Prolotherapy is a simple, natural technique that stimulates
the body to repair the painful area when the natural healing
process needs a little assistance. That's all the body needs,
the rest it can take care of on it's own. In most cases,
commonly prescribed anti-inflammatory medications and more
drastic measures like surgery and joint replacement may not
help, and often hinder or even prevent the healing process.
The basic mechanism of Prolotherapy is simple. A substance is
injected into the affected ligaments or tendons, which leads to
local inflammation. The localized inflammation triggers a wound
healing cascade, resulting in the deposition of new collagen,
the material that ligaments and tendons are made of. New
collagen shrinks as it matures. The shrinking collagen tightens
the ligament that was injected and makes it stronger.
Prolotherapy has the potential of being 100 percent effective at
eliminating and chronic pain due to ligament and tendon
weakness, but depends upon the technique of the individual
Prolotherapist. The most important aspect is injecting enough of
the solution into the injured and weakened area. If this is
done, the likelihood of success is excellent.
Prolotherapy involves the treatment of two specific kinds of
tissue: tendons and ligaments. A tendon attaches a muscle to the
bone and involves movement of the joint. A ligament connects two
bones and is involved in the stability of the joint. A strain is
defined as a stretched or injured tendon; a sprain, a stretched
or injured ligament. Once these structures are injured, the
immune system is stimulated to repair the injured area. Because
ligaments and tendons generally have a poor blood supply,
incomplete healing is common after injury. This incomplete
healing results in these normally taut, strong bands of fibrous
or connective tissue becoming relaxed and weak. The relaxed and
inefficient ligament or tendon then becomes the source of
chronic pain and weakness.
The greatest stresses to the ligaments and tendons are where
they attach to the bone, the fibro-osseous junction. The most
sensitive structures that produce pain are the periosteum
(covering of the bone) and the ligaments. It is important to
note that in the scale of pain sensitivity (which part of the
body hurts more when injured), the periosteum ranks first,
followed by ligaments, tendons, fascia (the connective tissue
that surrounds muscle), and finally muscle. Cartilage contains
no sensory nerve endings. If you are told that your cartilage is
the cause of your pain, you have been misinformed; the cartilage
cannot hurt because they contain no pain sensing nerves. If
there is cartilage damage, the ligaments are typically the
structures that hurt. Ligaments are weakest where they attach to
bone. The periosteum is the most sensitive area to pain and the
ligaments second. It is now easy to understand why this area
hurts so much. This is where the Prolotherapy injections occur,
and thus eliminate the chronic pain of many conditions including
arthritis, mechanical low back pain, degenerative disc disease,
cartilage injury, and sports injuries.
Prolotherapy works by exactly the same process that the human
body naturally uses to stimulate the body's healing system, a
process called inflammation. The technique involves the
injection of a proliferant (a mild irritant solution) that
causes an inflammatory response which "turns on" the healing
process. The growth of new ligament and tendon tissue is then
stimulated. The ligaments and tendons produced after
Prolotherapy appear much the same as normal tissues, except that
they are thicker, stronger, and contain fibers of varying
thickness, testifying to the new and ongoing creation of tissue.
The ligament and tendon tissue which forms as a result of
Prolotherapy is thicker and stronger than normal tissue, up to
40% stronger in some cases!
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