Prolotherapy
Definition
Prolotherapy is the treatment of soft-tissue damage through the use of injections. The injections lead to inflammation in the area, and the body reacts by increasing the blood supply and sending more nutrients to the area, resulting in tissue repair. The term prolotherapy is derived from the word prolo, short for proliferation, as the therapy is intended to proliferate tissue growth in the damaged area.
Origins
The idea behind this therapy dates back more than 2000 years to Hippocrates, who used it to treat soldiers with injured shoulders. Instead of injections Hippocrates used a hot poker, which he speared into the shoulder joint, causing inflammation and stimulating the body to repair itself. Prolotherapy using injections was derived from a treatment developed by H.I. Biegeleisen called sclerotherapy, used to treat varicose veins. In the 1950s, George Hackett, often called a pioneer of prolotherapy, was experimenting with and touting the benefits of the procedure.
Benefits
Prolotherapy has been used to treat chronic neck and back pain, joint pain from arthritis, headaches, fibromyalgia, sports injuries, carpal tunnel syndrome, and partially torn tendons, ligaments, and cartilage.
The benefit of prolotherapy is that it is a non-surgical procedure that can be administered in a clinic, saving patients from undergoing anesthesia and surgery followed by a long recovery period. It's also cheaper than surgery. The average back or neck surgery costs about $40,000, while a single prolotherapy treatment runs anywhere from $90–$200, though patients may need several treatments. Furthermore, with prolotherapy there is no loss of mobility as there is with back surgery, when doctors fuse together the vertebrae in an effort to create stability in the spine.
Another benefit is that prolotherapy takes patients off drugs. Patients escape the cost of pain killers and their side effects.
Description
In prolotherapy, a doctor injects a sugar water or salt water-based solution into the damaged ligament or tendon at the point where it attaches to the bone. The injection produces an inflammation, which increases blood flow, swelling, and pain. The body then launches a course of repair and healing. The inflammation tricks the body into thinking another injury has occurred, so it sends in macrophages, which are cells that ingest and destroy the irritant solution. These cells clean up the area. The body then sends in fibroblasts, which are cells that help build fibrous tissue. The fibroblasts excrete collagen, a protein that makes the ligaments denser and stronger. The stronger ligaments provide more support for the joints, often alleviating the pain.
The length of treatment sessions varies and depends on the area being treated. For example, treatment of an injured elbow involves injections only in one site, whereas treatment of larger areas, like the neck and back, involves more injections. Treating an elbow may take only a few injections, whereas the back may involve up to 50 injections for one treatment. The more injections, the longer the treatment.
The treatment generally involves several sessions, usually three to six, which are separated by two or three-week intervals. Some practitioners space treatments four or six weeks apart.
Though doctors have practiced prolotherapy for more than a half-century, it is still considered an alternative treatment; therefore most insurance policies don't cover it.
