Prolotherapy

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Together, we can relieve and manage prolotherapy with our individualized and multi-faceted treatment approach, that is safe & effective.

What Is Prolotherapy?

Prolotherapy is short for “proliferation therapy,” Proliferation, of course, means “rapid production.” What Prolotherapy is said to rapidly produce is collagen and cartilage. Collagen is a naturally occurring protein in the body that is a necessary element for the formation of new connective tissue that holds the skeletal infrastructure together. These include, tendons, ligaments, muscle fascia and joint capsular tissue.

Prolotherapy is given as an injection of a mild irritant, often dextrose (a simple sugar), into a specific area of the body that is arthritic, worn down, or injured. When the irritant is injected into the knee or other area, it causes the body’s immune system to stimulate the inflammatory process. While it may seem counterintuitive to create more inflammation, it is in fact inflammation that is part of the body’s natural healing response.

This burst of increased inflammation attracts fibroblasts (immature cells present in connective tissue) and chondrocytes (cells that produce cartilage) and brings them to the area of degeneration or injury.

These cells rebuild the collagen (more specifically, what is called the “collagen matrix” of the tissue) and enable it to strengthen and restore the body part in many cases to pre-injury status.

There is a long history of medical studies on the effectiveness of Prolotherapy for chronic musculoskeletal pain.
A February 2023 paper (1) wrote: “Prolotherapy is beneficial in a variety of different musculoskeletal conditions, including, but not limited to, lateral epicondylosis, rotator cuff tendinopathy, plantar fasciitis, Achilles tendinopathy, osteoarthritis, low back pain, sacroiliac joint pain, and TMJ laxity.”

A September 2022 paper (2) wrote: “(Knee Pain) and disability were significantly improved with prolotherapy and platelet rich plasma injections (PRP) compared with exercise therapy. Although PRP is more effective than prolotherapy in the first month after treatment, prolotherapy may be preferred due to its low cost, long-term efficacy, and low complication rates. . . ”

A September 2022 paper reported (3) that ultrasound-guided dextrose prolotherapy and corticosteroid injections had similar positive outcomes in alleviating pain in carpal tunnel syndrome. The benefit of using Prolotherapy is that dextrose would have less side-effects than the triamcinolone (steroid).

What to Expect

The injection itself comprises natural substances that stimulate the healing response, along with local anesthetic agents that relieve pain at the injection site. Most patients don’t feel pain, and any pain they do feel is a result of the injection, not the treatment. Discomfort will also depend on the structure or joint that is being treated, the solution being used, and how skilled the administering physician is.

Patients may experience mild swelling and stiffness, which can be relieved with simple over the counter pain relievers. We recommended not using anti-inflammatory drugs, such as aspirin and ibuprofen, because they suppress the inflammatory healing process.

Good Candidates for Prolotherapy in Arizona
Prolotherapy is ideal for treating:

Lower back or mid-back pain
Degenerative disc disease
Sacro-iliac joint instability or dysfunction
Neck pain
Knee pain
Meniscal tears
Wrist or hand pain
Osteoarthritis
Rotator cuff tears
Tennis elbow
Plantar fasciitis
TMJ

What is Dextrose Prolotherapy?

Dextrose Prolotherapy is known as non-surgical ligament/tendon reconstruction. It is a permanent treatment for chronic musculoskeletal pain. Dextrose Prolotherapy is a mixture of dextrose and lidocaine that is injected into weak or injured ligaments, tendons, and joints. These injections cause temporary, low grade inflammation that stimulates the healing cascade.

How does Dextrose Prolotherapy work?

When Dextrose Prolotherapy is injected into the damaged area, it stimulates the tendon or ligament to activate the healing cascade. As a result, new collagen begins to form in the injured tissue. As this collagen matures, it becomes stronger and tighter, and eventually allows the tendon or ligament to withstand the stress of daily and sports related activities.

What are the potential benefits Dextrose Prolotherapy?

Patients can see a significant improvement in symptoms. This may eliminate the need for more aggressive treatments such as long term medication or surgery, as well as a remarkable return of function.

I’ve heard of cortisone shots. Is this the same thing?

Studies have shown that cortisone injections may actually weaken tissue. Cortisone shots may provide temporary pain relief and stop inflammation, but they do not provide long term healing.

Dextrose Prolotherapy heals and strengthens these tendons and ligaments.

What can be treated?

Dextrose Prolotherapy injections can be performed in tendons, ligaments, and joints all over the body. Sports injuries, arthritic joints, and more specific injuries including tennis elbow, partial ACL tears, partial rotator cuff tears, plantar fasciitis, greater trochanteric bursitis of the hip, and Achilles tendinosis may all be effectively treated with Dextrose Prolotherapy. In addition, Dextrose Prolotherapy has been reported to decrease pain in osteoarthritis.

How many treatments are necessary and how often is this therapy administered?

While response to treatment varies, most people will experience significant improvement in symptoms after only 1 treatment. Some patients require anywhere from 2 to 6 sets of injections. Each set of treatment is spaced approximately 4 to 6 weeks apart. There is no limit to the number of treatments you can have. The risks and side effects do not change with the number of injections.

Is Dextrose Prolotherapy right for me?

If you have a tendon or ligament injury and traditional methods have not provided relief, then Dextrose Prolotherapy may be the solution. The procedure is less aggressive and less expensive than surgery. It will heal tissue with minimal or no scarring and prevent further degeneration of the tissues. There will be an initial evaluation with Dr. Andre Silano to see if Dextrose Prolotherapy his right for you.

Are there any special instructions?

You are restricted from the use of non-steroid anti-inflammatory medications (NSAIDs) one week prior to the procedure and throughout the course of treatments. You must also be at least 3 months removed from cortisone injection and one week removed from oral corticosteroids. Initially, the procedure may cause some localized soreness and discomfort. Most patients only require some extra-strength Tylenol to help with the pain. Ice and heat may be applied to the area as needed. After the first week after the procedure, patients will typically start a rehabilitation program with physical therapy. However, aggressive physical activity is discouraged.

How soon can I go back to regular physical activities?

Dextrose Prolotherapy helps regenerate tendons and ligaments but it is not a quick fix. This therapy stimulates the growth and repair of tendons and ligaments, and requires time and rehabilitation. Through regular visits, your doctor will determine when you are able to resume regular physical activities. On average, patients return to sports between 8 to 12 weeks after the Dextrose Prolotherapy injection.

Does insurance pay for Dextrose Prolotherapy?

Most insurance companies do not cover the Dextrose Prolotherapy injections. However, most patients can use their healthcare flexible spending account to pay for the procedure.