Prolotherapy, or regenerative injection therapy (RIT), is a non-surgical treatment for the treatment of muscle and joint pain. Prolotherapy has a long history, and has been used since the 1930’s in orthopedics.
Prolotherapy is an injection therapy that involves stimulating a healing response through the use of an irritating solution. The irritating solution has primarily been dextrose-based, although other formulas have been used and can be effective. While dextrose prolotherapy is the treatment solution most commonly associated with prolotherapy, platelet rich plasma (PRP) injections and stem cell therapy also work by stimulating an inflammatory response and healing cascade to improve pain and function in tendon and ligament pathology.
Doctors mainly use prolotherapy to treat injured joints and ligaments, but may also use prolotherapy body to treat a range of conditions, such as:
There are no clear answers about how prolotherapy works in the body to reduce pain from osteoarthritis. Many studies are small, but have shown short-term benefit when compared with control patients. Technique likely matters, and treating the whole knee joint as opposed to selective parts of the knee is more effective in alleviating knee pain and healing the damage.
The mechanism of action behind prolotherapy is not completely understood, however, current theory holds that the injected irritating solution mimics the natural healing process of the body by initiating a local inflammatory cascade, which triggers the release of growth factors and a healing response.
Prolotherapy is likely to be safe, as long as the practitioner has training and experience in these types of injections. Risks involved with injecting substances into a joint.
Possible adverse effects include:
Injections are typically given monthly over three to six sessions. The mechanism of action is unclear; inflammatory and nerve-specific effects are hypothesized.
Prolotherapy is performed in the office using a dextrose solution, and injecting the solution into the injured area using ultrasound guidance to ensure the prolotherpy is placed into the injured tendon or joint.
How do you know where to place the prolotherapy injection?
We use musculoskeletal ultrasound to identify the injured tendon, ligament or joint. Ultrasound is then used to guide the needle for the injection.
Prolotherapy injections are performed under local anesthesia with numbing medication. Patients will typically do not feel pain when injecting a tendon or joint. Mild to moderate swelling or soreness can occur at the injection site and these effects typically resolve within a few days to a week.
More than one injection is sometimes needed, and injections are typically given monthly over three to six sessions. The mechanism of action is unclear; inflammatory and nerve-specific effects are hypothesized.
Prolotherapy has been used for decades, often by patients who are looking to avoid surgery and minimize recovery time. Despite growing evidence and studies, prolotherpay is considered “experimental” by most insurance plans and most plans do not cover prolotherapy. Health Saving Accounts and Flexible Spending Accounts can be used towards the payment of the procedure. Our billing department can answer questions regarding cost.
Dr. Sussman is published in peer-review journals on the use of regenerative medicine, including on the role of rehabilitation after regenerative injections.