Prolotherapy (proliferative therapy) is a treatment for patients with chronic joint and muscle pain; it is offered as an alternative to over-the-counter pain relievers (NSAIDs), corticosteroids and, in some cases, surgery. Prolotherapy is based on the premise that the injection of a mild irritant, usually dextrose, into a joint, ligament or tendon triggers a localized inflammatory response, thereby stimulating an increase in blood supply to damaged tissue. With this increased blood flow comes an increased supply of immune cells and collagen to assist in repairing the damage, and stimulating the formation of new, healthy connective tissue.
Uses of Prolotherapy
Prolotherapy is used to treat a variety of musculoskeletal conditions. Although its effectiveness has not been proven, proponents point out that it has seemingly successfully treated a wide variety of conditions, including the following:
- Osteoarthritis
- Fibromyalgia
- Connective-tissue damage
- Partially torn tendons or ligaments
- Sacroiliac and sciatic problems
- Chronic tendonitis
- Degenerative disc disease
- Whiplash
- Myofascial pain
Although why it seems to work has not been established, there is anecdotal evidence that prolotherapy warrants further investigation and, as long as it seems to be helping patients, should continue to be used. In some documented cases, the tissue treated with prolotherapy appears to be stronger and thicker than the original. There is also evidence that prolotherapy repairs connective-tissue damage, even years after the original injury occurred.
The Prolotherapy Procedure
Prolotherapy solution is injected into the ligament or tendon at the site of the injury or damage. The precision with which the injection is placed ensures that the resulting inflammation is only to the damaged tissue. The body reacts by increasing the flow of blood and nutrients to the damaged area, helping tissue in the region to regenerate.
Treatment with prolotherapy depends on the nature and extent of the damage within the joint, as well as how quickly a person heals. For some people, treatment may consist of only a few sessions, whereas others may require more than 10. For most injuries, the average number of treatment sessions is between four and six. Treatments may be administered every 2, 4 or 6 weeks.
Risks of Prolotherapy
Possible side effects, which can last between 2 and 4 days after treatment, include swelling at the injection site, fatigue, headache and nausea. More common side effects are soreness and some stiffness at the treatment site for 1 to 2 days post-procedure. The most serious risk, though rare, is that the injection, if incorrectly administered, will cause nerve damage.
Does prolotherapy actually work?
Some studies have found that prolotherapy does reduce people's pain. Others find that any benefits are likely a placebo effect, meaning it helps people because they believe it will. If you choose to use prolotherapy, make sure you receive it from a reputable clinic and provider.
What is the success rate of prolotherapy?
Most clinicians find that 80 – 90% of patients experience at least a 50% reduction in pain after a series of prolotherapy injections. Of course, results can vary. Some patients discover that their pain disappears altogether.
Is prolotherapy better than cortisone?
In one study of the treatment of tennis elbow using both steroid and prolotherapy, the conclusion was that both injection therapies were proven to be effective in the short-term treatment of chronic lateral epicondylitis, but dextrose prolotherapy seems to be slightly more efficacious than steroid injection over a longer period.
How long does prolotherapy last?
On average, patients experience one year of improvement and relief from prolotherapy. However, there is a huge variation and sometimes improvement lasts from three months to 15 years.
Is prolotherapy the same as stem cell treatments?
Prolotherapy focuses on stimulating the body's natural healing processes through injections, while stem cell therapy utilizes the regenerative potential of stem cells, and PRP therapy harnesses the power of platelets and growth factors. Each therapy has its own advantages and is suitable for different conditions.
