Prolotherapy, is a technique consisting in injecting certain tissue irritating substances like for example hypertonic glucose (sugar water) among others, that when injected into precise points, stimulates healing and tissue regeneration and repair. It stimulates tissue to proliferate (therefore the name of prolotherapy) and heal. This may not sound like a cutting-edge medical technique, but a growing number of doctors are now following the teachings of the father of Prolotherapy, Dr. George Hacket MD from Canton, Ohio. He is considered the father of Prolotherapy because he brought this technique to mainstream medicine. His research was published in some of the main medical journals of his time and presented at the prestigious American Medical Association meetings starting in June of 1955. Some of the statistics on his research include: 1) Sample size: 1,656 patients, 2) Patient age range: 15 to 88 years old, 3) Duration of the discomfort: three months to 65 years, 4) Average duration of symptoms: four and a half years, 5) Duration of study: 19 years, 6) Number of injections given: 18,000
There is, to say the least, an amazing amount of convincing evidence that the technique can provide long lasting results. A more familiar name to you, former United Stated Surgeon General, C. Everett Koop MD, himself a patient treated with prolotherapy, wrote the Preface of the book “Prolo your pain away!” and consider it “A must read for anyone experiencing chronic musculoskeletal pain”.
In Dr. Hacket study twelve years after treatment, an impressive 82 percent of the patients considered themselves cured. Dr. Hackett also proved in the laboratory that Prolotherapy induces the growth of ligament and tendon tissue and is especially effective at strengthening the weld of these structures to the bone, by proliferating their fibro-osseous junction. Dr. Gustav Hemwall from Oak Park, Illinois continued the studies of Dr. Hacket after his retirement and again he found that the great majority of patient who completed treatment with Prolotherapy obtained relief.
Unfortunately, major medical insurance companies view prolotherapy as investigational or experimental therapy and do not cover its cost. Medicare also has decided not to cover prolotherapy injections but has expressed willingness to reconsider it down the road.
How does prolotherapy work?
The beauty of Prolotherapy is that it is a natural technique that stimulated the body by providing a little assistance to the body’s own healing mechanisms. Notice that I said a little assistance, because oftentimes that is all that is needed for the body to heal itself. Other measures such as surgery, joint replacements, and powerful pain medications interfere with the body’s own healing mechanisms and additionally are more traumatic, more dangerous, more expensive and often require long periods of rehabilitation and expose the patients to dangerous and debilitating complications.
The basic technique in prolotherapy consist in injection a proliferative/irritating solution of homeopathic ingredients such as dextrose (sugar water) along with saline solution and local anesthetics to stimulate the proliferation and regeneration of the target tissue such as ligament and tendons to accomplish healing and long lasting relief of the discomfort. This causes an inflammatory response at the injection site that signals your body own stem cells, chondroblast, fibroblast and other cell to proliferate and produce new connective and other tissues to repair and strengthen the affected area tendon and ligaments. For this injection to work, they have to be precisely placed at the junctions of bone and ligaments and bone and tendons. These points are called Ah Shi point in acupuncture and have been used for thousands of year in Acupuncture for the treatment of painful conditions. These are points in the body with very marginal blood supply and precisely for that reason nutrients do not easily get to these tissues and waste products are not removed and when injury occurs in these areas they do not heal well if at all. We need to help them heal with Prolotherapy.
The tendons and ligaments in our body provide stability to our joints and structure to our body. They are not like muscles or rubber bands that have the capability to go back to their original shape. These tendons and ligament when they get stretched out they stay stretched out. This leads to what is called ligamentous laxity, i.e. loose ligaments. Now we have loose ligaments holding bone together and this leads to unstable joints that do not function properly and feel like they are sloshing around and may lead to clicking sounds. This looseness of the joints leads to bone grinding, damage of the cartilage and pain. Additionally in an attempt to stabilize loose joints, the surrounding muscle may go into spasm and this may cause additional pain.
Studies done using knee ligaments of animals have shown that injecting proliferant solutions on five subsequent sessions over a six week period, increased ligamentous mass by 44%, ligamentous thickness by 27% and ligament-bone junction strength by 28%. This is another piece of evidence that prolotherapy is effective. This repair of loose and damaged ligaments and tendons is the desired result of Prolotherapy.
Who will benefit from prolotherapy?
1) Since Prolotherapy take maximum advantage of the immune system, those patients with a compromised immune system may not be able to mount a sufficient inflammatory response to grow new tissue and benefit from prolotherapy. Additionally people with autoimmune disease like Lupus, MS, Myasthenia Gravis, etc. may have such an over reactive immune system that it may interfere with Prolotherapy.
2) Because of the intimate relationship between the immune system, the endocrine system and the nervous system, patients with nervous system problems of endocrine system problems may not allow the immune system to mount the needed inflammatory response needed to create and regenerate new tissues.
3) At times some patients have emotional issues that may prevent ANY technique from resolving a particular painful condition.
Finally remember that the need for more than one visit does not mean that prolotherapy is not working. Most conditions will require five or six subsequent treatment to obtain results. And like with anything else in life, remember that for example just because you painted your house once, it does not mean that it will never require painting again.