Proliferative or regenerative type injections use naturally occurring substances to elicit the body’s own cellular intermediates to create an inflammatory response. These cellular structures proliferate and help rejuvenate the inflamed tissue, restoring function and reducing pain. Prolotherapy stimulates your own body’s healing mechanism to restore normal function into the damaged area. Prolotherapy uses a dextrose (sugar water) solution, which the physician injects into the ligament or tendon using an ultrasound guided technique.
These injections cause inflammation in these weakened areas which increases the blood supply and flow of nutrients to this area allowing for tissue growth and the strengthening of the ligaments and tendons.
The agents that are typically used have FDA approval for injections, for other uses than prolotherapy. Which medication used would depend on the desired effect and would have to be to individually determined, depending on the case and what we are treating, (ligament, tendon, muscle or joint).
Prolotherapy has been shown to be a safe, effective way to alleviate your pain when used in conjunction with treatment modalities such as ice/heat, massage, osteopathic manual therapy, formal occupational or physical therapy and medications. It has been used to treat painful joints, sprained/strained ligaments, partially torn tendons, back and neck pain, myofascial pain, along with tender and trigger points.
Typically these injections are well tolerated and have a low risk of complication, limited to local pain, stiffness or bruising. With any injection, there is a risk of bleeding, infection or injury to a nerve. These risks are low and severe adverse reactions are noted less than five percent of the cases.
We want to create a local inflammatory reaction, as this has been showed be the initial phase of healing. Therefore we do not want to take an anti-inflammatory medication to counter act our injection. One can use acetaminophen or tramadol or a low dose opiate may be used to treat the pain.
The Veteran’s Administration acknowledges Prolotherapy and has stated on their web sites that prolotherapy does seem to be an effective, safe treatment for joint and musculoskeletal pain, osteoarthritis and back pain.
However, The Federal Government states that there is not enough data due to lack of scientific research to approve these injections at this time for reimbursement.