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Prolotherapy: What is it and What to Expect?

Prolotherapy is an interesting procedure promoted for correction of musculoskeletal disorders. It is an option to consider by patients who desire to avoid going under the knife. It supposedly not only helps to correct acute orthopedic issues, but also chronic ones.

There are reports of people feeling impressive relief after undergoing the procedure. But will prolotherapy help with the actual orthopedic problem you are having? Is it safe? Read on to determine if this is a right option for you.

What is Prolotherapy?

Also known as proliferation therapy, prolotherapy is an injection-based procedure for correcting issues affecting the musculoskeletal system. It also goes by the name non-surgical ligament and tendon reconstruction or regenerative joint injection.

This practice, which is often classified as alternative medicine, involves introducing injectables into connective tissue. It helps to promote healing of injuries and tiny tears, which other non-surgical forms of treatment might have failed to improve.

A major reason prolotherapy is thought more preferable to surgery is that it involves less risk. It also produces longer lasting effects than most pain relievers and anti-inflammatory drugs.

As practiced today, the procedure mostly uses natural irritant or substance, possibly from a patient's own body to promote healing.

Contrary to what some might think, prolotherapy is not a new practice. It has been traced back to ancient times. A similar procedure was said to have been used for the treatment of Roman soldiers who suffered shoulder joint dislocations as early as fifth century BC.

Since then, prolotherapy has seen significant improvements in practice. The advances mean it is now possible to promote more thorough healing without the scarring linked to archaic methods.

The original term for this medical practice was "sclerotherapy," covering treatment involving both joint and vein injections. Today, prolotherapy concerns injections for correcting musculoskeletal conditions, while the former deals with treatment of vascular (blood vessel) defects.

What's in the Prolo Injection?

Prolotherapy injections can contain a variety of formulas. Usually, what you find in them are natural substances. They do contain saline solution, dextrose, glucose, procaine, lidocaine, or some other natural irritants.

In most recent years, there appears to be a shift in terms of preference towards injections using platelet-rich plasma (PRP). These are different from others mainly because they use substances that come from a person's own body.

As the name indicates, PRP is plasma with very high concentration of platelets obtained from the individual for treatment. The levels are usually higher than that present in the body. This is made possible through a process that typically involves centrifuging.

Platelets boast a variety of cytokines, growth factors, and other bioactive factors. PRP prolotherapy basically uses stem cells from the body of the person being treated.

How Does Prolotherapy Work?

The substance or irritant that prolotherapy injections contain activates the body's natural healing response. How does this work exactly? You may wonder.

The injections are believed to promote inflammatory response. Before you freak out, this does not mean inflammation in the negative sense. We are talking about a mild response.

Inflammation is actually beneficial for promoting healing in the body. The injections create mild inflammatory response near the area of injury or tear. They trick the body into commencing repair of affected area by producing new collagen tissue, ligaments, or tendon fibers.

PRP prolotherapy goes further. It introduces stem cells taken from other parts of the body to the site of injury. Usually, doctors obtain these from adipose (fat) tissue or the bone marrow.

Stem cells are known for their remarkable adaptability. They can transform into the structures of whatever area they are introduced. In the case of orthopedic issues, they can create new fibers and blood vessels. Stem cells can, thus, help to improve damaged tissue and joint.

Who Should Consider Prolotherapy?

There is a wide array of musculoskeletal conditions that prolotherapy can be used to treat. They can benefit people suffering from any of the following:

Degenerative knee cartilage
Plantar fasciitis
Osteoarthritis
Neck pain
Knee pain
Back pain due to degenerative disc disease or sacro-iliac joint dysfunction, among others
Knee meniscal tears
Temporal mandibular joint syndrome
Osteitis pubis
Chronic elbow pain, including tennis or golfers elbow
Shoulder pain and rotator cuff injuries

It is believed that prolotherapy can help with virtually all musculoskeletal complaints. The procedure may be worth considering if you are not seeing much improvement from drugs, physical therapy or surgery.

But then, this does not mean it is for everyone. We should also point out that some affected areas are more difficult to treat than others.

Who Performs the Procedure?

It is important to realize that not just any doctor will do when it comes to getting prolotherapy. The procedure is deemed an alternative medicine practice. So, you need to do some work to find the right experts. These, obviously, will be trained prolotherapists.

To be able to practice in the U.S., a doctor must get training by the American Osteopathic Association of Prolotherapy Regenerative Medicine. There are also now other recognized bodies that provide necessary training for medical experts.

A must for training, in many cases, is possession of license to practice as a medical orthopedic physician.

What to Expect

Thorough evaluation is necessary before prolotherapy is given to a patient. The doctor needs to decide if this procedure will indeed improve the issues that a patient is having.

This evaluation starts with medical history and is usually followed by physical examination. There are usually imaging tests you will need to do for assessment of the location and extent of the particular injury.

Your doctor may also deem some laboratory tests potentially useful in making a decision. The information he gets from the different tests and examination will give an idea of potential for success.

If prolotherapy is deemed to be potentially beneficial, you will need to ensure sufficient food intake on the day you will be going for the injections. The best type of meal to eat on the day should be one that is very rich in protein.

You will also need to stop taking anti-inflammatory drugs, if you have been on such. The use of these should be halted 2-3 days before receiving prolotherapy injections. Otherwise, the efficacy of the procedure will reduce.

It is relevant to mention that the injections are not always a one-off thing. You may need to take them again after some time. On average, treatment is about once a month.

Is Prolotherapy Painful?

You should expect some degree of pain with this procedure. After all, what we are talking about here involves treating orthopedic pain with injections.

Pain sensation should increase in the interim after getting the injection. The extent will depend on a variety of factors. These include the skill of the doctor performing the procedure and the particular area that is being treated.

You may be given pain relievers – but not anti-inflammatory drugs – to deal with the discomfort.

How Much Does the Procedure Cost?

Prolotherapy may prove rather costly for some patients to get. This is because insurance companies do not always cover such treatments. You may, therefore, have to pay for everything out of your pocket.

Each session can cost up to $600, or more. Certain factors determine the exact amount you can expect to pay. Among these are extent and location of injury and the particular physician that will be managing the procedure.

What’s the Success Rate Like?

Success of prolotherapy depends on the factors that doctors first assess when considering the suitability of the procedure for a particular individual. History of orthopedic issues, nutritional deficiencies, and overall state of health are major determinants.

Success rate is high among patients considered ideal for prolotherapy. Many people have reported benefits from the procedure in the control of pain associated with diverse orthopedic issues, including sciatica, herniated disc and rotator cuff injuries.

Research has shown that prolotherapy can indeed help to resolve some orthopedic complaints, even though sample sizes were small. Up to 95% of subjects in studies reported improvement.

Professional athletes are believed to also get help from prolotherapy in recovering from what could potentially be career-ending injuries. Legendary sportsmen Peyton Manning and Kobe Bryant are among those thought to have benefitted from the procedure.

Risks and Side Effects Of Prolotherapy

Our prolotherapy evaluation will certainly not be complete without discussing the problems that can arise from the procedure. This is because there are possible risks and side effects, although there are not many reports of such.

A potential risk involved in getting prolotherapy is working with a doctor that lack necessary skills. This might not only reduce or eliminate the benefits, but also increase the likelihood of you experiencing side effects. So, you need to make sure the physician you will be working with has the right credentials.

Talking about side effects, the most common ones that patients may experience include:

Swelling or pain at site of injection
Headaches
Stiffness
Allergic reactions

Infection may also occur around the site of injection, although this is rare. There are also very rare reports of nerve damage from prolotherapy.

It is possible to control these risks and side effects by ensuring you select a properly trained and experienced professional.

Available information shows that prolotherapy is a safe and beneficial procedure for orthopedic pain management. But more, larger studies will be needed to further promote its acceptance in the medical community. The treatment may be worth checking out if you desire to avoid surgery in resolving your complaints. The success rate in research is pretty impressive, although study group sizes were small.

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REFERENCES

What is Prolotherapy? | The American Osteopathic Association of Prolotherapy Regenerative Medicine (http://prolotherapycollege.org/what-is-prolotherapy/)

Prolotherapy Benefits, Uses, Facts & Recommendations - Dr. Axe (https://draxe.com/prolotherapy/)

Prolotherapy: Uses, side effects, and costs (https://www.medicalnewstoday.com/articles/320330.php)

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