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What is prolotherapy?

Prolotherapy facilitates the body’s own healing mechanisms to repair damaged tendons and ligaments.   Ligaments are strong, flexible connective tissues (like ropes or guide wires) which support the joints and bind our bones together.  When you injure a ligament or tendon, your body naturally heals with inflammation, which results in the formation of new collagen and strengthening of the joint.  But sometimes that process is unable to complete itself, causing pain, numbness, joint instability, and muscle spasms.  Prolotherapy is a safe and effective way to induce inflammation, stimulating the body to begin its own healing process. 

The procedure:

Prolotherapy involves ultrasound-guided injections of a mixture of lidocaine (which temporarily numbs the tissues to relieve pain) and dextrose (sugar water) in strength sufficient to irritate the tissue and cause repair by the body’s own healing mechanisms.  Experiments have shown that ligaments and tendons are strengthened and thickened by prolotherapy; and thus, prolotherapy is an effective therapy in relieving chronic pain.

The injection of the irritant solution acts to create a mild inflammatory response very locally.  Weaknesses and faulty structural elements are repaired, and the resulting improvement of function and relief of pain are very often dramatic.  Many patients who have previously undergone multiple other forms of treatment without pain relief, including physical therapy, chiropractic adjustments, and even surgery, receive lasting pain relief after prolotherapy is performed.

Depending on the site and size of area involved, this may necessitate many injections during one office visit.  The injections may be uncomfortable because they require multiple needle sticks. Tiny injections of numbing medicine are usually given first, so there is much less pain as the treatment itself is performed.

Most patients tolerate this well but some patients, prior to the procedure, may require some medication for pain control.  Please discuss premedication with the doctor if you have unusually strong reactions to discomforts that are part of minor procedures (such as dental repair).  Since anti-inflammatory medications (ibuprofen, Motrin, Aleve, etc.) are known to hinder the healing process, they should be stopped before prolotherapy. Tylenol is still acceptable since it isn’t an anti-inflammatory.

Post-prolotherapy:

After the procedure, most patients feel fullness and numbness in the injected areas.  The number of injections to obtain relief varies considerably from patient to patient and injury to injury. Some people are relieved totally with one injection whereas others required a series of injections.  Generally, several injection sessions are done with most patients. If, after 3 or 4 sessions there has been an adequate inflammatory response and there is no improvement in pain, prolotherapy will usually not be continued. If progress is being made with prolotherapy injection, the usual time between subsequent injections is 4-6 weeks. 

After prolotherapy, patients are encouraged to do regular stretching exercises but not to over stress the areas that have been treated—to allow for proper healing and strengthening. You should preferably discontinue the use of anti-inflammatory medications during the course of treatment.