The information on this website is for educational purposes only. Do not act or rely upon the information on this website without seeking independent professional medical advice.  Prolotherapy is a medical technique. As with any medical technique, results will vary among individuals, and there is no guarantee that you will receive the same outcome as patient reports here. Prolotherapy injections may not work for you and as with all medical procedures there are risks involved. These risks should be discussed with a qualified health care professional prior to any treatment so that you have proper informed consent and understand that there are no guarantees to healing.

Prolotherapy is a method of injection treatment designed to stimulate healing.  Prolotherapy owes its origins to the innovation of Dr. Earl Gedney, an osteopathic physician and surgeon. In the early 1930s, Dr. Gedney caught his thumb in closing surgical suite doors thereby stretching the joint and causing severe pain and instability. After being told by his colleagues that nothing could be done for his condition and that his surgical career was over, Gedney did his own research and decided to “be his own doctor.” He knew of a group of doctors called “herniologists” that used irritating solutions to stimulate the repair of the distended connective tissue ring in hernias. He extrapolated this knowledge to inject his injured thumb and was able to fully rehabilitate it.

In 1937, Gedney published “The Hypermobile Joint,” the first known article about Prolotherapy (then called “sclerotherapy”) in the medical literature. The 1937 article gave a preliminary protocol and two case reports - one of a patient with knee pain and another with low back pain - with both successfully treated with this method. Gedney followed up this paper with a presentation at the February 1938 meeting of the Osteopathic Clinical Society of Philadelphia which outlined the technique. The solutions used then (and now) are primarily dextrose-based, although other formulas are used and can be effective. Prolotherapy is practiced by physicians in the U.S. and worldwide, has been shown effective in treating many musculoskeletal conditions - such as tendinopathies, ligament sprains, back and neck pain, tennis/golfers elbow, ankle pain, joint laxity and instability, plantar fasciitis, shoulder, knee pain and other joint pain.  It has been endorsed by C. Everett Koop, the former US Surgeon General who was helped by it himself as well as practicing it.
 

HOW PROLOTHERAPY WORKS

Prolotherapy works by causing a temporary, low grade inflammation at the injection site, activating fibroblasts to the area, which, in turn, synthesize precursors to mature collagen and thus reinforce connective tissue. It has been well documented that direct exposure of fibroblasts to growth factors (either endogenous or exogenous) causes new cell growth and collagen deposition. Inflammation creates secondary growth factor elevation. The inflammatory stimulus of Prolotherapy raises the level of growth factors to resume or initiate a new connective tissue repair sequence which had prematurely aborted or never started. Biopsy studies show ligament thickening, enlargement of the tendinosseous junction, and strengthening of the tendon or ligament after Prolotherapy injections.

Prolotherapy is used for musculoskeletal pain or injury which is either unresolved after eight weeks, or (if earlier) where enhanced healing is desired. Prolotherapy works by raising growth factor levels or effectiveness to promote tissue repair or growth. It can be used years after the initial pain or problem began, as long as the person is healthy. Because Prolotherapy works to repair weak and painful joint areas, it is a long-term solution rather than a temporary measure such as drugs or Cortisone. 


Alternative Treatments:  Dealing with Chronic Pain
"In the case of chronic ligament or tendon pain that hasn't responded to more conservative treatments such as prescribed exercise or physical therapy, Prolotherapy may be helpful." 
Mayo Clinic Newsletter, 2005
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Injections to Kick-Start Tissue Repair
"The technique reactivates the healing process by injecting a mildly irritating substance - commonly a somewhat concentrated sugar solution along with the pain killer lidocaine - into the injured area to stimulate a temporary low-grade inflammation. In some cases, growth factors themselves may be injected." 
The New York Times, August 2007
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Prolotherapy for Musculoskeletal Pain
"Prolotherapy, considered an alternative therapy, is quietly establishing itself in mainstream medicine because of its almost irresistible draw for both physicians and patients: nonsurgical treatment for musculoskeletal conditions."
Practical Pain Management, January/February 2007
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Platelet Rich Plasma in Prolotherapy
“Since the early 1990s, and especially within the last couple of years, the use of platelet rich plasma (PRP) as a Prolotherapy formula has gained popularity.”   
Practical Pain Management 2009.    
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