Are you a candidate for Prolotherapy?

You may be if:

• You need surgery or surgery has failed
• Anti-inflammatory drugs only give you temporary relief
• You have chronic pain and have been told there is no effective treatment
• Adjustments, massage, and manipulation give temporary results at best
• You need to change positions often because of pain
• You have chronic, deep, achy spinal pain
• You are fatigued and lack endurance from pain
• Pain interferes with your sleep

The original use of prolotherapy is attributed to Hippocrates who used a heated iron applied to the anterior shoulder joint to provide stability for chronic dislocation in javelin throwers. Since then, many different injectable solutions and techniques have been used with varying success. Today, state of the art prolotherapy uses gentle injection methods to treat weakened ligaments, tendons, and other structural tissues that are pain generators, the cause of joint instability, and the precursors to degenerative osteoarthrosis and tendinosis. These injections stimulate a local regenerative response in the injection site and surrounding tissue resulting in joint stabilization, increased structural integrity of tendons and ligaments, and a marked reduction or complete elimination of pain that is long lasting to permanent.

We have used prolotherapy for nearly every region of the body for the past 20 years. This includes but is not limited to spinal pain (neck, thoracic, lumbar, sacral, coccygeal), scoliosis, chronic headaches, TMJ, osteoarthritis/osteoarthrosis /pain in all major joints (knee, shoulder, elbow, ankle, hip, sacroiliac, etc.) and minor joints (fingers, thumb, toes, wrist, sternal, scapular, facet, ribs, etc.). In addition, many people with repetitive strain injuries, fibromyalgia, and sports injuries to muscles, tendons, ligaments and joints benefit greatly with prolotherapy as it accelerates tissue healing and decreases pain.

(courtesy, Dr. Ross Hauser, Caring Medical)

Then why haven’t I heard about it?

Like many other things, lack of public familiarity often has to do with the overt influence of pharmaceutical, surgical, and medical device interests that dominate the medical system. Prolotherapy has long been practiced by select doctors that have sought out specialized training such as that offered by the American Association of Orthopedic Medicine (AAOM), the Naturopathic Academy of Therapeutic Injection (NATI), and the training offered by yours truly through the Natural Medicine Clinic seminars, workshops, and preceptorships. There are probably less than several hundred physicians in the US that have the advanced specialized training necessary to safely and competently perform the entire range of prolotherapy procedures.

So then, is prolotherapy safe?

It is very safe when correctly trained physicians that have adequate experience and have achieved competence in the areas treated do prolotherapy. However, any procedure or treatment has risk of adverse reaction and complication. The risk with prolotherapy is very small and is very rare but can include increased pain, numbness, infection, allergic reaction to the solution, headache, pneumothorax, dizziness, nausea, or even death (last one known was in the 1950s from untrained practitioners).

How do you know where to inject?

This is the art and science of medicine and prolotherapy. Practitioners are trained to use physical exam techniques and palpation methods to determine the optimal location for treatment. Some doctors are naturally gifted with sensitive touch and others may learn it. Imaging studies with Xrays, CT scans, or MRIs may be helpful but musculoskeletal diagnostic ultrasound is the preferred state of the art method to complement physical exam. We have been using it for ~15 years and have found that it has been a great aid in accurate diagnosis and quantifying tissue healing with treatment. Our new cutting edge ultrasound has image resolution that is higher than MRI and includes features such as color flow mapping, Doppler, 3D and 4D imaging, as well as the ability to do motion studies of symptomatic areas.

How much treatment will I need?

This is difficult to say, as there is a broad range of problems and overall health status of individuals seeking treatment. A young and healthy person with a minor problem may only need 1-2 treatments to regain function and to be symptom free. An older person who has been told they need joint replacement will require a series of treatments and may not become symptom free but generally will have better function and much less pain. We have many patients who have successfully avoided joint replacement of knees, hips, ankles, shoulders, wrists, and elbows. In the more advanced cases, treatment with PRP (platelet-rich plasma) may be necessary for optimal results.

In advanced joint degeneration and chronic spinal pain, with degenerative disc disease and facet arthrosis, four treatments are generally considered a series and significant improvement generally noticed. Additional series of treatments may be necessary in some patients to continue improvement and gain higher functional ability.