case of lower-back pain, in which a patient needs injections at the sacroiliac joints. In a small percentage of patients, however, the sacroiliac joint remains weakened because the pelvic joint in the front (pubic symphysis) also needs to be treated.
Although most doctors do not deny that prolotherapy can work for some patients, unless it receives a tried-and-tested seal of approval, the treatment is unlikely to gain wide use.
Risks of Prolotherapy
Prolotherapy, similar to all invasive medical procedures carries risks, such as:
- Bleeding or bruising in the area
- Increased pain
- Swelling
- Stiffness
- Joint effusion
- Infection
- Spinal headache (a headache when you sit up)
- Nerve injury
- Tendon/ligament injury
Because prolotherapy causes inflammation, patients might experience bruising, pain, stiffness and swelling in the area after receiving injections. Typically, these symptoms last one to seven days.
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