What is Prolotherapy?
Prolotherapy is an injection technique that is designed to stimulate healing in injured parts of your body that may be slow to heal or may not have healed completely. It is used to treat sprained ligaments, strained tendons and damaged cartilage. This means that it can be applied to chronic heel pain (plantar fasciitis sometimes called heel spur syndrome), sprained ankles, Achilles tendon strains and tendinopathies (a chronic degeneration of the tendon). Sprained ligaments at the front and side of the knee can also be treated by this method.
What does Prolotherapy use?
Local anaesthetic and simple solutions for injection such as a sterile solution of glucose (Baxter) and saline that are widely used for sports injuries. We can also use some of your own blood from a small sample taken from your arm (only as much as a normal blood test) or we can just use parts of that blood sample called platelets which we spin out of the blood sample in a sterile procedure using a centrifuge. What do you mean by ‘a technique’, an injection is an injection isn’t it? – well, no, not really. Since the 1950’s a body of evidence has been building up that if you repeatedly pass a needle (a very fine one!) into an area of damaged tissue then you cause an irritation (called a cytokine response) that starts a healing process in a damaged area of tissue so treated. Acupuncturists have actually been doing this for centuries, they call it ‘pecking the bone’ When this procedure is done using modern equipment like sterile syringes and ultra fine sterile needles under a local anaesthetic it can be a lot more comfortable than an acupuncture needle but equally or more effective.
Why use other solutions as well as local anaesthetic?
These other substances can aid the process, especially a little bit of your own blood or the extract from it. The other injectable liquids can stimulate healing by affecting the fluids that pass into and out of your cells in a process called Osmosis.
Is prolotherapy safe?
In 1993 Dr Tom Dorman (1) published the results of a survey detailing some half million treatments. There were no fatalities and the few adverse events were mostly short lived except for some which involved injections around the spine and ones which accidentally went through the chest wall, all of these injections were given by medical doctors. There were no serious effects in the lower limb and there have been no reports since of any resulting from injections given by podiatrists who specialise and operate in the structure and function of the lower limb only.
What are the risks of prolotherapy?
There are risks associated with everything you put into your body. All you have to do is look up the risks for any of the anti-inflammatory medications (even over-the-counter medications). With any injections there is a slight risk of infection, bruising or a reaction to the substances injected such as the anesthetic. There may be soreness after the procedure for a day or two. Most of the time there is no adverse reaction beyond very minor bruising at the procedure site. Care, knowledge and skill on the part of the practitioner treating you can minimise any risk.
Does prolotherapy work, is prolotherapy a ‘miracle cure’?
Yes it often does work and no its not a miracle cure. It will not remove the cause of the problem, only try to cure the results. If for example your heel pain is caused by a collapsed arch then an arch support will be needed as well to stop recurrence of the damage. The prolotherapy can control the pain and speed the healing.
(1) Dorman TA, Prolotherapy: A Survey. J Orthopaedic Med 1993;15:49
Are prolotherapy treatments painful?
It depends on the individual, mostly it is not painful. Once the injection is completed most patients say that the pain disappears immediately. The goal of prolotherapy is to have you walk out of the clinic room pain free. Post injection you may have some bruising or pain on/around the injection site, this should subside within 1-7 days. If after 7 days you still have pain contact us or you GP.
How successful is prolotherapy treatment?
This depends on multiple factors such as the body part, how long you have had the injury/pain for and your circumstances. About 85% of the people state they are pain free after completing a course of 6-8 injection treatment, with some gaining a significant improvement.
Is prolotherapy a cure for chronic pain?
Prolotherapy can be very effective in treating chronic pain. With an experienced practitioner, most patients indicate that once they have undergone a course of treatment, most of their symptoms resolves.
Can I expect to become pain free after prolotherapy treatment?
The simple answer is YES, many people become pain free in the long term. The goal of each treatment is to get you walking out of the clinic pain free. Post injection you should be free of pain for anywhere from a couple of hours to few days initially. Therefore, with every treatment session you should remain free of pain afterwards for longer and longer periods of time until the pain subsides. This is the main reason why you require multiple treatments.
How many prolotherapy treatments will need? How frequently?
Mostly, we recommend patient to have 6-8 treatments, although some people may require less or more sessions.
Most people become pain free or see significant improvement after a course of 6-8 treatments.
Can I stop my pain medication?
Please discuss this with your practitioner. You will be advised to consult you GP before stopping any medications.
Is it safe? What are the side effects of prolotherapy?
The treatment is safe with very few side effects as follows:
- Some localized bruising may occur around the injection sites but it is not very common.
- No allergic reactions have been recorded as of yet.
- Extremely low risk of infection ONE in 300,000 injections.