What is Prolotherapy?
Prolotherapy, also called Regenerative Injection Therapy (RIT), is an effective technique for treating many types of joint or musculoskeletal pain. Prolotherapy is series of injections in and around the joint structure that stimulate the body’s own mechanism to grow and strengthen joint tissues.
Is Prolotherapy for Me?
Whether the pain is from acute injury or long-term joint wear and tear, Prolotherapy is a very effective option that offers long term relief for many people. More importantly, Prolotherapy addresses the root cause of the pain, and is nearly always a better option than long term use of anti-inflammatory or pain medication and can often avoid invasive and costly joint surgery.
Conditions Treated with Prolotherapy
• Tennis Elbow
• Knee Pain
• Hip Pain
• Golfer’s Elbow
• ACL/PCL Injury
• Frozen Shoulder
• Rotator Cuff Problems
• Thumb, Wrist, & Hand Pain
• Shoulder Pain
• Ankle Sprain
• Foot Pain
• Knee Degeneration from OA
• Carpal Tunnel Syndrome
• Thrower’s Elbow
• Patients wanting to avoid joint surgery
How do I know if Prolotherapy is for me?
If you have tenderness, a feeling of “looseness” to the joint, or any type of unresolved joint pain, prolotherapy is worth considering. To evaluate whether prolo is appropriate for you, Dr. Keith Wilkinson will gather the history of your condition, palpate your joint structure and complete the necessary orthopedic tests. Dr. Wilkinson will then discuss the suitability of Prolotherapy to your condition.
What is in the Prolotherapy solution?
The solution injected in Prolotherapy is a combination of dextrose (concentrated sugar), procaine, and often vitamin B12 or glucosamine sulphate. The dextrose acts as a mild irritant to the tissues to stimulate the healing mechanism. Procaine is a mild anesthetic. Vitamin B12 and/or glucosamine sulphate are added to the solution to assist in proliferation of the growth factors and cartilaginous tissue.
How does Prolotherapy work?
The dextrose acts as an irritant to the tissues which sets off a temporary controlled inflammatory cascade that is localized to the ligaments, tendons, and joint capsule. This cascade stimulates blood flow, increases growth factors that synthesize precursors to joint collagen, and promotes remodeling of the soft tissue surrounding the joint structure. See Articles on Prolotherapy for more information.
Why doesn’t soft tissue healing occur on its own?
Ligament and tendon tissues have a poor blood supply that limit the body’s ability to bring in nutritive growth factors after injury. Additionally, when one has musculoskeletal or joint pain they often take anti-inflammatory medications (i.e., NSAIDs, aspirin, ibuprofen, etc.). These medications are effective in reducing pain, but unfortunately they also inhibit the body’s own healing process. This leads to soft tissues that never fully heal, remain lax, and therefore compromise joint function.
Does Prolotherapy hurt?
Since prolotherapy is an injection procedure, there is mild pain approximating that felt on a skin pinch. However, small gauge (diameter) needles are used and the number of injections are kept to a minimum. When the solution is injected into the joint there is often a sensation of pressure. However, once patients have undergone successful treatment, they often remark that the pain was much less than they had anticipated.
What is done during a Prolotherapy appointment?
During the first appointment, Dr. Wilkinson will take a focused history on your condition and complete the necessary orthopedic testing. If you have reports from previous imaging studies such as X-Ray or MRI, bring these to the appointment for Dr. Wilkinson to review. From this assessment, Dr. Wilkinson will discuss the suitability of prolotherapy for you and recommend a treatment plan. This first visit can be completed in approximately 1 hour. Depending on the time taken during this initial assessment for questions or a more complex case, your first prolotherapy treatment can often be completed during this appointment. However, if necessary the first prolotherapy treatment can be started on your next appointment. Complete treatment of a joint usually requires 3-5 individual treatments that are approximately 4 weeks apart. However, each patient responds differently and may require slightly more treatments for complete healing. These subsequent treatments are more focused than the initial visit and can usually be completed in approximately 30 minutes.
Are there side effects to Prolotherapy?
Since the treatment uses an anesthetic, there is mild numbness in the joint for several hours after the procedure. Because fluid has been injected into and around the joint space, many patients report a feeling of fullness to the joint. There can also be some mild bruising around the injection sites. Because of loss of sensation of joint position from the anesthetic, it advisable to refrain from rigorous physical activity for 24 hours after the procedure. (This is especially true for procedures on the foot/ankle and knee.) Additionally, since prolotherapy has initiated a healing process, it is best to moderate physical activity of that joint for several weeks after the procedure. Even though these are standard precautions, many patients have no symptoms associated with the treatment 2-3 days after the procedure. If you have concerns, please discuss with Dr. Wilkinson.
Is Prolotherapy safe?
Yes. Prolotherapy was developed in the 1930’s and has been administered safely to hundreds of thousands of patients by MDs, DOs and NDs. However, since this is an injection procedure, prolotherapy has the same inherent risks of any medical procedure using needles. These risks are kept to a minimum by adhering to standard sterility and needling techniques. If you have concerns, please discuss with Dr. Wilkinson.