Introduction to Prolotherapy
What is prolotherapy?
Prolotherapy is an injectable solution usually made up of a sugar
compound, a local anesthetic, distilled water and specific vitamins and
minerals. The physician injects the solution directly into an area that needs
more healing or stability. Often times, past injuries or surgery never fully
heal or just don’t heal correctly. When the fluid solution is injected, the
sugar compound, usually dextrose, irritates the area just enough to cause a small
inflammatory response. The body brings a fresh blood supply through increased
circulation with nutrients to the agitated area so healing can begin. The sugar
is easily absorbed by the cells into the body and the new cells are already in
the area ready to restart some of the healing process toward the old injury. Prolotherapy
works best and is most often used in joints and joint areas.
What treatments look like
First, the doctor will examine the area that may need additional
healing or strengthening. Most people complain of pain in areas that didn’t
heal correctly because the tissue is still damaged or the miss-healed tissues
are not allowing the joint to work properly. Keep in mind, joint areas that
didn’t heal fully are not necessarily painful, they might just be loose. The physician
I worked with, Dr. Amber Belt, would examine how loose the joint is and then
test to find the tenderer and painful points marking them with pen. She then
mixes the solution in a rather large syringe. In joints, she injects dextrose,
the sugar, and lidocaine, the local anesthetic. In more fleshy areas, her
solution consist of dextrose, lidocaine, distilled water, and vitamin B-12 --
which she has found helps tissues heal. With a needle long enough for the area
of treatment, she injects the solution deep into the most painful and loose
points of the area. The injection time only lasts a few seconds, and the
patient is quickly out of pain. For ideal outcomes, treatments are suggested to
take place every two to six weeks until the area is healed. Depending on the
patient and their situation, treatments may last a few months, or indefinitely,
as in the case of pain relieve for arthritis or other causes of chronic pain. Treatment is as individual as the patient and
his or her pain they he or she are seeking relief for.
Side effects
The doctor should first make sure the patient isn’t allergic to
anything in the injection solution. This is highly unlikely, unless the patient
knows specifically that they are allergic to local anesthetics like lidocaine. The
injections can be particularly painful but tend to be less painful the more the
procedure is done and as the area heals. Immediately after the injection, the
local anesthetic begins to numb the area. Though the area is “numb”, it will
often feel achy and “squishy”. The “squishy” sensation is especially noticeable
inside the joint where it is filled with fluid that would not normally be
there. In the day or two following, most people find the area particularly
sore. After the soreness subsides, the area seems to returns to what the
condition was before. The aimed effects of the treatments are not usually
noticeable for a few months of persistent treatment. Prolotherapy should not worsen
the condition or cause permanent harm.
Intended outcomes
Since the treatments I witness didn’t immediately relieve pain, I
wasn’t quite sure what I was looking for to tell if this was a viable way to
relieve pain. At first when I heard that the solution had a local anesthetic, I
thought that must be the relief causing variable in this type of treatment.
Though the local anesthetic does relieve some pain, it is intended for the
discomfort of the injection and the hours following. After enough treatments,
the healed tissues that used to send alarm pain signals to the brain no longer
have to. This type of treatment takes time and patience and won’t give most
people that quick relief that some are seeking. This type of treatment, in time,
will help heal and relieve pain for the long-term in some cases. Prolotherapy
is not ideal for acute injuries; there is no use to remind the body of a new
injury. Many patients find it successful in treating old injuries and as an
alternative to surgery. As I talked to patients early on in their treatment
program, they weren’t noticing the positive effects immediately; the majority
of these patients, however, remained hopeful and patient, knowing their healing
and relief would come in time. As I talked to the patients well into their
treatment plans, I asked what they had noticed change in their body and how
they could tell if the prolotherapy had been successful. Common answers
included increased range of mobility without pain, delayed onset of pain, and
fewer sharp pain episodes. The further the patient was along in their treatment
plan, it seemed the more promising and positive the results became. Over and
over again I heard stories of people not only avoiding surgeries such as total
knee replacements, but also being pain-free and able to move in ways they had
not moved in many years, sometimes even decades. The positive outcomes are
across the board. I am currently in the process of evaluating literature and
writing a systematic review to help fully conclude the effects of prolotherapy.
Prolotherapy can help treat pain and range of motion associated
with arthritis, old injuries, trigger finger, and carpal tunnel. Almost all
joint and joint areas can be treated with prolotherapy according to Dr. Belt;
hips, knees, feet, shoulders, and even fingers can be treated. Prolotherapy can
be more successful in some cases if it is accompanied with physical therapy for
that targeted area.