Prolotherapy

Prolotherapy, also known as Regenerative Injection Therapy, is an injection technique used to treat chronic pain related to damage to underlying ligament and/or tendon structures. It involves injecting a small amount of a mixture of Novocain and dextrose (sugar), or other similar solution, directly at the site of damage. The sugar stimulates the body’s natural healing and repair processes.

The concept behind prolotherapy dates as far back as the ancient Greeks, when Hippocrates would treat athletes with unstable shoulders. He described touching the tip of a slender hot metal rod to the damaged ligaments. This "cauterized" the ligaments, causing them to tighten up. (It is interesting to note that orthopedic surgeons have used a similar technique surgically, involving lasers or heat probes, to tighten loose shoulder ligaments.) Modern use of prolotherapy traces its roots to the early 20th century when a surgeon from Ohio, George Hackett MD, started treating patients with chronic low back pain by injecting the ligaments around the low back. He demonstrated an 80-90% success rate.

The sugar solution is an irritant (like getting lemon juice in a cut on your finger), and it creates a local inflammatory reaction. This reaction then stimulates or "jump starts" the body’s own natural repair mechanisms.

For more information, you may view and download our comprehensive Prolotherapy handout, Regenerative Injection Therapy.

The pain from chronic ligament and tendon damage can be confusing, because damaged structures can refer pain to other locations that do not seem connected to the site of injury. Sprained ligaments in the neck, for example, can refer symptoms down the arm and can even cause vague and varied symptoms around the face. Damage to the sacroiliac ligaments of the low back can cause pain patterns that look identical to herniated disc pain.

Today, prolotherapy is used successfully to treat many different painful conditions, including:

  • Joint instability, including the knee, shoulder, wrist, ankle, hip and other joints
  • Chronic sports injuries
  • Certain types of arthritis
  • Chronic or recurrent tendinitis, such as Tennis elbow, partial rotator cuff tears, Achilles tendinitis or patellar tendinitis.
  • Chronic or recurrent sprains & strains of the ligaments and tendons
  • Whiplash injuries
  • Chronic back pain

Prolotherapy is designed to be a permanent fix, not simply a temporary procedure. Approximately 80-90% of patients appropriately treated with prolotherapy will experience benefit; some get 40-50% improvement, while others may get 90-100% improvement. There is no way, however, to predict how well someone will respond.

Effective treatment usually takes between 3 and 6 treatments. Treatments are given approximately once a month. If no signs of improvement are seen after 3 treatments, treatment is usually discontinued. If there is marked improvement after only 1-2 treatments, then no further treatments may be necessary. There is no limit to the number of treatments that may be given, as long as improvement continues to be seen. There is also no increase in risk factors with subsequent treatments.

The effectiveness of prolotherapy treatment may be enhanced by improving nutrition (including taking supplements such glucosamine and MSM) and optimizing hormone balance.

Prolotherapy is extremely safe, and while there are risks to any injection procedure, the risks are minimal. At Valley Sports Physicians we have never had any long-term adverse effects from prolotherapy treatments.

The physicians at Valley Sports Physicians & Orthopedic Medicine have a long and successful history of using prolotherapy. In fact, they often give lectures and teach workshops to other physicians on prolotherapy, and Dr. Tortland is one of the first physicians in the country actually certified in Prolotherapy.

Please be aware that prolotherapy is NOT covered by most insurance plans.