Prolotherapy Injections

What is prolotherapy? 

Prolotherapy is also known as proliferation therapy or regenerative injection therapy. It is a nonsurgical technique that uses injections of concentrated dextrose solution which stimulates growth factor production to treat injured connective tissues. Studies have shown that this procedure helps stimulate the body’s natural healing mechanisms by placing an injection into weakened and painful tissue which causes a mild inflammatory response that “tricks” the body to go into repair mode.

The injections are typically a preparation of an “irritant” solution containing dextrose, saline, and a commonly used anesthetic such as lidocaine. Prolotherapy is often a second-line treatment if initial treatments have been ineffective. It requires monthly injections for at least 4-6 months to adequately treat injured tissue and is normally accompanied by physical therapy to maximize therapy.

Prolotherapy is used for long term connective tissue health and may be used in some patients to prolong the need for surgery. Prolotherapy is often used in athletes or active individuals who do not want any down time because the procedure does not require long beaks in activity.

Studies have shown that prolotherapy may allow some patients may push back the need for surgery or avoid surgery on injured tissues altogether. Athletes and active patients may choose prolotherapy because it normally doesn’t require long breaks in activity.

Who may benefit?

You may be a candidate for prolotherapy if you have one of these conditions:

• Chronic back pain
  
• Sacroiliac pain. The sacroiliac joint is where the sacrum and the iliac bones meet. The sacrum is located at the base of your spine and sits in the middle of the iliac bones. The iliac bones are the large bones that make up your pelvis.
  
• Osteoarthritis of the knee, ankle, foot, shoulder, elbow, fingers or hip
  
• Tendinopathy, Rotator cuff, lateral and medial epicondylosis (tennis or golfer’s elbow), patellar (Jumper’s knee), Achilles, IT band
  
• Plantar fasciosis
  
• Osgood-Schlatter disease
  
• Chronic groin pain in athletes
  
• Temporomandibular joint (TMJ) pain 
  
• Hypermobility 

Contraindications

• Have an active infection such as cellulitis, local abscess, or septic arthritis
• Patients with bleeding disorders or patients on blood thinners. These patients are reviewed on an individual basis 
• Are unable to understand or comply with rehabilitation instructions following the procedure 

Relative contraindications include:

• Pregnant patients during the first trimester
• Immunocompromised patients. These include cancer patients who are actively receiving treatment, organ transplant recipients who are taking medications to suppress their immune system, people with HIV and people who take high-dose corticosteroids like prednisone or other medications to suppress their immune response.

What are the risks of prolotherapy?

Prolotherapy performed by an experienced physician is considered to be relatively safe. All medical procedures are associated with some level of risk. For example, patients may have side effects that occur with any needle injection. These include mild bleeding and temporary discomfort or pain flare lasting up to 7 days. With any needle injection there is risk of infection but is significantly reduced by using sterile technique. 

Serious side effects and complications are rare, but include:

• Allergic reaction
• Bleeding
• Nerve damage
• Infection
• Pneumothorax