Prolotherapy Q & A

by Rainer Fischer, ND

What Is Prolotherapy?

Prolotherapy — short for proliferative therapy — is an orthopedic procedure that involves injections into tissues and joints. It is used to stabilize joints by helping to strengthen and repair ligaments and tendons that have been stretched or torn. Originally called “sclerotherapy” (“sclera” means “scar”), this treatment originally included injections into joints, ligaments, tendons, blood vessels and hemorrhoids. Today, “prolotherapy” is used exclusively to refer to joint, ligament, and tendon injections.

How Does Prolotherapy Work?

Prolotherapy stimulates the body’s natural healing mechanisms. The body responds to an injury with an inflammatory response that increases the circulation to an area to bring in extra blood cells, along with infection-fighting and healing substances. In tendons and ligaments, which don’t have a good blood supply, the inflammatory response may not last long enough to effect complete healing. Prolotherapy tricks the body into thinking it has a new injury, which stimulates the inflammatory response.

What’s in the Injections?

The treatment is tailored to the individual patient, but generally speaking, prolotherapy injections contain natural substances to stimulate healing and some sort of local anesthetic. The local anesthetic — usually sarapin, procaine, or lidocaine — prevents the injection from being painful. Other ingredients include sterile sugar or salt solutions. Injections may include platelet-rich plasma — a concentration of platelets from the patient’s own blood. Platelets contain proteins that promote healing. Some physicians also use stem cells, which are also known to stimulate healing.

What Else Do I Need to Know?

The history of the injury and the length of time since the original injury can make a difference, and the patient’s overall health and ability to heal are also factors. Underlying nutritional deficiencies, chronic diseases, and circulatory problems can impede the healing process. Prolotherapy is typically used for problems like degenerative disc problems, tendon and ligament tears, plantar fasciitis, tennis elbow, or golfer’s knee. Treatment intervals vary, but a common pattern is a treatment every three to six weeks, for a total of four to six treatments.