Prolotherapy, also called proliferation therapy is a non-surgical and injection-based treatment used in chronic musculoskeletal conditions. It is a procedure where a natural irritant is injected into the soft tissue of an injured joint to kick start the body’s healing response, you will feel worse before you feel better, but the aim is to strengthen the ligaments in the joint resulting in better stability and pain relief.
What is Prolotherapy? And how does it work?
Prolotherapy, also known as regenerative joint injection or non-surgical ligament and tendon reconstruction, is part of the Regenerative medicine. It is a procedure where a natural irritant solution, such as a sugar called dextrose, is injected into the ligaments, tendons and the soft tissue of an injured joint. Once dextrose is injected at certain concentrations, it will trigger a natural healing process in the connective tissue of the joint, stimulating repair and the body will start to strengthen and repair damaged ligaments in the joint. The strengthening of the ligaments, over time, helps to stabilize the joint. And once the joint is better supported, the pain can disappear.
In some cases, people with chronic conditions, such as arthritis or osteoarthritis, may wish to use prolotherapy to help ease their pain.
Prolotherapy requires several treatments at the site of the injury or weakened area to be effective. It usually requires anywhere from 4 to 20 injections per session and several sessions over the course of three to six months, followed by occasional, as-needed treatment allowing a gradual build-up of tissue to restore the original strength to the area.
What conditions can be treated with Prolotherapy?
Prolotherapy is mainly used to treat injured joints, ligaments and tendons, it can be used for treating:
- Knee pain, including knee meniscal tears
- Wrist or hand pain
- Shoulder pain, including rotator cuff tears
- Elbow pain, including golfers elbow or tennis elbow
- Hip pain
- Foot pain, including plantar fasciitis
- Ankle pain or instability
- Other musculoskeletal pain or injuries
What are the risks and benefits of Prolotherapy?
Overall, Prolotherapy is a safe, alternative procedure to medication or surgery. It is an all-natural treatment that strengthens the joints and as the body repairs itself eventually leading to reduced pain. Also, the improved strength of the joint will help with stability and improve overall movement and function of the back and joints.
Prolotherapy is minimally invasive, non-surgical same day procedure. No general anaesthesia is required and most patients don’t need post-operative pain medication. You are fully awake and ready to go home within a few hours after injections in the affected area.
Potential risks of Prolotherapy may include a temporary swelling or temporary increase in pain levels, bleeding or develop an infection related to the injection site. If you develop symptoms you are concerned about please do not hesitate to contact us.
Prolotherapy Procedure Step By Step
The procedure is performed in an out-patient setting and can take up to an hour to complete. The main steps of the procedure are outlined below:
During the Prolotherapy procedure, the consultant will prepare the person’s skin with rubbing alcohol or another sterilizing solution. Numbing cream may be applied to the skin to reduce discomfort from the injection site. And once the irritant solution has been prepared, the consultant will use a long, thin needle to deliver the irritant solution to several different points around the treatment area of your body. The number of injections used depends on the injured area or joint affected, it usually requires anywhere from 4 to 20 injections per session. Ultrasound imaging is sometimes used to guide the injection.
In extreme cases, where the person is in considerable pain or discomfort, additional sedation may be used.
What are the necessary preparations before treatment with Prolotherapy?
First, in order to determine if you are a good candidate and will benefit the most from prolotherapy treatment, you will need to schedule an appointment with our Clinic to have assessment done by our Consultant, who will review your case, medical records, blood tests & radio-imaging scans and determine if you are a qualified candidate for prolotherapy. As people with some chronic conditions may not see effects from the prolotherapy, consultant may suggest other alternatives that would suit better for the particular condition. The choice of treatment is at the discretion of the Consultant and is based on your unique case. In certain cases it may be a combination of more than one treatment protocol. The options are: PRP, Stromal vascular fraction therapy and/ or Mesenchymal cell therapy.
It is important to make us aware of any medications you may be taking before coming in for the prolotherapy procedure, e.g. anti-inflammatory medication, such as Ibuprofen. Anti-inflammatory medication should be stopped 2 to 3 days before the procedure as continuing to take anti-inflammatory medication may prevent the procedure from working. However, we will advise you if you need to cease any medications at the time of making the appointment.
On the day of the prolotherapy, it is important that a person eats well, for example a protein-rich meal.
What can I expect after the treatment with Prolotherapy? When do I see results?
Immediately following the procedure, the affected joint may feel worse before beginning to feel better. The treatment may result in a temporary increase in pain with mild swelling and stiffness. A post-injection pain flare during the first 72 hours after the injections is common. Most patients with pain flares experience diminution of pain in 5–7 days after injections, regular activities can be resumed at this time. However in most cases, the discomfort passes fairly quickly and if needed pain also be reduced with pain relievers such as Paracetamol, Panadol or other prescribed medication. Anti-inflammatory drugs, such as aspirin, Ibuprofen or Nurofen, are not recommended for pain relief, because their action suppresses the desired inflammatory healing process produced by the prolotherapy injections.
A typical treatment program involves several sessions over the course of three to six months. However, the intervals can vary and may be more frequent, or take longer, depending on the specific condition and severity of the area being treated, as well as the particular protocol. Typical intervals between treatments are every three to six weeks, with an average interval of once a month, for a total of three to six treatments. Most patients will notice improvement after two treatment sessions. However, if the improvement is not seen by then, reassessment of the patient will be done and treatment will be adjusted.
You will be asked during the period of the treatment and follow up to keep an accurate record of your progress to compare to your starting point.
The final outcome of the treatment and extent of improvement varies from one patient to another depending on type and severity of the condition, age, etc…