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 Virgina. She had the great fortune of learning Prolotherapy from one of it’s 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 or x-ray guidance. Prolotherapy is an important tool in treating chronic joint instability, chronic whiplash, recurrent ankle and wrist sprains and hypermobility syndromes such as Ehlers Danlos Syndrome.
Prolotherapy involves the injection of a concentrated Dextrose solution mixed with local anesthetics and other substances into damaged or overstretched connective tissue and joints to strengthen collagen and restore elasticity to tissue and enhance joint stability and reduce 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 repetitive overuse 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 go into spasm in an effort to stabilize an area of the body but once we inject the prolo solution and tighten lax tissue then surrounding muscles can relax. This is very common in the neck and shoulders. Prolotherapy is quite helpful in reversing some of this 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: Phase1 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 lasts 3 weeks and this is called the proliferative phase. This is the phase when new collagen is proliferating (is being laid down) to heal the injured tissue.
The final phase is the remodeling phase and this phase 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 strong tissue that provides adequate support.
The result of the prolotherapy 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 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 T relief gel which can be purchased at most health food stores or online.
Because of its unique and simple applications for pain we believe that prolotherapy injections will continue to be a mainstay of the treatment of pain for many decades to come.