Prolotherapy (Proliferative Therapy),  also know as Non-Surgical Ligament and Tendon Reconstruction and  Regenerative Joint Injection, is a recognized orthopedic procedure that  stimulates the body’s healing processes to strengthen and repair injured  and painful joints and connective tissue. It is based on the fact that  when ligaments or tendons (connective tissue) are stretched or torn, the  joint they are holding destabilizes and can become painful.  Prolotherapy, with its unique ability to directly address the cause of  the instability, can repair the weakened sites and produce new collagen  tissue, resulting in permanent stabilization of the joint. Once the  joint is stabilized, pain usually resolves. Traditional approaches with  surgery have more risk and may fail to stabilize the joint and relieve  pain, and anti-inflammatory or other pain relievers only act  temporarily. The original term used for this therapy was  “sclerotherapy”, coined in the 1930’s when this treatment was  discovered, and included both joint and vein injections. Today the term  “prolotherapy” is used for joint, ligament and tendon injections, while  “sclerotherapy” is used for the treatment of varicose veins, spider  veins, hemorrhoids and other vascular abnormalities.

Prolotherapy works by stimulating the  body’s natural healing mechanisms to lay down new tissue in the weakened  area. This is done by a very directed injection to the injury site,  “tricking” the body to repair again. The mild inflammatory response  which is created by the injection encourages growth of new, normal  ligament or tendon fibers, resulting in a tightening of the weakened  structure. Additional treatments repeat this process, allowing a gradual  buildup of tissue to restore the original strength to the area.

Any pain involving an injection will  vary according to the structure or joint treated, the choice of  solution, and the skill of the physician administering the injection.  The treatment may result in a temporary increase in pain with mild  swelling and stiffness. The discomfort usually passes fairly quickly and  can also be reduced with pain relievers such as Tylenol or other  prescribed medication. Anti-inflammatory drugs, such as aspirin and  ibuprofen, are not recommended for pain relief because their action  suppresses the desired inflammatory healing process produced by the  prolotherapy injections.

Each patient must be evaluated  thoroughly with patient history, physical exam and radiological or  ultrasound exam. When indicated, laboratory work, should be ordered or  evaluated prior to treatment. With this information, your physician can  evaluate your potential success with this therapy. Success depends on  factors which include the history of damage to the patient, the  patient’s overall health and ability to heal, and any underlying  nutritional or other deficiencies that would impede the healing process.  In appropriate patients, prolotherapy has a high success rate.

Areas/problems treated include: Low back  or mid-back pain including degenerative disc disease and sacro-iliac  joint instability/dysfunction, neck pain, knee pain, knee meniscal  tears, wrist or hand pain, osteoarthritis, shoulder pain including  rotator cuff tears, elbow pain including golfers or tennis elbow, foot  pain including plantar fasciitis, ankle pain or instability,  hypermobility, osteitis pubis, IT band syndrome, piriformis syndrome,  temporal mandibular joint syndrome (TMJ), or other musculoskeletal pain  or injury. Some areas or problems can be more challenging than others,  and it is therefore important to be evaluated by a physician trained and  experienced in this procedure so that an accurate assessment and  treatment plan can be given.

The anticipated rate of success depends  on a number of variables, including the patient’s history and ability to  heal, and the type of solution used. In patients with low back pain,  studies have shown a 85% to 95% of patients experience improvement with  prolotherapy (compared to studies showing a 52% improvement with back  surgery). Many studies done over the years show a high success rate when  prolotherapy is used for various ligament, tendon or joint  pain/injuries.