Prolotherapy is short for pro-liferative therapy which means that its primary function is to stimulate cellular growth & repair of tissue. The concept of initiating an acute localized inflammatory response in areas of chronic pain to generate a secondary healing phase has been around for centuries. In the past they used more generalized & crude methods of initiating this acute inflammatory reaction however nowadays we use needles to target specific regions that are generating pain. In modern day prolotherapy we inject dextrose, a simple sugar molecule, to initiate this inflammatory response and procain, a local anesthetic, to reset the nervous system which innervates the “painful” tissue.

Prolotherapy can help you body repair a variety of musculoskeletal issues including but not limited to muscular strains/tears, ligament sprains, joint instability, pain associated with tendinopathies. These terms are general and encompass common pathologies like rotator cuff impingement/tears, separated shoulders, knee ligament tears, sprained ankles, hip impingement & pain, whiplash, low back & pelvic instability to name a few. Each patient is an individual and should be treated as such meaning if you have these conditions prolotherapy may or may not be the right treatment depending on your own individual health picture.

When the prolotherapy solution is injected into damaged tissues it initiates a localized inflammatory cascade bringing in white blood cells like granulocytes, monocytes, and macrophages. These immune cells begin to clean up debris that may be causing the chronic low grade inflammation seen with chronic pain. Additional these cells will recruit fibroblast to lay down strong connective tissue at the sight of injection.

The exact time for each person to begin to see benefit is variable depending on the severity of injury, how long this problem has persisted, and the patients overall vitality. Typically the tissue should heal ~15-20% per injection which mean a patient should expect to get close to 100% after 3-8 treatments. These injections are typically done 1 every couple of weeks however timing and frequency is always assessed on an individualized basis. It is important to remember that although the dextrose & procaine will be metabolized quickly the recovery phase following injections last significantly longer because your immune system is still repairing for up to 12 months.

Prolotherapy will be done using needles into the origin or insertions of tendons/ligaments onto bones. Although there is pain and discomfort associated with these types of injections, this pain can indicate that the solution is being placed in the right places. The anesthetic onset is typically within a matter of minutes however some discomfort is expected. Following treatment the area of injection may sensations of fullness which should dissipate over 1 hour. In the following days you may feel mild aches or discomfort in the area of injection similar to that of an intense workout. 

Prolotherapy works by creating localized inflammation which is why it is important to discontinue the use of NSAID’s prior to and following treatments with prolotherapy as these pharmaceuticals will decrease the inflammatory pathway we are trying to stimulate. These medications include medications like  motrin, advil, ibuprofen, aleve, naproxen, Celebrex, and other similar pills. Also included would be full-strength Aspirin and Robaxisol, although baby Aspirin taken for the prevention of heart disease can be taken. Additionally this therapy used your bodies healing mechanism which means that if your vitality or ability to heal is impaired due to other systemic ailments we may need to work on these areas prior to injecting to insure you get the maximal benefit out of prolotherapy.