Prolotherapy: An Effective Treatment for Chronic Pain

Jenny L. F. Andrus, MD

In my busy practice as an Interventional Pain Management Physician, I often see patients that complain of muscular, tendon or joint pain.  Sometimes, the diagnosis for their complaints is easy and straightforward – they have arthritis or they have a tendon tear.  At other times, the pain generator is not so easily identified or the patient’s pain may be caused by a number of problems which are afflicting the patient concurrently.  It is my job to tease out these problems and find the best methods of treating the symptoms, if I can’t cure them completely.  Fortunately, I have a number of resources available to me with which I can treat patients for pain.  Prolotherapy is one of those and it is an effective way to treat chronic pain without surgery or taking oral medications.

Prolotherapy, aka proliferation therapy or regenerative injection therapy is simply where an irritant solution is injected into the painful tissue, muscle or joint in order to relieve pain.  The irritation generates increased blood flow which brings healing nutrients to the painful or injured area, which speeds healing.

Historically, the ancient Romans used heated needles to treat the shoulder pain of wounded gladiators.  The needles would aggravate the internal tissue of the already injured gladiators and this would speed their healing.  After all, an injured gladiator was of no use to their owner, who wanted only those healthy enough to fight in the arena.  Hence, the earliest form of Sports Medicine was born!

In the past century, prolotherapy was used in the 1930s to treat laxity of ligaments.  In the 1950s, an American general surgeon named Dr. George Hackett, began using injectable irritant solutions to treat joints and hernias.  Because of his pioneering work, he is now known as the father of modern Prolotherapy.

Recently, Prolotherapy has seen a resurgence in popularity as the interest in Regenerative Medicine has grown.  Regenerative medicine focuses on using the body’s own healing mechanisms, with a little nudge from modern medical technology, to restore, repair and regenerate the human body.  Platelet Rich Plasma therapy is also in this category of medicine.

What conditions can be treated with Prolotherapy?

Tendinitis, osteoarthritis, low back pain, tennis elbow are just some of the conditions that can be treated.

Are there any reasons I can’t have Prolotherapy?

•    If you have an infection, cellulitis or abscess
•    If you are taking a blood-thinner, such as Coumadin
•    If you have a bleeding disorder
•    If you have Infectious arthritis
•    If you have an Allergy to a prolotherapy agent
•    If you have an Acute fracture
•    If you have Gout

How is the injection performed?

Most commonly, an injection of an irritant solution (either dextrose, glycerine or phenol is given mixed with Lidocaine, a numbing agent).  The injections are performed every two to six weeks for about six months.

Are there any side-effects?

There may be irritation, redness and soreness at the injection site.  This can be managed with Tylenol and the application of ice to the injection site intermittently for several hours after the injection.  Rarely, there may be bruising, lightheadedness, infection, nerve damage or allergic reaction.  As with any injection, there may be complications, but these are very rare.

Is Prolotherapy covered by insurance?

Not at this time.  However, Prolotherapy is the most-cost-effective of all of the forms of Regenerative Medicine therapies available.