What is prolotherapy?


Prolotherapy (aka regenerative injection therapy -RIT) is a non-cortisone type of injection that can treat many orthopedic conditions. “Prolo” is short for proliferation, because the treatments cause the proliferation (growth, or formation) and remodeling of new ligament or tendon tissue in areas where it has become weak. Ligaments are bands of tissue that hold bones together. Ligaments can become weak or injured and may not heal back to their original strength or endurance. The blood supply to ligaments is limited and therefore limits healing in these areas. The ligaments have many nerve endings; therefore patients will feel pain at the areas where ligaments are damaged or loose. Tendons help to connect muscle to bone and also lack blood supply which lead to poor healing. Prolotherapy uses dextrose (sugar water) solution mixed with a numbing agent such as lidocaine and injects this into the tendon or ligament at the attachment to the bone. This causes localized inflammation in these weak areas which then increases the blood supply and flow of nutrients and growth factors and can stimulate the tissue to repair itself.


Prolotherapy is helpful for what conditions?


The treatment is useful for many different types of disorders, including neck and back pain, sports injuries, partially damaged tendons or ligaments, arthritis, and fibromyalgia.


How many treatments are necessary?


The response to treatment varies from individual to individual, and depends upon one’s healing ability. Some people may only need a few treatments while others may need 10 or more. The average number of treatments in 4-6, and there is not the concern of repeated injections as with cortisone. Once you begin treatment, your doctor can tell better how you are responding and make appropriate recommendations.


What are the risks and side effects?


This procedure is safe when performed with sterile ultrasound and proper sterile injection techniques. The most common side effect is discomfort which is temporary. The other risks involve infection, bleeding, and worsening of pain. Ice is not allowed post injection for prolotherapy as it is used post biopuncture or steroid injection therapy. Ice directly inhibits inflammation, which is what we are trying to induce and is the purpose of the prolotherapy. This may be the reason for increased pain post injection in comparison with other injection therapies.