Prolotherapy is a non-surgical orthopedic approach to treating a wide range of musculoskeletalinjuries. Using natural substances, most typically a variable concentration of dextrose, prolotherapy injections can stimulate the body’s natural healing processes to help strengthen,heal, and even regenerate injured ligaments, tendons, joints, and other connective tissues.
When connective tissue structures such as ligaments, tendons, or joint capsules are injured, the initial healing response is triggered. This process is an inflammatory cascade which starts by increasing blood flow to the region, thereby bringing white blood cells, platelets, growth factors, chemical signals called cytokines, and more to the site of injury. The body first breaks down damaged tissue, and then begins to repair the connective tissue the best it can. This inflammatory process, however, can often be too inflammatory, leading to excess inflammation damaging nearby healthy tissues, or can be inadequate, leading to poor healing and repair of
damaged structures.
This process is often inadequate to fully heal the damaged tissue, leading to weakened, unstable joints. Prolotherapy works by using a substance such as dextrose called the injectate – to stimulate a local inflammatory response in specific target tissues. By initiating this controlled inflammatory cascade, it stimulates the body to use its natural processes to heal and strengthen the area of treatment, which had been previously damaged. By restarting this process in a controlled manner, the skilled prolotherapy physician can help direct the body to create a more robust repair process, leading to better collagen production, increased strength of connective tissue, and overall improved structure and function of the target tissues.
Prolotherapy has been in use for nearly 100 years as a technique to help improve the integrity of damaged ligaments, tendons, and various joints. Specific conditions that prolotherapy has been used and researched for include osteoarthritis, low back pain due to ligament sprains and strains, tendon strains, sacro-iliac joint dysfunction, hypermoblile joints, golfer’s or tennis elbow, plantar fasciitis, and unstable joints due to dislocation, such as the shoulder joint.
The efficacy of prolotherapy for a specific condition depends on a number of individual factors, and must be accurately assessed by a physician. Sometimes, prolotherapy will be the exact therapy that is needed. Other times, the physician may recommend a stronger therapy such as PRP (Platelet-rich plasma), or a less invasive therapy such as guided rehabilitation exercise, extracorporeal shockwave therapy, or other manual therapies.