PROLOTHERAPY

The term Prolotherapy was first coined by George S. Hackett, M.D., in the 1950’s, and was defined as “the rehabilitation of an incompetent structure by the generation of new cellular tissue.”   Hackett was the first to recognize ligaments as a source of instability and chronic pain and as a result he spent several years developing injection therapy for tendons and ligaments.  He treated thousands of patients with this method and reported a 90% improvement. The prefix “prolo” refers to the term proliferate because the treatment causes the proliferation (growth) of new ligament tissue in areas where it has become weak. Prolotherapy has been a form of treatment for chronic pain used by allopathic and osteopathic physicians for more than 50 years.  There are numerous physicians who studied with Hackett still practicing and instructing other physicians on Prolotherapy today.  Milne J. Ongley, M.D., incorporated Hackett’s theory of ligament relaxation and its treatment into a method of orthopaedic medicine and he integrated techniques and materials to ensure the safety of these methods.  Prolotherapy is also referred to as “proliferant injection therapy” and “sclerotherapy.”

PROLOTHERAPY

Over the last 150 years, it has been discovered that a vast array of agents stimulate the growth and re-growth of ligament tissue.  In many cases, it is thought, that ligament growth is stimulated by an internal bruise and the initiation of the natural healing process.  In this regard, Fibroblasts, cells that create the fibroblastic “strings” of the body that lay down collagen, are stimulated to produce and reproduce collagen.  Thus, Prolotherapy is designed to provoke the body’s natural process of healing by stimulating ligaments to grow and heal themselves.

PROLOTHERAPY SPECIFICALLY HEALS TWO TYPES OF TISSUE: TENDONS AND LIGAMENTS 

Tendons are tough bands of fibrous tissues that connect the muscle to bone. While they exert no pulling force of their own, tendons transfer the contractions of muscles and can exert an elastic force if stretched by an outside force.   Ligaments function to hold the bones of the body together and they constitute the binding materials “rubber bands” which join the bones together, crossing the joints.  In the spine, the ligaments cross between each vertebra and its neighbour.  This creates a mobile, strong and flexible support for the body.  However, in relation to stretched ligaments, Dr. Hackett introduced the term relaxation of ligaments.  In some cases as a result of injury, the ligaments can become frayed and torn.  It is commonly thought that ligaments become “relaxed” primarily because of the shrinkage of the vertebrae and the intervertebral discs and only in part from direct stretching and damage to the ligaments themselves.  

When tendons and ligaments become damaged and weakened, they may not heal back to their original strength, due to the fact that they have a limited blood supply.  The ligaments in the spine are particularly important; when the ligaments do not hold the vertebrae in perfect alignment this allows for one or more displacements between the two pelvic bones.  This is typically referred to as “putting your back out” and the cause for this abnormal movement is probably ligament relaxation.

Prolotherapy works by means of the body’s natural process of Inflammation.  Treatment involves the injection of a proliferant (a mild irritant solution) into the ligament or tendon where it attaches to the bone.  This injection causes an inflammatory response which ‘turns on’ the body’s healing process.  Localized inflammation occurs in the weak areas causing an increase in the blood supply and flow of nutrients which stimulates the tissue to repair itself.  Once the growth of new ligaments and tendons is stimulated, they will become thicker, stronger, and will contain more fibres.

The proliferant solution consists of:
1. Dextrose – a type of sugar.  It is used in a concentrated form; safe for even a Diabetic as such as small amount is used.
2. 1% Procaine – acts as a local anaesthetic and a vasodilator
3. Methylcobalamin - the form of vitamin B12 active in the central nervous system. It is an active coenzyme of the vitamin B12 analogs that is essential for cell growth and replication.

Benefits of Prolotherapy

Prolotherapy is a great treatment option for chronic pain due to ligament relaxation because it stimulates ligaments to become stronger and shorter.  The treatment is successful with many different types of musculoskeletal pain such as arthritis, back pain, neck pain, fibromyalgia, sports injuries, unresolved whiplash injuries, carpal tunnel syndrome, chronic tendonitis, partially torn tendons, ligaments and cartilage, degenerated or herniated discs, TMJ and sciatica.