PROLOTHERAPY

PROLOTHERAPY

Contents hide
1 What is Prolotherapy?
2 How does Prolotherapy work?
3 Post-Prolotherapy Instructions
4 Frequently Asked Question About Prolotherapy Therapy Injections

What is Prolotherapy?

Proliferative Therapy, also known as Prolotherapy, is a method of injecting an anesthetic and an irritant (usually containing dextrose and fish oil) into joints, ligaments or tendons that are weakened, torn or pulled. It is a non-surgical method by which ligaments and tendons are repaired, resulting in strengthening of the weakened connective tissue by using the body’s own healing powers.

Prolotherapy is not a new concept. While treating wounded soldiers by cauterizing the injuries to stop bleeding, Hippocrates noticed the added healing benefits that resulted in the ligaments and tendons.

Prolotherapy was used in the 1800's and was further developed in the 1940s by Dr. George Hackett, and long-term studies were done by Dr. Gustav Hemwall from the 1950s through the 1990s.

Prolotherapy differs from Platelet-Rich Plasma (PRP) in that PRP injections are a totally natural process that stimulates the repair of soft tissue and joints.
It is important to understand that the purpose of this treatment is to strengthen these weakened areas, and not to decrease pain. The decrease in pain usually results from the increased stabilization and ability for the muscles to relax. Prolotherapy is useful in the treatment of:

prolotherapy

What causes the connective tissue to become weakened?

Repetitive use injuries, poor posture, improper stretching, auto accidents, falls, etc., can cause these tissues to become torn and stretched.  This can be compared to elastic – it is flexible when it is new, but as it ages it becomes less pliable, more brittle, and loses its elasticity.

As a result of the weakened tissues, joint mobility changes, strength can decrease, and muscles go into spasm, all of which result in more pain and postural/functional limitations.  Arthritis is actually the body’s way of trying to strengthen a joint when the connective tissue is torn or lax, resulting in degenerative changes that are permanent.  Prolotherapy is helpful in reversing some of these changes.

How does Prolotherapy work?

With Prolotherapy, an injectate is injected into the lax or torn areas causing a stress inflammation.  This inflammation results in the proliferative cells migrating to the weakened area, allowing for growth of new, strengthened tissues.  This is how Prolotherapy provides a mechanism by which the body can work toward healing itself.

Prolotherapy helps stimulate the body to make collagen.  This is accomplished through a series of injections, not of collagen, but of a mild chemical or a natural irritant such as dextrose (sugar), which stimulates an immune response facilitating the body to produce collagen naturally.  The immune response is facilitated because the procedure causes a stress inflammation (unlike that caused from an infection) and the body responds to this, thereby starting the repair process. The procedure increases the number of fibroblasts, which synthesize collagen.

The making of new collagen facilitates tissue repair, which allows for strengthened and restored tendons, ligaments and joints, and ultimately translates into more significant and/or permanent pain relief.  There is no evidence that this process causes scarring in the area of the injections.  The advantage of Prolotherapy is that it does not interfere with the patient’s activity level during treatment (activity can continue at work, exercise and play), and there is no postoperative recovery time.

How long will the effects of treatment last?

Because the therapy stimulates the body to create new healthy tissue, the effects are considered permanent. Results are not seen immediately, as it takes months for the process to fully mature. Studies have shown that tendon size can increase from this treatment by as much as 35-40%.

Does proliferative therapy work on all areas of the body?

All joints respond to treatment. In fact, the treatment has also been successful in cases involving almost all types of:

Are there any side effects with Prolotherapy?

Some people may have sensitivity to the proliferative agent and/or the anesthetic, as evidenced by swelling, headache, nausea and tiredness.  This reaction is only temporary as it rarely lasts longer than two to four days after the injection.  However, experiencing soreness and stiffness a couple of days afterward is normal.  It is best to avoid the use of aspirin and anti-inflammatories for post-injection pain and soreness, as these medications interfere with the healing process.

How many treatments are required to receive the maximum benefit?

This is an individual matter depending on many factors.  The goal of prolotherapy is to help each patient optimize return to function through proper therapy and exercise.  The maximum benefits are achieved when full strength and endurance are reached, and posture is improved.

The degree of ligament/joint laxity and underlying arthritis will impact the number of treatments.  In general, we recommend starting with 3-5 sessions of injections performed at three-to-four-week intervals.  We then recommend waiting three months to determine if further injections are indicated.

Unlike steroid injections, the benefits of Prolotherapy evolve gradually, thus patience is encouraged with the healing process; it is beneficial to set reasonable expectations relating to the time frame for healing.  The ultimate goal of Prolotherapy is to allow each patient to be able to do more physical activity with less pain.

For additional information, please visit the following:
American Association of Orthopaedic Medicine®

Post-Prolotherapy Instructions

Congratulations! You have taken your first step in a process to heal your chronic condition through regenerative therapy. After your Prolotherapy Injections, there is very little downtime, as opposed to a surgical procedure, and the healing process goes on for the next 4-6months.  The first 1-2 weeks, however, are when you may feel the most discomfort. It is advisable to plan for a few days of rest post-procedure to accommodate the expected soreness.

Please follow the following guidelines to make sure your healing progresses and in order to optimize your outcome. If you have any questions or problems, please contact this office at 757-227-3820

DO's

  • DO REST. Plan to rest the treated area for the next 1-3 days.
  • DO use Tylenol to control the pain. There is now more inflammation as the healing cascade is starting and an increase in pain is expected as with any medical procedure. A typical regimen is to take 500mg OTC Tylenol 3 x daily.
  • DO MONITOR the injection site for increasing redness or discharge. Increased tenderness, mild swelling, and even warmth is to be expected after these treatments. However given the rather simple and more natural approach with regenerative treatments, reactions and infection risk is rather low.
  • DO stay hydrated, well nourished, active, and get plenty of sleep. The healing is just beginning with this treatment and using the affected area with normal movements such as walking will help increase the blood flow and healing.

DON'TS

  • DON’T ICE the affected area for 72 hours; this is to allow the repair process to maximize potential.
  • DON’T take any NSAID medications, vitamins, or supplements unless approved by your clinician. This includes nutritional supplements, herbs, NSAIDs, and even marijuana and CBD for the week following your treatment.
  • DON’T apply creams, lotions, oils, or makeups to the injection sites for at least 8 hours.
  • DON’T EXERCISE or perform strenuous activity with the affected area. The procedure is trying to stimulate healing and the injured area or site needs to go thru this repair process fully. You may perform ROM stretches as tolerated though.
  • DON’T SMOKE or drink Alcohol for 72 hours post injection. These items increase BAD inflammation and free radicals in our body and can delay or interfere with the healing process. Ideally minimize the use of these substances for a few weeks after your procedure or consider quitting altogether.

Frequently Asked Question About Prolotherapy Therapy Injections

Am I a candidate for Prolotherapy?

Now is the time to schedule a Prolotherapy consultation with one of our providers to find out.

Call 757-227-3820 or visit E-mail us to schedule an appointment.

Does Insurance Cover Prolotherapy?

At the moment, most insurances do not cover Prolotherapy Injections or Regenerative Therapies. We will assist you in determining if your insurance will cover the costs for these procedures. The costs can sometimes be paid with an HSA or FSA, so you will need to check with your Plan Administrator.

What is the cost?

At Coastal Virginia Spine and Pain Center, we believe that the cost to achieve pain relief should be affordable. We will make every attempt to minimize the out of pocket cost to all of our patients.