Prolotherapy also called proliferation therapy or regenerative injection therapy is a treatment of tissue with the injection of an irritant solution into a joint space, weakened ligament, or tendon insertion to relieve pain and to stimulate healing.
The concept of creating irritation or injury to stimulate healing has been recorded as early as Roman times where hot needles were poked into the shoulders of injured gladiators. Prolotherapy originated in the 1930's when Dr. Earl Gedney, an osteopathic surgeon successfully treated his own severe hand injury and was originally used in the treatment of ligamentous laxity. In the 1950s Dr. George S. Hackett, a general surgeon in the United States, began performing injections of irritant solutions in an effort to repair joints and hernias, effectively starting the basis for modern Prolotherapy. Dr. Gustav Hemwall, one of the earliest students mastered the technique and subsequently brought it to the notice of other physicians.
Joints weakened by trauma and overuse, become hypermobile and painful when ligaments and tendons attachments are stretched and torn.
With an injection of a mild irritant solution directly on the site of the torn or stretched ligament or tendon, Prolotherapy creates a mild controlled injury that stimulates the body's natural healing mechanisms to lay down new tissue on the weakened area. The mild inflammatory response that is created by the injection encourages growth of new ligament or tendon fibres, resulting in a tightening of the weakened structure. Additional treatments repeat this process, allowing a gradual build-up of tissue to restore the original strength to the area.
Thus, Prolotherapy relieves pain by directly impacting the underlying condition causing that pain, in contrast to other methods such as Painkillers and Steroid injections that may provide temporary pain relief.
The primary component injected in Prolotherapy is Glucose. A local anaesthetic is also added to prevent discomfort at time of injection.
As a local anaesthetic is given along with the injection, the injection is only mildly discomforting. The mild discomfort passes fairly rapidly and can be reduced with pain relievers such as Paracetamol. The treatment may result in mild swelling and stiffness.
According to the area or joint involved and the intensity of pain, treatment can be administered every two weeks (fortnightly) or four weeks (monthly). Normally three to five sessions of treatment is required.
This form of therapy can be used to treat different joints; such as knee, hip, ankle, wrist, elbow and shoulder. In addition, the cervical, thoracic and lumbar spine including the sacroiliac joints can also be treated. Prolotherapy is also successful in the treatment of carpal tunnel syndrome and temporal mandibular joint dysfunction.
Prolotherapy is safe as the major component of the injections is Glucose. Mild Pain and Irritation at the site quickly subsides and if necessary. Very rarely, pain may persist up to 72 hours and can be relieved with Paracetamol. Infection is very rare (1 in 300,000 injections.)