Prolotherapy is a modality we have used to treat ligament and joint laxity since 1992. Dr. Barr has more experience performing prolotherapy than any physician in the eastern part of Virginia. She had the great fortune of learning Prolotherapy from one of its originators, Dr. Gustav Hemwall, in the early 1990’s (Dr. Hemwall was in his 80’s at the time). Since learning the techniques from Dr. Hemwall, Dr. Barr has refined the technique to include image and/or x-ray guidance. This image guidance allows us to access and inject discrete areas of injury or laxity and ensures safety. Prolotherapy is an important tool in treating chronic joint instability, chronic whiplash, sports injuries, recurrent ankle and wrist sprains, and hypermobility syndromes such as Ehlers Danlos Syndrome.
Prolotherapy involves the injection of a solution consisting of Dextrose, Phenol and Glycerine mixed with Lidocaine into damaged or overstretched connective tissue and joint capsules to strengthen collagen and restore elasticity. This enhances joint stability and reduces pain.
Prolotherapy is a Natural Process
Unlike steroid injections, Prolotherapy is a totally natural process that stimulates the repair of soft tissue and joints. It is effective in treating pain due to ligament laxity, repetitive overuse injuries, whiplash injuries, poor posture, improper stretching, and traumas of various kinds.
We have learned over time that when ligaments and tendons are lax or slack then the surrounding muscles reflexly go into spasm in an effort to stabilize that area of the body. Once we inject the prolo solution into the affected tissues and healing takes place, the lax tissue naturally tightens allowing the surrounding muscles to relax. This is very common with neck and shoulder pain. Prolotherapy is quite helpful in reversing some of these chronic muscle tightness and pain.
Prolotherapy is usually done in a series of 3-5 treatment sessions performed at 3-4-week intervals. Depending on the complexity, a prolotherapy session takes 15-25 minutes to perform. Unlike steroid injections, there is no limit to the number of prolotherapy injections one can have if needed.
How does prolotherapy work?
There are three well-defined healing phases of prolotherapy. Phase one is the inflammatory phase lasting 3-4 days following the injections. This phase can cause a brief period of soreness, swelling and stiffness. Phase two is the proliferative phase which lasts 3 weeks. This is when cells called fibroblasts lay down new collagen to heal injured tissue. The final phase is the remodeling phase which lasts 3 months. This is the time that the new collagen is stretched and strained and as a result, the new tissue gets organized into stronger tissue that provides adequate support.
The end result of prolotherapy injection is a reduction of pain and deactivation of receptors that act as alarm sensors in the soft tissues causing pain and result in limping and other compensatory movement patterns.
Prolotherapy Offers Long-Lasting Benefits
Once the process of the prolotherapy ‘matures’ its benefits can be very long-lasting and in some instances the effects are permanent. Since the key to igniting the proliferative process is the initial inflammatory phase, we suggest the avoidance of Aspirin, Motrin, Aleve as well as other prescription NSAIDS for 1 week prior to your injections and three weeks after.
Ice applied to the area of injection can help manage post injection pain along with Tylenol and topical CBD salve or T relief gel.
Because of its many unique and simple applications for the pain, we believe that prolotherapy injections will continue to be a mainstay of the treatment of pain for many decades to come.