Prolotherapy is an injection-based treatment for chronic pain. The procedure is simple and involves a relatively small amount of an irritant solution injected into injured tissue to initiate healing. Prolotherapy can treat painful ligaments and tendons where they attach to muscle/bone as well as adjacent joint spaces. These injections are done in several sessions over the course of treatment.
Pacific Pain & Wellness Group in Torrance offers an expert team of doctors with years of experience performing prolotherapy. Give us a call today at (310) 437-7399 for a consultation to see how prolotherapy may be able to help you.
Prolotherapy for Chronic Pain Conditions
- Tendon, muscle, and ligament damage
- Arthritis of the knees, hips, and hands
- Degenerative disc disease
- Sprains and strains
- Lax or unstable joints
- Golfer/tennis elbow
- Neck pain
- Shoulder pain
- Shin splints
- Wrist pain/carpal tunnel syndrome
How Prolotherapy Works
The injection usually contains a solution of dextrose (a sugar), sarapin, sterile salt water, and a numbing medication. Prolotherapy is a more natural alternative to cortisone shots. In the last several years, new formulas have evolved to include platelet-rich plasma (PRP) and adult stem cell sources. These are usually taken from bone marrow or blood. The doctor will tailor your individual injection to meet your specific needs.
For most patients, PRP or stem cell therapy is performed in conjunction with prolotherapy. For example, prolotherapy can be used to strengthen tendons and ligaments after PRP or stem cell treatments have already been given. Factors that determine which ingredients go into your treatment solution depend on the state of your injury, whether it is a recent injury, or if you have a degenerative joint disease.
It is helpful to understand why your doctor selected the particular solution for your procedure. As a rough guide to clarify this, let’s look at three types of sample patient groups and their corresponding treatment solutions.
Patient group 1: A younger patient who is athletic, moderately active, or has a physically demanding job. This patient just suffered a recent tendon injury (such as a sprain) that failed to heal completely.
- The injury is still painful
- This injury may do well with an injection of sterile dextrose solution (water + medical grade sugar)
- Dextrose can help this patient’s body repair itself by strengthening the ligament
Patient group 2: Chronic difficulties with an old sprain that occurred years ago.
- The injury has gotten progressively worse, causing pain
- The injury has not responded to conservative treatments such as NSAIDS, other medications, cortisone shots, or physical therapy
- Soft tissue damage has progressed
- Joint instability appears to be permanent
- It may not be enough to attract this patient’s own cells to the affected area using prolotherapy
- PRP may be recommended to first inject healing factors into the damaged joint
- While PRP brings healing cells into the injured tissue, joint instability must still be addressed
- Prolotherapy can be used to stabilize this joint by strengthening the affected ligaments
Patients with the following conditions are usually good candidates for PRP.
- Ligament tear
- Tendon or muscle tear
- Rotator cuff tear
- Ankle sprain
- Tennis elbow
- Golfer elbow
Patient group 3: Chronic, long-term degenerative problems. These patients may eventually need joint replacement surgery.
- This is a patient who may have had a degenerative joint disease for many years
- They have exhausted all means of conservative care
- They have had limited success with PRP treatments and/or hyaluronic acid injections
- No other treatment options have provided significant relief
- This patient that may be a better candidate for stem cell therapy versus prolotherapy
Joints affected by degenerative joint disease that may benefit from stem cell therapy include:
How is Prolotherapy Performed?
Before your prolotherapy procedure, your doctor will view diagnostic images of the affected region including MRI scans and X-rays. You may be asked to stop taking certain medications prior to your procedure.
The actual procedure is quite simple. It includes:
- Cleaning the skin with alcohol at the injection site
- The injection contains local anesthetic (lidocaine or procaine) to make it more comfortable
- The dextrose/numbing injection will be guided by either ultrasound or X-ray fluoroscopy
The only pain you should feel during prolotherapy is when the needle is first inserted under your skin. This may feel like a slight pinch. The procedure lasts about 30 minutes. Then, you will rest for another 15 minutes, possibly with ice on the injection area. After that you can go home. You will be able to drive yourself home after your appointment.
How Does it Work?
Ligaments and tendons are subject to poor blood circulation. This lack of blood supply means that fewer nutrients “feed” these tissues when an injury occurs, which can hamper your ability to heal properly. The weakened areas, while they have little blood supply, have an abundance of nerves. This is why injured ligaments and tendons can cause such severe pain.
The injected solution is an irritant, which causes an inflammatory reaction in the body. Inflammation increases blood flow and brings much-needed nutrients to the area. Your body’s injury response prompts the rebuilding and restoration of weakened connective tissues, thus making them stronger.
What to Expect After Prolotherapy
Immediately after injection, most people experience significant pain relief from the numbing medication. This will wear off within a few hours, but pain relief is usually noticeable in as little as two weeks after injection.
You will need three to six follow-up injections, usually spaced one to two weeks apart for long-lasting results. It can take up to eight weeks for your body to produce enough new connective tissue for you to notice increased joint stability.
Prolotherapy may be right for you if:
- Your joints are weak or painful
- You have limited mobility that is stopping you from doing what you love
- Certain movements or low-impact activities cause you pain
Prolotherapy Treatment in Torrance – Pacific Pain & Wellness Group
For a personalized pain management plan, call our board certified doctors at (310) 437-7399. We offer caring and compassionate treatments that put your safety, comfort, and healing above all else.
At Pacific Pain & Wellness Group, we care about you as much as you do. Our goal is to help you feel better so you can live better. Get in touch with us today to see how we can help.