Prolotherapy: Non-surgical treatment method

What is Prolotherapy?

Prolotherapy (Proliferative therapy) is also known as Non-Surgical Ligament and Tendon Reconstruction and Regenerative Joint Injection Therapy, it stimulates the healing process of the organism, which strengthens and restores the damaged and painful joints and connective tissue.  It is based on the fact that ligaments and tendons are stretched or torn, causing them to become unstable and painful.  The unique ability of Prolotherapy is that it directly addresses the cause of the instability, restores the weakened area, and results in a continuous stabilisation of the joints by preparing new collagen tissue.  As the joint is restored, the pain disappears.  Traditional surgical approaches have more risks and can fail to stabilise the joints.  Anti-inflammatory drugs or painkillers temporarily relieve the pain. 

What is the mechanism of action?

Prolotherapy stimulates the body’s natural healing mechanisms and regenerates tissue in weakened area.  This is occur by direct injection to the injured area.  The weak inflammation caused by the injection is strengthening weakened structures as a result of the formation of new and healthy connective tissue and blood vessels.  Repeating this process several times causes the tissue to restore its natural strength in specific area. 

Types of Prolotherapy

 - Dextrose Prolotherapy
 - Platelet Rich Plasma Prolotherapy (Referred to as “PRP”)
 - Stem cell Prolotherapy

In Which disorders is it effective?

 - Degenerative Disc Disease including sacroiliac joint dysfunction, neck pain;
 - Knee pain;
 - Meniscus tear of the knee;
 - Wrist or hand pain;
 - Osteoarthritis;
 - Shoulder pain;
 - Elbow pain;
 - Golfer’s and tennis elbow;
 - Plantar fasciitis and foot pain;
 - Ankle pain, sprain and strain;
 - Osteitis pubis;
 - Piriformis syndrome;
 - Temporomandibular joint syndrome (TMJ) or other kinds of joint and muscle injuries. 

Is Prolotherapy painful?

Level of pain may differ due to several factors such as injected area, the type of injected solution and the skills and experience of the physician. The pain may increase temporarily due to mild swelling and tension within 2-3 days after the treatment. Because, Prolotherapy is based on the rehabilitation and recovery of damaged connective tissues, rather than relieving the pain temporary. 

Can Prolotherapy help everyone?

Every patient should have a medical history, physical examination, and radiological or ultrasound examination.  In case of indication, laboratory tests should also be performed according to the disease.  This information can help your doctor increase the efficacy of this treatment.  The effectiveness of Prolotherapy depends on the patient’s medical history, as well as the deficiency of any substances that affect the health and healing ability of the patient and the healing process.  The efficacy of treatment is very high for the patients suitable for Prolotherapy (87-90%). 

What are the intervals for Prolotherapy treatment courses?

Therapy intervals vary depending on the severity of the treated area according to the physician’s protocol.  Usually the treatment interval is 3-4 weeks, with an average interval of once a month, for a total of 4-6 treatments. However, in some cases the interval may be shorter or the number of sessions may increase. 

What is the rate of success in treatment with Prolotherapy?

The efficacy of Prolotherapy varies depending on various reasons:  the history of the disease and the condition of the healing cells and the solution used.  In patients with low back pain, research has shown that the chance of improvement with Prolotherapy is 95%.  Many studies, conducted over the years, show a high success rate when Prolotherapy is used for various ligament, tendon or joint pain or injury. 

Is Prolotherapy a new method?

Prolotherapy/sclerotherapy has been used since 500 B.C., when Roman soldiers with shoulder joint dislocations were treated with hot irons to heal the torn ligaments in the shoulder joint.  Advance in medicine, was improved on this process, and brought to the modern techniques of strengthening the fibrous tissue and creating new, normal collagen, instead of scarring the injured tissue.  Hippocrates described vein sclerotherapy around 400 B.C. using a “cylindrical iron tool” to treat varicose veins.  Injection of veins with sclerotherapy was first reported in 1623, but modern treatment of injection of sclerotherapy for veins, herniated disks and hemorrhoids has been performed since the early 1900’s.  Earl Gedney, a well-known Orthopedist, decreased his surgical practice and began to inject joints in the 1940’s and 1950’s, and spent the rest of his life researching and writing articles on the subject.  Dr. George Hackett, along with physician Gustav Hemwall, also wrote a book about this injection treatment.  Both, Gedney and Hackett’s work is still used today in physicians’ trainings.  Achievements in Regenerative Medicine have led to better solutions; Platelet-Rich Plasma (PRP) (which contain growth-factor solutions), as well as stem cells, have led to the use of injection solutions in this method.