Introduction

Prolotherapy is an injection procedure used to treat connective tissue injuries of the musculoskeletal system that have not healed by either rest or other nonsurgical therapies in order to relieve back pain. The injections promote a healing response in small tears and weakened tissue, with the goal of alleviating back pain and improving function. Prolotherapy is also referred to as sclerosant therapy, sclerotherapy, regenerative injection therapy, "proliferative" injection therapy, and nonsurgical ligament reconstruction.

Studies of prolotherapy in people with low back pain have had mixed results. A combination of prolotherapy and spinal manipulation or back exercises seems to be more effective than is prolotherapy alone.The American Pain Society recommends against prolotherapy for treating low back pain, but other authorities are suspending judgment until larger, more-thorough studies have been done. Until then, talk to your doctor before deciding whether prolotherapy is right for you.

Prolotherapy is a method of injection treatment designed to stimulate healing. Prolotherapy owes its origins to the innovation of Dr. Earl Gedney, an osteopathic physician and surgeon. In the early 1930s, Dr. Gedney caught his thumb in closing surgical suite doors thereby stretching the joint and causing severe pain and instability. After being told by his colleagues that nothing could be done for his condition and that his surgical career was over, Gedney did his own research and decided to “be his own doctor.” He knew of a group of doctors called “herniologists” that used irritating solutions to stimulate the repair of the distended connective tissue ring in hernias. He extrapolated this knowledge to inject his injured thumb and was able to fully rehabilitate it.

Treatment

Prolotherapy works by causing a temporary, low grade inflammation at the injection site, activating fibroblasts to the area, which, in turn, synthesize precursors to mature collagen and thus reinforce connective tissue. It has been well documented that direct exposure of fibroblasts to growth factors (either endogenous or exogenous) causes new cell growth and collagen deposition. Inflammation creates secondary growth factor elevation. The inflammatory stimulus of Prolotherapy raises the level of growth factors to resume or initiate a new connective tissue repair sequence which had prematurely aborted or never started. Biopsy studies show ligament thickening, enlargement of the tendinosseous junction, and strengthening of the tendon or ligament after Prolotherapy injections.

Prolotherapy is used for musculoskeletal pain or injury which is either unresolved after eight weeks, or (if earlier) where enhanced healing is desired. Prolotherapy works by raising growth factor levels or effectiveness to promote tissue repair or growth. It can be used years after the initial pain or problem began, as long as the person is healthy. 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.

The total appointment time takes approximately 30 minutes, including preparation, treatment and recovery time. Performed in a medical office, prolotherapy relieves pain without the risks of surgery, without general anesthesia or hospital stays, and without a prolonged recovery period. In fact, most people return to their jobs or usual activities right after the procedure.

Initially, mild but temporary swelling and stiffness may occur. Some patients see noticeable improvement after the first sessions are completed, while others realize increasing improvement on each successive visit. Research studies show that over 80 percent of people treated with prolotherapy report a good or excellent result. Many of them are permanently cured. Not only do they enjoy simple pleasures again – a good night’s sleep, sitting through a movie, taking a walk – but many also return to physical activities such as soccer, mountain biking, jogging, skiing, even horseback riding.