Prolotherapy

Prolotherapy refers to “proliferative therapy;” a technique whereby a physician injects an osmotic solution into a tendon or ligament to stimulate regeneration, or proliferation, of tissues. The solution can vary, but it may include calcium gluconate, dextrose, lidocaine, procaine, and/or B vitamins. Platelet Rich Plasma (PRP) may be used instead as the proliferant. Some prolotherapists even use stem cells, but this can be cost prohibitive for most people.

Indications for treatment include but are not limited to the following: tendinopathies, osteoarthritis, strains, sprains, partial tears of ligaments and tendons. There are some documented cases of full-thickness tears being completely regenerated by prolotherapy, including the Achilles tendon and rotator cuff attachments.

Prolotherapy Can Treat:

Joint Instability

Signs of joint loosening and instability such as popping, grinding, clicking, or snapping.

Common Conditions

Carpal tunnel syndrome, rotator cuff tears, and temporal mandibular joint issues.

Support Aids

Conditions helped by a brace, splint, crutch, walker, lift, or wheelchair.

Any popping, grinding, clicking or snapping in a joint (all of these signs of joint loosening and instability).
Any joint which is only partially helped by osteopathic or chiropractic adjustments/manipulations (or when adjustments or manipulations help but do not hold.
Manipulation frequently makes big improvements quickly. If prolonged Manipulation is necessary this is an indication of joint instability and injection reconstructive therapy may be helpful.
Any musculoskeletal problem which has failed with surgery and other methods.
Any condition which is helped by a brace, splint, crutch, walker, lift or wheelchair. People that need these aids frequently have weakened or lax joints.
Deep aching which is alleviated some by constantly changing positions.
Symptoms of decreased strength and endurance Increased pain with increased activity (swimming, biking and walking may be exceptions).
Various conditions such as osteoporosis with compression fractures, muscular dystrophy, multiple sclerosis and spinal defects such as scoliosis and spondylolisthesis (slipped spine).
Any joint which swells chronically may be a candidate for resolution with this therapy. Swelling may be an indication of chronic friction from instability.
Any joint, tendon, ligament, cartilage, for which cortisone, Indocin, Naflon, Clinoril, Feldene, Motrin or other anti-inflammatory drugs has been used may respond to reconstructive joint injection therapy.
Conditions like carpal tunnel syndrome, rotator cuff tears and temporal mandibular joint dysfunction may also respond to joint reconstruction injection therapy because joint, ligament, tendon, disc and cartilage weakening are involved.

Prolotherapy crudely dates back to 400 BC with Hippocrates and was later really attributed to physicians in the U.S. In the 1920’s George S. Hackett, MD of Canton, Ohio and Gedney and Shumann, both osteopathic physicians in Philadelphia, successfully treated patients with the technique. Since pharmaceutical companies cannot patent the solutions used as proliferants, and the insurance based American health care system promotes expensive surgeries when patients incur injuries, there is no widespread endorsement for this minimally invasive technique.

McDonagh Medical Center physicians were initially trained by Bill Faber, DO, a member of The American Osteopathic Association of Prolotherapy Regenerative Medicine (AOAPRM), which is the oldest prolotherapy association in the US dating back to 1938. McDonagh Medical Center has been practicing prolotherapy for 30 years.

A physician must receive special training in the use of proliferants and the techniques. Patients must also have good biochemistry status to heal areas which lack good blood supply. Many people assume that if they have no symptoms after an injury or if the symptoms last for only a few weeks, their bodies have completely healed their damaged structures, such as tendons, joints and ligaments. While the body has an inherent capacity to heal itself, it does have limitations and it typically heals itself to a “good enough” point. Years following an injury, degenerative symptoms can present as biochemical problems can exist for many years before a symptom appears.

To help facilitate tissue repair and proliferation, McDonagh Medical Center physicians recommend a regimen of high quality supplements to coincide with prolotherapy, and sometimes even IV EDTA therapy. The physicians may develop a customized detoxification program using natural methods to remove waste products left by drugs, pollutants, food additives and poor diet.

Bowel and dietary changes are also often recommended as a poor diet and slow digestion may hinder positive results from treatment. A number of our patients present after having failed a course of physical therapy and corticosteroid injections, with the next intervention being surgery. A common misconception regarding tendons and ligaments is that these structures gain strength with exercise. This is incorrect. This is because there are no muscle fibers in a tendon or ligament. The non-surgical joint, tendon and ligament therapy is indicated for joint, tendon and ligament problems which exercise and all other methods fail to help.

The cost invested for this therapy is usually only a fraction of what a surgery costs, without the risks of anesthesia and surgery itself. The goal of the therapy is to eliminate pain, improve range-of-motion of joints, return to Activities of Daily Living (ADLs), and to regain independence.

George Hackett, MD in 1956

University of Iowa in 1983 and 1985

Sansun Research Foundation in 1987 in a double-blinded human study, The Lancet, 1987.

McDonagh Medical Center “Magnetic Resonance Imaging Evidence of a Reduction in Disc Herniation Using a Combination of EDTA Chelation and Joint Reconstructive Therapy”. Journal of Advancement in Medicine, Volume 5, Number 4, Winter 1992.

Grote, DO, Walter, et. al. Repair of a complete anterior cruciate tear using prolotherapy: a case report. Int Musculoskelet Med. 2009 December 1; 31(4): 159–165. doi:10.1179/175361409X12472218840924.

Lazzara, Marc Adam, DO. The Non-Surgical Repair of A Complete Achilles Tendon Rupture by Prolotherapy: Biological Reconstruction. A Case Report. Journal of Orthopaedic Medicine. 1 Jan 2005.