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Prolotherapy: Innovative Way to Heal Ligament, Tendon, and Cartilage Injuries
By Jason Barker
Tendons and ligaments are tough elastic fibers that essentially hold us together. Tendons connect muscles to bone and assist in the movement of a joint. Ligaments attach bone to bone and keep joints stable. And in between bones, cartilage is a similar material that acts as a shock absorber.
These connective tissues can become damaged in any number of ways; the most common are strains and sprains. A strain is defined as an injured tendon, and a sprain is defined as an injured ligament. There are several grades, or degrees of severity, for both kinds of injury. Cartilage damage usually results in a tear, which might need to be surgically repaired.
It is possible to heal from strains and sprains and minor cartilage tears. However, if the process is incomplete, the once strong and taut connective tissues become more lax and weak. It is theorized that much of the joint pain we experience is the result of a chronic weakness or injury to the connective tissues supporting the joint.
The good news is that connective tissue injuries that don’t respond to conservative treatments like rest, icing the affected area, and physical therapy can be repaired with a natural technique called prolotherapy.
In prolotherapy, a solution of dextrose (sugar water) and a local anesthetic is injected into the damaged area. The injected solution is referred to as a proliferant, because it will trigger the proliferation of new connective tissue; hence the name “prolotherapy.”
The solution triggers a localized inflammatory response, which in turn directs the body to create new collagen, the substance from which connective tissue is made. Prolotherapy does not create scar tissue; rather it is a way to directly repair and regenerate healthy connective tissue.
By creating inflammation, prolotherapy exactly mimics how the body tries to repair tissue on its own and results in a repaired, stronger tendon, ligament, or cartilage. While inflammation is typically given a bad rap, it is also a necessary and beneficial process for healing and repair, especially when it can be limited to certain areas.
For the person receiving prolotherapy, it is important to remain active or incorporate activity as part of the treatment plan. In fact, patients are encouraged to start moving the day after receiving treatment.
Movement is important, because connective tissue will heal and strengthen when force is placed upon it — and that force should be the normal stress we place on our bodies by walking, running, or simply using the affected joint. As a person continues to exercise after prolotherapy, the connective tissues have a much better chance of healing because of the increased blood flow to the connective tissue.
Because everyone heals differently, the number of injections and length of time to heal varies. Typically, one may need four to six injections per area, given once every two weeks. Pain resolution can occur anytime from the days right after treatment to several weeks or months later. Treating damaged tendons and ligaments and minor cartilage injuries with prolotherapy can eliminate the cause of pain. Once repaired, tendons and ligaments are stronger, and quite often the person is able to return pain-free to their sport.
Prolotherapy was pioneered in the 1930s. More recently, prolotherapy is experiencing a resurgence in popularity because of its simple, safe approach, as well as its benefits in resolving pain and keeping people active. In many cases prolotherapy can keep people from undergoing surgery or taking anti-inflammatory medications for the rest of their lives. In fact, anti-inflammatory medications (non-steroidal anti-inflammatory drugs, or NSAIDS) are part of the reason why connective tissues do not heal properly; the drugs actually inhibit cartilage repair.
Prolotherapy is useful for a number of conditions. Thus, getting a proper diagnosis is important in order to determine if prolotherapy is indicated.
Prolotherapy is a specialty procedure that many different kinds of physicians can perform. Naturopathic doctors (ND), osteopathic doctors (DO), and medical doctors (MD) can all perform prolotherapy. Chiropractic physicians (DC) cannot perform prolotherapy, but they can give a referral to a physician who does. Not all doctors have heard of it, so you may need to ask around for a qualified provider.
Jason Barker, ND, is a general practice and sports medicine physician. His practice is at Back In Motion Sports Injuries Clinic in Beaverton, OR. He can be reached at 503-524-9040 or www.drjasonbarker.com. |
