The Basis of A Prolotherapy Treatment

The Prolotherapy Doctor's Examination
A Prolotherapy physician will physically examine the patient, being careful to gently press on the suspect area causing pain. When the physician's touch elicits an intense pain spot, known as a trigger or tender point, this is the spot where Prolotherapy is given. 

One of the tests you can do at home to determine if you are a candidate for Prolotherapy is to gently press, for example your knee that hurts, the joint causing pain. If you can put your finger on an exact spot of acute pain, you have found the trigger or tender point, the junction of bone and connective tissue that is injured or weakened. Prolotherapy is also effective for areas of the body that are painful but not tender.

The Injections 
Unlike the cosmetic use of collagen which requires injecting bovine collagen into the skin to rejuvenate and restore a more youthful appearance, Prolotherapy stimulates your body to produce it's own collagen to rejuvenate and rebuild your body's infrastructure, allowing you to again with youthful vigor. The ingredients used in Prolotherapy consist of a variety of tested, refined, and researched compounds that have been successful in helping alleviate chronic pain. 

At our practice at Joint Rehabilitation, we use a mild dextrose solution in 99% of our cases. Our practice is also somewhat unique when it comes to patient comfort. Injections are injections and there are people who hate them, fear them, even get queasy over them. We make every effort to minimalize pain and reduce the stress associated with getting an injection. Where most Prolotherapist use a thick, long needle, we use a short, very thin needle, this has a significant impact on lessening discomfort. Additionaly we use a “derma-jet” anesthesia spray. Nearly all the pain associated with an injection occurs at the point where the needle breaks the skin. A quick spray from the “derma-jet,” numbs the skin just before the injection so the patient hardly feels anything.

The Treatment 
The solutions used in Prolotherapy are designed to have a "double-edged" effect: a combination of anesthetic and proliferant qualities. (Patients who suffer from chemical sensitivities are given a simple dextrose solution.) The anesthetic agent alleviates the "pain trigger,” this also lets me know (as the Prolotherapist) that the solution was placed in the proper area, while at the same time the proliferant agent begins to strengthen the ligaments and tendons at the trigger or tender point site.

The injections at the trigger points cause an irritation, that stimulates the body's natural process for repairing damaged tissue by creating collagen and cartilage. Joints are gradually pulled back into proper alignment as the newly produced collagen reinforces the muscles, tendons and ligaments, then shrinks to tighten the joint capsule and prevent excessive and unnatural movement. This is all part of the natural healing process. Rather than just alleviating the symptoms like pharmaceutical pain-killers do, Prolotherapy fixes the very structure of the body, effecting a hopefully permanent cure, instead of surgically removing important anatomical components. Prolotherapy fixes the damage, naturally and permanently.

What exactly is injected 
during Prolotherapy?

There are a number of different types of injections which have proven to be successful in Prolotherapy. Although they work in different ways, motivating the body to heal itself through a variety of natural responses, the end result is the same: to cure pain by building new tissue and stabilizing the joints.

All of the solutions used in Prolotherapy are designed to have a "double-edged" effect: a combination of anesthetic and proliferant qualities.

The anesthetic agent alleviates the "pain trigger" while at the same time the proliferant agent begins to strengthen the ligaments and tendons at the trigger or tender point.

Some prolotherapists use mild chemical irritants, such as phenol, guaiacol or tannic acid, to trigger the healing process. These substances attach themselves to the walls of the cells wherever they are injected, causing irritation that stimulates the body’s reactive healing process. Others prefer to use chemotactic agents, primarily morrhuate sodium, a fatty acid derived from cod liver oil. Most closely aligned to the compound Sylnasol used by Dr. Hackett in his pioneering efforts, these proliferants attract immune cells directly to the injected area.

The dramatic sounding "osmotic shock agents" are actually simple compounds like dextrose and glycerine.

These are the most commonly used ingredients in the arsenal of Prolotherapy. Extremely safe and water-soluble, they are easily excreted from the body after having their initial desired effect. They work by causing cells to lose water, which leads to inflammation and the subsequent stimulation of the healing response.

Particulates such as pumice flour are microscopic particles that attract macrophages, tiny organisms which gobble them up, in turn secreting polypetide growth factors that result in collagen production.

Besides these general differences, the specific combinations of chemicals and substances used are as varied as the "schools" of Prolotherapy using them.

Some practitioners add co-factors, such as the anti-oxidant mineral manganese, or a combination of glucosamine sulfate and confroitin sulfate which is believed to aid in the repair of arthritic joints, or other co-factors believed to increase the efficacy of the compounds they are used with.

Despite the enormous success of the compounds used today, the most exciting advances in Prolotherapy may be just around the corner, in the form of Growth Factors or Growth Hormones. In addition, fetal stem cells have been injected.

Growth factors cut to the chase, so to speak, acting directly on the cells and joints of the body to stimulate the proliferation of fibroblasts and regeneration of collagen and cartilage.

The most important variable of all, however, as in all medical practices, is the ability and experience of the therapist one chooses. Besides being a licensed medical doctor, it is important that the prolotherapist also be in tune with the underlying premise of homeopathy. It is not our duty to cure, but rather to entice the body into curing itself.