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Prolotherapy

  • It is a safe and effective injection treatment
  • Suitable for various conditions i.e ligament strains, tendinopathy
  • Fast tracks healing

What is Prolotherapy

Prolotherapy has been used by health professionals for many years.  It was first developed by a USA surgeon, George Hackett in the 1940s and has since been researched by many other doctors and refined to what it is today:

A safe, effective injection treatment that provides increased strength in joints, ligaments, and tendons by making new connective tissue.

The solution used is usually 25% glucose or less, mixed with a local anesthetic called lignocaine. Prolotherapy has been shown to eliminate even chronic longstanding back, neck, and joint pain.

 

What is Involved In Treatment?

The palpation of pain around the area of injury will determine the injection site.

The local anesthetic in the solution takes effect immediately, relieving pain for a short duration. This can be useful diagnostically, especially if there has been some doubt about where the pain is coming from.

The glucose solution injected then causes the body’s own inflammation process to begin and start the healing process. Pain may occur and last around 2 days. Pain relief may be necessary, such as panadol but NSAID’s are to be avoided during this time.

How Many Treatments?

A series of  2 – 6 for the foot, while the knee is variable.

The spacing of the treatments varies from weekly to monthly, with fortnightly being the timing of choice.

 

What Conditions is Prolotherapy Used For?

Ligament Strain

Ligaments attach bone to bone and are responsible for providing joint stability and protection. Therefore strained ligaments leave muscles and joints weak and unprotected, causing muscle spasms and instability.

Strengthening ligaments in the lower limb (e.g sprained ankles) and many other injuries, has been the primary goal of prolotherapy treatment for years.

There are over 60 research reports published in medical journals showing that the technique is more effective than most other treatments for these problems.

Mobility has also been shown to increase with this type of treatment. This is because stiffness is often due to protective muscle spasms, and once the pain from the ligaments is relieved the muscles relax.

 

Tendinopathy

Tendons attach muscles to bone and when overused they become painful and occasionally fail to heal due to excess of a specific growth factor VEGF.

The thick or torn tissue is seen on diagnostic ultrasound, with modern techniques, also showing neovessels around the tendon. These neovessels have nerves alongside them which are very painful.

The usual treatment for tendinopathy in knees and ankles (i.e the Achilles tendon) is managing training loads and strengthening exercise, which can take months. Prolotherapy treatment allows the healing to occur much quicker as the glucose in the prolotherapy solution inhibits VEGF.

 

Neuropathic pain

Pain can be due to direct injury to the nerves. If there is damage or restrictions of the nerve fibres this will reduce the flow down of nutrients, necessary to repair the trunk of the nerve, causing it to become painful and tender all along the nerve.

Inflammation in the nerve (neurogenic inflammation) also causes inflammation in the soft tissues and joints, preventing healing. The glucose in the prolotherapy injections allows healing in the nerve itself and the tissues it supplies.

The development of this technique was by Dr John Lyftogtin NZ. It uses very fine short needles to treat the cutaneous nerves that are very close to the skin.

 

Osteoarthritis

Ligaments are vital for joint stability and protection. If strained and loose, the joint moves out of the track it was designed to follow, and the cartilage becomes worn causing osteoarthritis and associated pain.

Prolotherapy for worn joints (knees, ankles) involves treatment of the ligaments around the joint and usually injection into the joint, as it also stimulates regrowth of cartilage. This has been seen on X-ray in some knees.

Precautions to Aid Treatment

Pain Relief

  • Avoid aspirin, anti-inflammatory drugs, or topical pain relief creams.
  • For pain relief use paracetamol, tramadol or codeine.

Exercise

Is necessary to re-educate correct muscle patterns and strengthen surrounding structures. These can begin immediately or when pain levels permit. Depending on the type and nature of your injury, the prescription of specific exercises and walking is advisable.

Nutrients

Are very important to encourage good health and aid in the repair of ligaments, discs, and bones. It is advisable to take the below supplements during treatment and for three months following the final treatment.

  • Vitamin C 1000 – 2000 mg/day (makes strong connective tissue, helps to heal).
  • Manganese (as chelate) 5-10mg/day (essential for discs, cartilage).
  • Zinc 15-30mg/day (wound healing, important for new protein).

Note: people who eat lots of vegetables, wholemeal bread, nuts, meat, fish, chicken, and eggs will do better than those who eat lots of sweet foods and breakfast cereals and white bread and pasta.

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