Prolotherapy is short-form for “proliferative therapy”. This type of injection therapy is used for damage and injuries to tendons, ligaments, and joint capsules. It involves injecting dextrose with an analgesic solution (most commonly, procaine) to help promote proliferation of the connective tissue in the tendons, ligaments, and cartilage/connective tissue within joint capsules. This helps to add stability to the joint. The proliferation happens due to dextrose stimulating a controlled inflammatory response which aids in tissue repair through bringing platelet-derived growth factors to the site of injection. These growth factors help create the collagen connective tissue framework. Over time, this framework remodels itself and becomes stronger. The more injections, the more opportunity for the connective tissue to develop better tensile strength.
Inflammation is necessary for tissues to heal and repair and problems arise when the inflammation is prolonged or gets out-of-control. This makes prolotherapy great for chronic musculoskeletal pain involving strains, sprains, partial tears, arthritis, and other joint capsule injuries.
Treatments are typically every 3-4 weeks and 4-6 treatments are usually recommended for prolonged injuries. Most individuals will experience pain relief after the first few treatments but some may not experience relief until the 5th treatment. For an acute situation, one or two treatments may be sufficient.
Prolotherapy can benefit the following conditions:
Partial ligament tears / sprains
Partial tendon tears / strains
Medial Tibial Stress Syndrome (Shin Splints)
Neural prolotherapy is a prolotherapy technique that uses a lower dose of dextrose and is used to help with neurogenic pain and inflammation “nerve pain”. The reason for using a lower dose of dextrose is because the goal is not to proliferate and grow new tissue but rather to stop the pain-producing signals from the nerves (reduce the amount of Substance P). This reduces inflammation in the nerves.
Trigger Point Injections
Trigger point injections use procaine (an analgesic) along with vitamin B12, magnesium, or other therapeutic injectable solutions to help relieve trigger points in muscles. These are great for athletes or anyone involved in any form of physical activity and has developed tight muscles or notices ‘knots’ in their muscles which creates pain as the muscle is unable to relax completely. Trigger points can be identified through palpation of your muscle and identifying areas of pain that feel harder than normal.
Mesotherapy / Biopuncture / Neural Therapy
Please note that these injection therapies do not address the root cause and are a therapy to help rebuild strength in your joints, tendons, and ligaments so you can perform activities of daily living that you once used to. It is recommended to limit stress on the affected area for a few weeks after the injection treatments and gradually return to your regular activity level.
If you are susceptible to chronic injuries or delayed healing from injuries, there may be an imbalance at the physiological level that should be addressed such as autoimmune diseases, chronic inflammatory conditions, hormonal imbalances, and, poor digestive health. A more in-depth naturopathic initial visit can help to identify these areas.
Chiropractic treatments are recommended prior to the injection to help with joint mobilization and massage therapy is recommended after the injection to help with moving the fluid around the affected area.
It is advisable to not take any anti-inflammatories (Advil, ibuprofen, Curcumin, Turmeric, Aspirin, Boswellia etc) for 2-3 days prior to your prolotherapy treatment and 2-3 days after. This allows for the controlled inflammatory response needed for tissue repair to take place. If you are wanting to take something for pain, Tylenol is okay.
***Prolotherapy and pain management injections are available at Ascent Integrative Health (Downtown location). Prolotherapy treatment is covered under extended health benefit plans that cover “naturopathic services”***
****Please note at this time Dr. Shah is currently trained in prolotherapy for shoulders, hips, knees, and ankles