Prolotherapy: an overview

Prolotherapy is an injection-based treatment technique used for chronic pain of various types, osteoarthritis and sport injury typically involving tendon or ligament sprain. It involves injections of a dextrose/procaine solution into the joint, tendon, ligament or painful tissue to promote regenerative of the injured tissue. The term ‘prolo’ related to ‘proliferation’ because the injected tissue tends to become stronger and thicker.

Often chronic pain is driven by instability of joints because at the site where weakened ligaments and tendons attach to bone, the nearby sensory nerves become over-stimulated by the increased tension. Localized pain results, muscle spasms become more frequent and referred pain to other nearby structures occurs. Essentially, with a loose joint, tension builds and the muscles in the surround area tighten in attempt to stabilize the joint. Each of these factors promotes pain. It is well known that the blood supply to ligaments is poor and for this reason, these types of injuries typically become chronic problems.

With prolotherapy, the aim is to strengthen the weak ligaments or tendons that are at the root of the instability. The overall concept of prolotherapy is that the injected solution promotes a localized inflammatory response and the exact site of injury. Secondary to this, local circulation improves and the tissue receives more oxygen and nutrients from the bloodstream. The exact mechanism has not yet been proven and debate around how it should be used in medicine remains. The clinical data and over 50 years of use in medicine suggest that prolotherapy is a viable treatment for many injuries involving tendons, ligaments and vertebral discs.

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