What is it?
Prolotherapy, also known as Regenerative Injection Therapy
(RIT), is a safe, non-surgical treatment for acute and chronic joint
pain. It is the only clinically proven treatment that can naturally
regenerate and repair damaged tendons and ligaments in painful joints
from injury or normal wear and tear. Clinical case studies show that
Prolotherapy has consistent success rates of 75-80% for healing chronic
joint pain1, and can increase the size and strength of
tendons and ligaments by approximately 25-40% 2. Our former
Surgeon General, C. Everett Koop, has been treated successfully with
Prolotherapy 3.
What types of pain can Prolotherapy treat?
How does it work?
Prolotherapy involves a series of therapeutic injections that
stimulate the body to regenerate the connective tissue in joints-
namely, tendons and ligaments. Treatments given over the course of
several weeks can eliminate pain and provide long lasting stability to
the joint. Strength, flexibility and range of motion are improved as
well.
To understand how Prolotherapy works, it is important to know
that tendons join muscle to bone, and ligaments join bone to bone.
Tendons and ligaments support the stability and function of a joint. The
area where they connect to the bone is the target for treatment with
Prolotherapy. Tendons and ligaments are composed of networks of fibrous
proteins, the main ingredient of which is collagen. Overuse, strain, or
injury can cause these collagen fibers to tear resulting in
inflammation, causing aches, pain, and a decreased range of motion.
Prolotherapy stimulates natural repair mechanisms. Collagen
producing cells are triggered to regenerate connective tissue in joints.
Tendons and ligaments become thicker, tighter and stronger.
Prolotherapy may be a safe alternative to surgery, and possibly
eliminate the need for prescription pain medications - a new lease on
life!
Who is it good for?
Prolotherapy is for anyone
who has joint pain, not just for people with injuries due to sports or
accidents. As we age, the ligaments and tendons of our joints lose their
elasticity, becoming lax, weak, and unstable. Injured joints heal
slowly and often incompletely because of a limited blood supply to the
area. In addition, there are many nerve endings in ligaments and tendons
that cause pain when there is loss of stability to a joint. Even if
there is minimal discomfort, any weakness can ultimately tear further
and create greater dysfunction and pain. Further, the surrounding
muscles of a weak joint contract and remain tense to support the
instability. This leads to them being chronically tight, stiff, and
sore, resulting in a decreased range of motion, flexibility, and
strength.
At this point, activities and hobbies become limited; exercise
is difficult, sleep is restless, and energy levels are lowered.
Furthermore, physical limitations due to pain and fatigue can affect
mental/emotional health. Understandably, it is discouraging when
you are prevented from doing what you love because your body hurts.
Fortunately, there is a solution: Prolotherapy.
What are the results?
Prolotherapy treats the source of your
pain, not the symptoms. Every course of treatment begins with a careful
history and physical examination to determine the exact location of
damaged ligaments and tendons. Dr. Monagle then uses a small, fine
needle to inject a natural regenerative solution into the affected
joint, which triggers the body to repair damage, relieve pain, and
restore function. Throughout the course of treatment, newly regenerated
joint tissue becomes strong and tight again, allowing the surrounding
muscles to relax, become more flexible, and do their job which is to
move your body! You are able to return to the physical activities and
hobbies you love, exercise becomes easier, sleep is restful, and a
general fatigue is replaced with renewed energy.
When will the pain be gone?
The initial healing
phase can be expected to continue for two to four weeks following each
treatment. As the tendons and ligaments grow stronger and more capable
of stabilizing the joint, the pain is continually relieved. Relief can
be rapid, noticeable even before leaving the clinic. Many of
our patients have reported a noticeable decrease in pain after only two
or three treatments. Three to eight treatments are usually required for
complete repair, with an interval of two to four weeks between
treatments. The number of treatments and interval length varies with the
severity of the injury and health of the patient. Several areas of pain
can be treated on each visit.
Is
Prolotherapy Safe? What are the side effects?
Prolotherapy is extremely safe, non-toxic and effective, when
performed by a trained and licensed physician. Using the current
solutions and techniques, there have been no reported significant side
effects of this treatment in over 35 years. There is occasionally some
bruising at site of injection, and mild soreness that can last 1-3 days.
Dr. Monagle is trained and board certified by the internationally
recognized Naturopathic Academy for Therapeutic Injection (NATI, www.injectiontx.org).
References
-
Merriman Prolotherapy versus intra-operative fusion in the
treatment of joint instability of the spine and pelvis. Journal of the
International College of Surgeons, 1964 42:150-159. Results: The success
rate of the fusion was very variable. The success rate of the
prolotherapy was a 80-90% cure rate.
-
Liu, Y. An in
situ study of the influence of sclerosing solution in a rabbit medial
collateral ligaments and its junction strength Connective Tissue
Research 1983 2:95-102. He found that after five injections the ligament
mass increased in by 44 percent, the thickness by 27 percent, and the
strength of the ligament bone junction increased by 28 percent. This
study showed that prolotherapy actually causes tissue growth and
strengthening.
-
Koop, MD.,
C. Everett. Former Surgeon General Treated successfully with
Prolotherapy. Website: www.doctormaxwell.com/DrKoopProlo.htm
Additional
Prolotherapy References:
-
In 1974 Dr. Hemwall presented the results of 2007 prolotherapy
patients. The results were: 1871 patients were treated with
prolotherapy. 1399 (75.5percent) patients reported complete recovery or
cure. 413 (24.3 percent) reported general improvement. 25 (0.2 percent)
patients showed no improvement.
-
Hackett M.D.
Low back pain British Journal of Physical Medicine 1956 19.25-33. 656
patients received a total of 18,000 injections. 12 years after the
prolotherapy was completed 82% of the patients considered themselves
cured.
-
George
Hackett presented data in front of the AMA on June 1958 on prolotherapy
and cervical whiplash. 1656 patients. 82% of patients considered
themselves cured.
-
George
Hackett, M.D. presented data in front of the AMA on June 1955 on
prolotherapy and back pain. 563 patients. 82% of the patients considered
themselves cured.
-
Schwartz
R. Prolotherapy: A literature review and retrospective study Journal of
Neurology, Orthopedic Medicine and Surgery 1991;12:220-223 He performed a
retrospective study of 43 patients with chronic low back pain who had
been unresponsive to other treatments, including surgery. He gave
prolotherapy treatment to the sacroiliac joint area over six weeks. 93
percent of the participants reported significant improvement. Only three
of the patients reported no improvement.
Prospective
studies showing the effectiveness of prolotherapy:
-
Reeves KD Hassanein K Long term effects of dextrose
prolotherapy for anterior cruciate ligament laxity: A prospective and
consecutive patient study. Alt Ther Hlth Med 2003; 9(2): Using simple
dextrose injection into 16 knees with a loose ACL ligament, 10/16 knees
were no longer loose by machine measurement at time of follow-up, and
symptoms were improved. Symptoms of osteoarthritits improved even in
those who still tested loose
Double blind
studies showing the effectiveness of prolotherapy
-
Ongley, M. A new approach to the treatment of chronic low back
pain. Lancet July 18, 1987. 2:143-146. this is a double-blind study in
the most difficult cases of continuous low back pain patients who
suffered for ten years or longer. They divided 81 patients who had
surgery, medications, manipulations adjustments, exercise, physical
therapy and other treatments, which failed to provide adequate relief
for 10 or more years. One group was given manipulation and a
reconstructive solution of dextrose, glycerine and phenol. The other
group was given sham manipulations and normal saline injections. Great
care was taken to insure that neither the patient nor the physicians
knew which solution was injected. Both groups were given a total of six
treatments. It was found that 88% of the group injected with the
reconstructive solution had moderate to marked improvement. Treatment
was far superior to the placebo group.
-
Klein A
randomized double-blind trial of dextrose-glycerine-phenol injections
for chronic low back Journal of Spinal Disorders 1993 6:23-33.
Prolotherapy was shown to be effective versus placebo for treating low
back pain.
-
Reeves KD
Hassanein K Randomized prospective double-blind placebo-controlled study
of dextrose prolotherapy for knee osteoarthritis with or without ACL
laxity. Alt Ther Hlth Med 2000;6(2):37-46 Results: Less than one ounce
of simple 10% dextrose over 6 months in each joint resulted in 35%
reduction of pain, 45% improvement in swelling and 67% improvement in
knee buckling as well as a 13 degree improvement in knee range of
motion. Treatment solution was superior to placebo solution. (P = .015)
-
Reeves KD
Hassanein K Randomized prospective placebo controlled double blind study
of dextrose prolotherapy for osteoarthritic thumbs and finger (DIP, PIP
and Trapeziometacarpal) joints: Evidence of clinical efficacy. Jnl Alt
Compl Med 2000;6(4):311-320 Results: Less than 1 teaspoonful of simple
10% dextrose solution over 6 months in each joint resulted in a 42%
improvement in pain and an 8 degree improvement in flexibility.
Treatment solution was superior to placebo solution in pain improvement
(p = .027) and in flexibility (p = .003)
Studies on
the incidence of complications of Prolotherapy
-
In 1993 Dr. Dorman published a survey of Prolotherapy
injections performed by 95 respondents. 12 These physicians
reported on a total of 494,845 patients. Of these 343,897 patients were
treated for low back, 98,430 for other areas of the spine, and 26.85
percent also reported non-spine peripheral joint injections. The
cumulative years in practice of all the practitioners in the survey were
1092. Only 66 minor complications were reported. These included 24
reports of allergic reactions and 29 cases of pneumothorax (a condition
caused by a needle placed into the lung cavity). All of these resolved
without serious problems. There were also 14 reports of major
complications, defined as the patient needing hospitalization or having
transient or permanent nerve damage.
Histology studies in both humans and animals have proven
that Prolotherapy strengthens ligaments:
-
Maynard J. Morphological and biomechanical effects of sodium
morrhuate on tendons Journal of Orthopedic Research 1985 3: 236-248.
treated rabbit tendons with sodium morrhuate. He found that after six
weeks the diameter of the tendons increased by 20 to 25 percent.
-
Dorman T.
Treatment for spinal pain arising in ligaments using prolotherapy: A
retrospective study Journal of Orthopedic Medicine 1991 13(1):13-19 Drs.
Dorman and Klein performed biopsies of posterior sacroiliac ligaments
in three patients with chronic low back pain both before and after
prolotherapy injections. They found that that after six weekly
injections combined with mobilization and stretching exercises, that
there was an increase in the average ligament diameter measured by
electron microscopy from 0.055 micrometers to 0.087 micrometers. Light
microscopy showed an increase in the collagen producing fibroblasts. In
addition, the range of motion of the patients was significantly
increased and their pain was significantly decreased as well.
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