Prolotherapy, also known as Proliferative Therapy or Regenerative Injection Therapy (RIT), is the injection of a dextrose solution into an injured tendon or ligament to cause irritation for the purpose of stimulating the body’s natural healing process in order to strengthen weakened areas, improve function, and reduce pain.
The goal of Prolotherapy is to produce dense fibrous tissues which strengthen the attachment of ligaments, tendons, joint capsules, and fascial structures. By strengthening these areas, degenerative processes can be slowed. As new tissue is formed, hypermobile “loose” joints progressively stabilize.
The concept of creating irritation or injury in order to stimulate healing dates back to Roman times where hot needles were inserted into the shoulders of injured gladiators.
In the US, Prolotherapy originated in the 1950s by American surgeon Dr. George Hackett who used a sclerosing agent in weakened or elongated ligaments to make them stronger. Hackett reasoned that if weak ligaments were the cause of most joint and ligament pain, strengthening them would resolve the pain. He was quite successful, publishing 16 articles and a textbook on his procedure, and claiming an overall 80% success rate. In 1955, Dr. Gustav Hemwall became acquainted with George Hackett at a medical meeting and started practicing prolotherapy shortly thereafter. Dr. Hemwall is regarded as a pioneer of Prolotherapy, and taught the treatment to numerous physicians until his passing in 1998.
Prolotherapy solutions generally contain dextrose (a sugar) and lidocaine (an anesthetic).
The dextrose, which is an irritant, is hypothesized to initiate a mild inflammatory process to recruit the body’s natural repair mechanisms and start the healing cascade. The result is repair and growth of new ligament and tendon fibers that strengthen lax, weakened, or elongated tendons to restore strength and function.
Most patients tolerate the procedure well with local anesthesia (lidocaine). Because the treatment induces a mild inflammatory reaction as part of the healing process, you may experience some stiffness or soreness for 3-5 days following the injection. Pain can be controlled with pain relievers if needed.
While each case is unique and treated on an individual basis, most patients respond to 3-4 treatments depending on how long the injury has been present as well as the degree of the damage. Treatments are typically spaced 2-3 weeks apart depending on the condition being treated and the patient’s response to the treatment.
Prolotherapy is considered safe when administered by a properly trained physician. Injections are done under sterile conditions to minimize the risk of infection. Risks of Prolotherapy are similar to conventional joint injections. Possible adverse effects include local swelling, bruising and transient pain.
Some patients prefer to go home and rest after treatment while others continue work or other activities immediately after treatment. Strenuous workouts or sports may need to be stopped or modified for two or three weeks after injections to give the repaired tissue a chance to mature.
Unlike steroid (cortisone) injections which provide temporary pain relief by inhibiting inflammation, Prolotherapy induces a mild inflammatory response to stimulate healing. Because Prolotherapy works to repair weak and painful joint areas, it is a long-term solution rather than a temporary measure such as drugs or Cortisone.
Prolotherapy is effective in treating pain syndromes associated with lax, weakened, or elongated tendons and ligaments in a variety of areas including the neck, back, knee, shoulder, hip, elbow, wrist, hand, foot, and ankle.
No. Prolotherapy is not covered by insurance companies at this time.