What is prolotherapy?
Prolotherapy is a treatment used to treat joint ailments. The treatment involves injecting a natural irritant (dextrose) into the soft tissue of an injured joint to produce a mild inflammatory response. This begins a healing response. The treatment itself or in combination with other therapies, such as spinal manipulation, has been shown to improve disability in cases of arthritis, low back pain and tendon injury.
How does prolotherapy work?
The treatment initiates a healing cascade that duplicates the natural healing process of poorly vascularized tissue such as ligaments, tendons, and cartilage. After injection with a solution containing dextrose the body produces a mild inflammatory response. This is followed by a proliferation cascade where more collagen is deposited in ligaments, cartilage and tendons. This increases the strength of the tissue and pain resolves.
Confirmation that prolotherapy induces the repair of ligaments and other soft tissue structures has been reported in both animal and human studies. Prolotherapy injections to rabbit ligaments increased ligamentous mass (44%), thickness (27%), as well as ligament-bone junction strength (28%) over a six-week period. In human studies, biopsies revealed a 60% increase in ligament size after prolotherapy injections. Another study relying on ultrasound also showed that treatment with prolotherapy increased ligament size by 27%.
Who will benefit from prolotherapy?
Most patients with chronic joint pain and instability will benefit from prolotherapy. Prolotherapy can provide permanent relief from joint pain. Anyone considering surgery for a chronic joint injury may want to consider prolotherapy first.
How effective is prolotherapy?
Studies show that prolotherapy helps to reduce pain and disability in arthritis and tendon overuse injury. When compared to other therapeutic injections, prolotherapy compares favorably with other commonly used injections including hyaluronic acid and corticosteroid injections.
Corticosteroid injections tend to provide symptomatic relief quickly but usually benefits are short lasting whereas prolotherapy tends to provide improvements long term. In patients with sacroiliac joint pain, almost 60% of patients having received prolotherapy injections had improvements in pain of more than 50% after 15months vs. only 10% of patient having received steroid injections. Similar results were found when it comes to treating osteoarthritis of the hand. Prolotherapy was found to be more effective that corticosteroid injections especially in the long term. Prolotherapy was also more effective at improving function.
There is preliminary information showing that prolotherapy is likely helpful in most joint conditions including temporomandibular dysfunction.- Research shows that in rotator cuff injuries, prolotherapy improves range of motion and shoulder function. Similar results were obtained for arthritis of the knee with results demonstrating that prolotherapy reduced pain, improved function and quality of life when compared to patients receiving salt water injections.-
For knee osteoarthritis, patients receiving an average of four prolotherapy treatments had a 17.2% improvement in pain after four weeks and a 36% improvement after 52 weeks. In other studies, prolotherapy was shown to be effective at relieving pain in the short, medium and long term without significant side effects.
Prolotherapy is particularly effective when combined with other therapies such as spinal manipulation.
Prolotherapy for instability of the upper spine
Chronic neck pain is often a symptom of an unstable cervical spine. The presence of excessive motion between two consecutive vertebras is known as cervical instability. When ligaments in the neck are injured they become elongated. Sometimes this comes from a traumatic injury such as whiplash or concussions but it can also be the result of constant stain inflicted by poor posture. This allows for more motion between vertebras and irritates the facet joints - the joints that, together with our neck ligaments, provide stability to the spine. This instability irritates the facet joint and leads to pain, headaches and referred pain. This instability also severely increases the risk of developing arthritis and other chronic degenerative changes to the spine. Studies show that facet joint pain is responsible for the majority of neck pain. The treatment needs to be aimed at repairing the ligaments in the neck to restore some stability. This is precisely what prolotherapy does.
Cervical instability can also lead to the compression of the vagus nerve. The nerve is a major component of the parasympathetic nervous system. As such, it helps to control mood, immune response, digestion and heart rate. Compression of the vagus nerve affects our ability to regulate the stress response and can lead to significant disability and mood problems such as anxiety.
What are the potential side effects?
As with any treatment, potential side effects are possible but rare. Most studies report decrease pain and disability with the use of prolotherapy. Although serious adverse effects are exceedingly rare, benign reactions such as temporary post-injection pain, stiffness, and bruising are common.
Dr. Ludo Brunel is a Naturopathic Doctor and is certified in administering Prolotherapy. Please contact Cadence Chiropractic, Sport & Health to learn more about Dr. Ludo and what he can do for you at 403.521.2278
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