reaction of the treatment is localized inflammation triggering a wound healing
cascade leading to increased blood supply and flow of nutrients and growth
factors. This stimulates the tissue to repair itself by deposition of new
collagen, the material that ligaments and tendons are made of.
The new collagen then shrinks as it matures leading
to ligament/tendon tightening and increased strength.
PRP (platelet Reduced Plasma)
PRP is injected in the same manner as prolotherapy;
however, the substance injected is different.
About 50ml of blood is drawn from the patient and
spun in a centrifuge to separate the blood components and from this serum is
extracted. This serum is then injected back into the joint for treatment. This
serum already has concentrated growth factors which lead to healing of the
The treatment is slightly more painful than
prolotherapy, however the healing power is faster, more enhanced and requires
Ligaments can be described as "rubber bands" that
actually hold bone to bone and allow flexible movement of joints. Injury,
overstretching and degeneration/weakness of ligaments can cause them to become
weak and damaged to a state of disrepair. The reason that ligaments don’t heal
easily is largely due to the lack of blood supply to the area. As a result,
healing is slow and not always complete. In addition, the nerve endings to
ligaments can become impaired or damaged, so you may feel acute intense pain.
This pain can then become chronic.
Tendons are the name given to tissue which connects
muscle to bone. Tendons may also be damaged in the same manner as ligaments
which can result in pain and scar tissue development if not treated
Why Is There
Pain With The Treatments?
With Prolotherapy, an important concept to
understand is that chronic pain leads to tissue destruction and acute pain leads
to tissue regeneration. With this treatment, patients often say “I already have
inflammation and you want to give me more?”
The idea behind this is that acute inflammation
leads to healing. The ligament and tendon tissue which forms as a result of
Prolotherapy is thicker and stronger than normal tissue, (up to 40% stronger in
The basic Prolotherapy solution is 12.5% to 20%
dextrose with 1% procaine. The dextrose makes the solution more concentrated
than blood, acting as a strong proliferant. Procaine is an anaesthetic that helps
reinforce the diagnosis because the patient may experience immediate pain relief
after the injection. The dextrose solution, in addition to being safe, will not
affect a diabetic’s blood sugar level. Other injectables may be added such as
hyaluronic acid or Vitamin B12 (methylcobalamin).
The hyaluronic acid would be added in cases of
osteoarthritis where cartilage regeneration is the desired outcome and
methylcobalamin is used in nerve regeneration. Homeopathic remedies may also be
added to help speed the healing process; however, these will vary depending on the type