|
What
is Prolotherapy?
Ross Hauser, M.D.
Prolotherapy is a simple, natural
technique that stimulates the body to repair the painful area when the natural
healing process needs a little assistance. Notice I said "a little
assistance". Because often, 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. Yes, you
heard me right. 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!
In 1983, Y. King Liu performed a
study using the knee ligament in rabbits. This study was done in order to
quantify the strength of the tissue formed by Prolotherapy. In this study, a
proliferant was injected into the femoral and tibial attachments of the
medial collateral ligament, the inside knee ligament. The ligaments were given five Prolotherapy treatments and then compared to non-injected ligaments. The
results showed that in every case Prolotherapy significantly increased
ligamentous mass, thickness, and cross sectional area as well as the ligament
strength. In a six-week period, ligament mass increased by 44 percent,
ligament thickness by 27 percent, and the ligament bone junction strength by
28 percent. This research was yet another attestation to the effectiveness of
Prolotherapy, showing that Prolotherapy actually causes new tissue to grow.
Imagine what it would mean to an athlete to run 40 percent faster, jump 40
percent higher, or be 40 percent stronger? This new growth of stronger,
healthier tissue is the normal and desired outcome with Prolotherapy.
The concept behind Prolotherapy
George S. Hackett, M.D.
The term Prolotherapy was coined
by George S. Hackett, M.D., the "father of Prolotherapy", in 1956.
He describes Prolotherapy as follows:
"The treatment consists of
the injection of a solution within the relaxed ligament and tendon which will
stimulate the production of new fibrous tissue and bone cells that will
strengthen the weld of fibrous tissue and bone to stabilize the articulation
(where the bone and ligament meet) and permanently eliminate the disability.
To the treatment of proliferating new cells, I have applied the name
'Prolotherapy' from the word 'Prolo' (Latin) meaning offspring; 'proliferate'
- to produce new cells in rapid succession (Websters Dictionary). My
definition of Prolotherapy as applied medically in the treatment of skeletal
disability is 'the rehabilitation of an incompetent structure by the
generation of new cellular tissue.'"
Dr. Hackett, after 20 years of
experience, arrived at the conclusion that injured ligaments were the primary
cause of chronic pain. Injured tendons were the second most common cause. He
referred to this weakness in the ligaments and tendons as
laxity.
Prolotherapy involves the injection of substances that stimulate new tissue
growth at the junction between the fibrous tissue (ligaments and tendons) and
the bone. Most things break down at a junction site because this is the
weakest part of the structure; this is especially true in weight bearing
joints. A good example of this is when the leg of a chair is wobbly or loose.
This is usually due to a loose connection where the leg attaches to the seat
of the chair. By tightening the attachment of the leg to the seat, the chair
becomes more stable.
Dr. Hackett used the word
"weld," which is a very accurate description of Prolotherapy.
Prolotherapy welds the ligaments and tendons to the bone. When welding steel,
the welder is applying a very hot probe or flame to melt two pieces of metal
together. Two large pieces of metal would require welding many areas all along
the long seam. Why do so many spots need to be welded? The reason is to make a
stronger connection. If one area weakens in the future due to wear and tear,
the others will hold the structure together.
This is the concept behind
Prolotherapy. All of the injured tissue must be treated for injuries for
chronic pain to be eliminated. Prolotherapy causes the proliferation of new
ligament and tendon tissue exactly where the injections are given. It is just
like spot welding. It strengthens the exact spot where the weld or injection
takes place. The more injections, the stronger the weld.
|
Prolotherapy
Our
Prolotherapy Books - 
POWER
OVER PAIN