Prolotherapy is the most common form of regenerative therapy. It has been used from the mid-twentieth century and has been changed and refined throughout the years according to the experience of the various practitioners.
The fundamental tenet of prolotherapy turns conventional teaching on its head: inflammation, especially acute inflammation, is beneficial to the injured tissue, because it attracts growth factors to the area and, therefore, promotes proliferation and repair of tissue. Repeated systemic (oral) or local (injectable) administration of anti-inflammatory medication can be detrimental to healing and repair of tissue.
Local, acute inflammation is promoted by injection of a tissue irritant, like dextrose (sugar) solution into the injured or painful tissue. This is repeatedly done, at intervals of 2-6 weeks, to continue to stimulate an inflammatory response and hence repair of the affected tissue.
The body gets rid of the irritant dextrose by flooding the particular region with serum, which contains growth and tissue repair molecules. The body is tricked into promoting a local release of growth factors for prolonged periods of time and in increased concentrations, exceeding the normal healing time periods.
Dextrose solutions can also be used in conjunction with ozone gas, which, when injected into the affected tissue, can sometimes promote a better healing response. Prolozone is a form of prolotherapy that also employ ozone. Other agents are sometimes used with dextrose, customized to the individual patient needs.
Prolotherapy is most commonly used to treat chronic degenerative conditions of tendons and ligaments (soft tissue), in the temporomandibular joint, shoulder, elbow, knees, and Achilles’ tendon. More rarely, prolotherapy is used for chronic neck and back pain, although these conditions respond less well because of their diagnostic complexity. For many patients, prolotherapy is efficacious and cost-effective compared to other, more traditional therapies.
Prolotherapy is performed in the office. In extreme circumstances, sedation is available, although almost never used. Prolotherapy is a low-risk procedure, which may produce short term increased pain due to stimulation of the inflammatory response. Local anesthetic is often used in the prolotherapy solution to ease the discomfort associated with the procedure.
Often, prolotherapy is used for patients who have failed corticosteroid injections and who want to avoid or delay surgical interventions.