Prolotherapy is the natural stimulation of the body to produce collagen and cartilage in injured or overused areas in order to reduce or eliminate pain. The treatment stimulates the immune system to bring fibroblasts and chondroblasts to areas of pain and grow more soft tissue to rejuvenate the area.
Prolotherapy treatment is the injection of an irritant (Dextrose- pharmaceutical-grade sugar water),platelet rich plasma, in the painful area or joint that creates a short duration of inflammation. The Prolotherapy rapidly produces collagen and cartilage, the soft tissues of the body, which stimulates the immune system’s own healing mechanism. The new collagen and cartilage strengthens and restores joints, and supporting soft tissue, reducing or eliminating many different types of pain.
In most cases I inject Platelet rich plasma(SDP/RDP), Dextrose (pharmaceutical grade sugar water), and lidocaine, a numbing medicine.
Prior to injection, most parts of the skin are numbed with a cold spray so that the patient doesn’t feel the needle insertion very much, if at all.
After a treatment, some patients feel stiffness for a short while, which can last up to 24 hours, or occasionally more. I have done sports after my Prolotherapy treatments without difficulty (although I advise my patients to rest the area till the next visit, and do cross-training if exercise is an important aspect of their life). Some patients are immediately “healed” while many feel nothing during the first week after their procedure.
Every patient is different. Every injury or pain is different. And it is difficult to forecast how many treatments will be needed. Wrists, ankles, and knees usually heal in about 2-4 treatments. Backs and necks often take twice as long. The speed of healing is also related to how patients take care of themselves.
Every Prolotherapist I have met concurs that about 80-90% of their patients feel better after treatments.
There are three things that can inhibit healing.
There are several reasons why prolotherapy treatments are used instead of surgery:
Like most medical treatments, patients have different reactions to prolotherapy:
This is sort of a trick question. Most people are born pain-free, and suffer injuries, arthritis, or overuse injuries over time. In other words, most people are “perfect” when they are born. Since we can continue to “wear out” or be reinjured, it is impossible to predict how long your healing will last. Sometimes patients come back a year or more later for a “booster” procedure in the same area. It really depends how well you take care of yourself. Many patients, including myself, have had a dozen or more pain-free years.
I have treated countless patients with rotator cuff tears in the shoulder, meniscal tears in the knee, or fibrocartilage tears in the wrist. Most of them have healed.
Rarely will a patient have a follow-up MRI of the area once the pain is gone (why spend the money). This did occur recently with a college-level golfer from one of the top golf teams in the country, whose wrist was ready for surgery. I performed Prolotherapy on his wrist and his orthopedic surgeon ordered an MRI since he became pain-free under my care, and the ortho wanted to know if the golfer was ready to compete again. The ortho said this was the first tear of this type that he had ever seen heal. I got a call from my patient as he walked off the course from his first tournament at Riviera Golf Club in Los Angeles, thanking me for his “miracle”.
There is a study showing that Prolotherapy can tighten loose knees from anterior cruciate ligament laxity, and reduce or eliminate the pain.