Prolotherapy for Joint Pain

Prolotherapy is a regenerative therapy process that stimulates the body’s natural healing processes. It involves injecting a solution of medication to damaged tissues to induce low-grade inflammation in the affected area. It is a non-invasive alternative to surgical treatments and is used successfully for a variety of bone, muscle, and joint problems.

Prolotherapy injections typically contain a combination of dextrose (as an irritant), procaine (decreases pain signals) and B vitamins  (supports  cell regeneration) that together causes a localized inflammatory response which the immune system responds to with it’s own regenerative cells, helping to stimulate and repair the joint or site of injury. Several injections are usually indicated and are typically spaced four weeksa apart. Most patients respond best with two or three treatments.

Chronic pain and Prolotherapy ~

Chronic pain stinks.  It is down right is difficult to treat, causes high levels of stress, and negatively impacts many aspects of life.  I’ve been through chronic pain, and I have seen so many others who have been through it as well.  This is why I have sought long and hard for treatments that really work.  Among the various treatments that I have discovered that truly addresses pain, without any side effects, is prolotherapy.

Prolotherapy

Prolotherapy is an injection therapy, which triggers the body to strengthen damaged ligaments and tendons.  This in turn stabilizes and strengthens the joint, reduces pain, and improves joint and spine mobility.

So how does prolotherapy work?

The essence of how prolotherapy works is through stimulating the growth of healthy ligaments and tendons, and by removing the damaged tissue.  To best understand this process, we will use a partially torn ACL as an example here. With prolotherapy, we are helping the body remember about the damaged tissue, so it can heal the old ACL injury.  The injection, which contains dextrose, triggers the body to create a localized inflammation at the ACL. The inflammation causes the local blood vessels to open, flooding the knee with fresh blood and oxygen.  The inflammation mobilizes and stimulates the body’s tissue builders, growth factors, fibroblasts, and cytokines to rebuild collagen, and strengthen the ACL. The body’s macrophages (think cellular Pac-man) arrive to clean up damaged tissue and rid the body of cellular debris.  The procaine in the injections gives immediate relief to the painful region. With a series of injections, spaced about one month apart, prolotherapy can effectively treat many types of joint and muscle dysfunction.

What is the history of prolotherapy?

This therapy goes way back into time.  Hippocrates had a barbaric version of prolotherapy using hot pokers pressed into the armpit to treat torn rotator cuff tendons.  Ancient day Egyptians were said to treat lame animals with hot branding techniques to stimulate recovery. Since the 1930s to modern day prolotherapy, injections include a combination of dextrose and procaine or lidocaine.  Over the last several decades prolotherapy momentum has been growing, and the therapy is being utilized by MD’s, DO’s, and ND’s.

Chronic Pain!  How did I get here?!  

Ligamentous laxity

Often the underlying cause for musculo-skeletal problems is from what is called ligamentous laxity.   Ligament laxity happens when you get injured, or is a result from chronic overuse of an area of the body.   If you do not allow that area of the body to fully heal, it can become a chronic problem, causing chronic pain.  When the ligaments are overstretched or partially torn, this causes the joint to be unstable, weak, and potentially damages other structures as well.  Often with a weak joint, the surrounding muscles go into spasm, with more pain and limitation in mobility. If the problem persists, nerves can become compressed, causing numbness, tingling, weakness, and even disability.  The key to full recovery is to identify and treat the underlying ligament laxity. This is why prolotherapy is so effective at treating chronic pain, because it addresses the ligament laxity.

What about inflammation and circulation?

It’s all about inflammation, but not likely how you think of inflammation.  Often times in naturopathic medicine, we are trying to combat systemic inflammation with diet, lifestyle, and supplements.  This is also true in musculo-skeletal problems. However in chronic injuries, and musculo-skeletal pain, we absolutely need inflammation, but only in the area that is injured.  Prolotherapy and other regenerative treatments are so effective because they actually draw circulation and a small amount of inflammation to the injured area, so the tissue can heal.  As you can imagine, the conventional model of NSAIDS and RICE therapy: Rest, ice, compression, and elevation, shuts down the inflammation cascade, shunts blood away from the problematic area, and predisposes us to developing a chronic musculo-skeletal problem.  Because of this, when one of my patient’s gets injured, I recommend therapies to promote circulation and to avoid using NSAIDS, so that the injury does not become a chronic problem.

Right treatment for the right patient

Prolotherapy is a phenomenal treatment for chronic musculo-skeletal pain that is a result from an old injury or from overuse.  Below is a list of some common conditions that prolotherapy addresses:

• Sciatica
• Osteoarthritis
• Compressed vertebral discs
• Partially torn ligaments or tendons of the knee or shoulder
• Tendonitis or tendonosis of the elbow or shoulder
• Plantar fasciitis
• Carpal tunnel syndrome
• Chronic neck pain
• Chronic headaches
• TMJ syndrome
• And many more conditions

However, prolotherapy is not for everyone, and there are many conditions that cannot be addressed with prolotherapy.  Conditions that are not appropriate for prolotherapy include joint pain as a result from autoimmune diseases, fibromyalgia, Lyme disease, or completely torn ligaments or tendons.