For someone suffering from joint pain, prolotherapy can be a safe and effective way to get them back to their usual activities. My opinion is that a targeted treatment at the source of the problem is a better option than a systemic treatment that circulates to the entire body. Prolotherapy causes proliferative cells to migrate to the weakened area, targeting the problem.
Chronic joint pain is an astronomically common condition, especially given our aging population. In fact, the majority of people over the age of 65 will have radiographic evidence of osteoarthritis. As we age, body tissues such as vertebral bones, spinal discs, and knee cartilage, lose height due to decreased bone density, loss of vascularity, wear and tear, and disc degeneration. While these tissues lose height, the ligaments connecting the bones remain the same length, causing these supporting ligaments to buckle. These lax, weakened ligaments can lead to segmental instability resulting in pain.
Poor posture (head forward, slumped during prolonged sitting, rounded lower back) exacerbates the laxity of ligaments in the neck and low back. The laxity of ligaments causes an instability which stimulates proprioceptive nerve fibers and can lead to chronic muscle spasm in the body’s attempt to stabilize the area. Prolotherapy is an injection treatment using safe, natural, proliferant substances such as dextrose, to stimulate the body’s natural healing cascade where the ligament and tendon join to the bone. Prolotherapy treats the cause of the chronic pain by correcting the ligament laxity.
Prolotherapy has been shown to be effective in treating knee osteoarthritis by combining intra-articular (inside the joint) injections of proliferant solutions with ligament and tendon injections to stabilize the knee joint. Studies have shown improvement in pain, function, and stiffness when using prolotherapy to treat knee OA.
Clinical trial literature is growing which supports the use of prolotherapy in osteoarthritis, low back pain, ligament and tendon injuries. A newer use of prolotherapy has been gaining momentum called neural prolotherapy. Neural prolotherapy involves multiple subcutaneous injections of proliferent solution to treat the hundreds of small nerve fibers under the skin which can contribute to chronic pain when chronically activated.
Proliferative therapy is a worthwhile technique in the tool kit of treatments for joint pain. Prolotherapy has fewer side effects than medications and fewer risks than surgery or platelet-rich plasma (PRP). Prolotherapy is far less expensive than PRP while studies show the two treatments to have similar outcomes. Prolotherapy is an effective modality when combined with weight loss to offload the joint and a focused exercise program to strengthen supportive muscles.
Dr. Bren Boston, M.D. is board certified in Physiatry and Pain Medicine through the American Board of Physical Medicine and Rehabilitation and specializes in treating musculoskeletal conditions with a non-surgical approach. Learn more and schedule an appointment by contacting firstname.lastname@example.org.