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Prolotherapy: Repair damaged tendons, ligaments and joints

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In recent years, there has been much excitement about the use of platelet rich plasma (PRP) and stem cell therapies derived from bone marrow to treat torn ligaments and tendons and joint pain especially in professional athletes.

These therapies are in fact a form of prolotherapy, an injection treatment option that holds its roots back to 1930’s.

What is prolotherapy?

Prolotherapy stands for proliferation therapy. Prolotherapy is a form of injection therapy where a mild irritant solution such as dextrose is injected into the injured area to create a controlled area of inflammation. It is also form of sclerotherapy where tendons and ligaments are thickened and tightened. This doesn’t provide immediate relief but usually requires multiple injections over the course of a few months. However, the pain relief from repair of damaged tissue tends to be lasting and permanent.

Modern day prolotherapy owes its origins to the innovation of Earl Gedney, DO, an osteopathic physician and surgeon. In the early 1930s, Gedney caught his thumb in a surgical suite door, stretching the joint and causing severe pain and instability. After being told by his colleagues that nothing could be done for his condition and that his surgical career was over, Dr. Gedney did his own research and decided to “be his own doctor.” He injected his own thumb with prolotherapy solution. It worked! His thumb pain was gone. After recovering, he injected patients with knee pain and low back pain, successfully relieving their pain. Researches later found that collagen was being produced at the injection sites and it was a reproducible event. Prolotherapy has been found to effectively treat many musculoskeletal conditions, including tendinopathies, ligament sprains, back and neck pain, tennis/golfer’s elbow, ankle pain, joint laxity and instability, plantar fasciitis, shoulder, knee, and other joint pain. PRP and adult harvested stem cells are in fact also a form of prolotherapy.

The major benefit of using PRP over dextrose would be a smaller number of treatments required to relieve pain and heal the injured area. (1-2 with PRP and stem cells vs 4-5 for dextrose solution)

Its not the prolotherapy, PRP, or stem cells injected: it’s the expertise of placing the solution at the site of injury.

Regardless of the injectable solutions used, the patient’s innate ability to heal must be considered. This means the practitioner must consider the patient’s systemic medical issues such as diabetes, history of smoking, diet and lifestyle, nutritional status, and hormone balance. Also, avoiding any steroids and non-steroidal anti-inflammatories such as aspirin, ibuprofen, and naproxen during the healing process is useful for about 2 weeks before treatment and a month after treatment. Additionally, any new injuries may detract from the area that we want to heal.

Can a patient fail prolotherapy?

Yes. In addition to the issues above such as smoking and taking anti-inflammatories, there are inappropriate placement of the injectable solution and inadequate innate ability of the patient to heal. Correct these 2 issues, and prolotherapy simply gets results.

Contact the experts at Southwest Pain Management to learn more about this therapy.

AUTHOR: Dr. Robert Groysman MD

Dr. Robert Groysman is a Diplomate of the American Board of Anesthesiology and American Board of Pain Medicine, and a proud member of the Texas Pain Society, American Society of Interventional Pain Physicians, and Spine Intervention Society. He participates in research, frequently attends professional conferences, and continually adopts new procedures and techniques for relieving pain into his practice at Southwest Pain Management.

In recent years, there has been much excitement about the use of platelet rich plasma (PRP) and stem cell therapies derived from bone marrow to treat torn ligaments and tendons and joint pain especially in professional athletes.

These therapies are in fact a form of prolotherapy, an injection treatment option that holds its roots back to 1930’s.

What is prolotherapy?

Prolotherapy stands for proliferation therapy. Prolotherapy is a form of injection therapy where a mild irritant solution such as dextrose is injected into the injured area to create a controlled area of inflammation. It is also form of sclerotherapy where tendons and ligaments are thickened and tightened. This doesn’t provide immediate relief but usually requires multiple injections over the course of a few months. However, the pain relief from repair of damaged tissue tends to be lasting and permanent.

Modern day prolotherapy owes its origins to the innovation of Earl Gedney, DO, an osteopathic physician and surgeon. In the early 1930s, Gedney caught his thumb in a surgical suite door, stretching the joint and causing severe pain and instability. After being told by his colleagues that nothing could be done for his condition and that his surgical career was over, Dr. Gedney did his own research and decided to “be his own doctor.” He injected his own thumb with prolotherapy solution. It worked! His thumb pain was gone. After recovering, he injected patients with knee pain and low back pain, successfully relieving their pain. Researches later found that collagen was being produced at the injection sites and it was a reproducible event. Prolotherapy has been found to effectively treat many musculoskeletal conditions, including tendinopathies, ligament sprains, back and neck pain, tennis/golfer’s elbow, ankle pain, joint laxity and instability, plantar fasciitis, shoulder, knee, and other joint pain. PRP and adult harvested stem cells are in fact also a form of prolotherapy.

The major benefit of using PRP over dextrose would be a smaller number of treatments required to relieve pain and heal the injured area. (1-2 with PRP and stem cells vs 4-5 for dextrose solution)

Its not the prolotherapy, PRP, or stem cells injected: it’s the expertise of placing the solution at the site of injury.

Regardless of the injectable solutions used, the patient’s innate ability to heal must be considered. This means the practitioner must consider the patient’s systemic medical issues such as diabetes, history of smoking, diet and lifestyle, nutritional status, and hormone balance. Also, avoiding any steroids and non-steroidal anti-inflammatories such as aspirin, ibuprofen, and naproxen during the healing process is useful for about 2 weeks before treatment and a month after treatment. Additionally, any new injuries may detract from the area that we want to heal.

Can a patient fail prolotherapy?

Yes. In addition to the issues above such as smoking and taking anti-inflammatories, there are inappropriate placement of the injectable solution and inadequate innate ability of the patient to heal. Correct these 2 issues, and prolotherapy simply gets results.

Contact the experts at Southwest Pain Management to learn more about this therapy.

AUTHOR: Dr. Robert Groysman MD

Dr. Robert Groysman is a Diplomate of the American Board of Anesthesiology and American Board of Pain Medicine, and a proud member of the Texas Pain Society, American Society of Interventional Pain Physicians, and Spine Intervention Society. He participates in research, frequently attends professional conferences, and continually adopts new procedures and techniques for relieving pain into his practice at Southwest Pain Management.

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