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What is Prolotherapy?

Prolotherapy is an elective non-surgical treatment option that may be advised by your healthcare provider to treat connective tissue injuries and musculoskeletal disorders which cause chronic and progressive pain. The procedure involves injecting an irritant to the injured connective tissues such as tendons, ligaments or joints to stimulate regrowth and healing of tissue. Hence, it is also known as proliferation therapy or regenerative injection therapy.

Picture of Prolotherapy

How does Prolotherapy work?

Normally, tendons and ligaments holds the bones together in place. When these tissues get injured or damaged, the bones and joints can become misaligned resulting in pain. The irritant substance injected into the injured area during prolotherapy causes mild inflammation and increases blood circulation in that area. Thus prolotherapy encourages the body’s natural healing mechanism by regenerating new cells and tissues.

How are prolotherapy injections administered?

Prolotherapy injections contain a mixture of a local anesthetic and an irritant such as sugar water (dextrose) or saline (a mixture of sodium chloride and water).
Prolotherapy injections are directly administered intramuscular or intradermal depending on the targeting area. About 6-8 weekly injections may be given.

Indications of Prolotherapy

Prolotherapy may be indicated for:

  • Musculoskeletal pain like neck pain and back pain
  • Chronic sprain or strains
  • Whiplash injuries
  • Osteoarthritis
  • Chronic tendonitis
  • Sports injuries

Contra-indications of Prolotherapy

Prolotherapy is contra-indicated in the following conditions:

  • Non-musculoskeletal pain
  • Metastatic cancer
  • Septic joints
  • Cellulitis
  • Systemic inflammation
  • Spinal anatomical defects
  • Morbid obesity
  • Bleeding disorders
  • Chemotherapy

Preparations for Prolotherapy

In preparing for the prolotherapy, the following steps may be performed:

  • Your doctor diagnoses your condition thorough a physical examination and taking a medical history.
  • Blood tests and imaging tests such as X-ray or MRI may be ordered to confirm the diagnosis.
  • You may be advised to stop anti-inflammatory medicines 2-3 days prior to the procedure.
  • Joint exercises may be recommended for a few days or weeks before the procedure.
  • A high protein diet is recommended to promote healing and recovery.

Prolotherapy Procedure

The prolotherapy procedure involves the following steps:

  • The skin over the target area is cleansed with a sterilizing solution.
  • A topical anesthetic gel or cream is applied over the cleansed skin.
  • Tender sites are located by palpating the target area.
  • A thin sterile needle is inserted inside the target area and the irritant solution is injected.
  • After injecting the solution, the needle is removed and a heat or cold pack is placed over the site for 10-15 minutes.

Follow up after Prolotherapy

You may be recommended to:

  • Rest the injected site for 2-3 days.
  • Perform range of motion exercises.
  • Resume activities as tolerated.
  • Pain reliever is advised if there is severe pain.
  • Complete the course of injections as required and advised by your doctor.

Merits of Prolotherapy

Following are some of the benefits of prolotherapy observed in patients:

  • Improves healing of connective tissue
  • Low risk procedure
  • Clinically proven results
  • Improves joint mobility and function
  • Complications of Prolotherapy
  • Common side effects related of prolotherapy are usually temporary and include:
  • Increase in pain
  • Stiffness in the joints
  • Bruising at the injection site
  • Headache
  • Nausea and vomiting
  • Diarrhea
  • Minor allergic reaction