Short for “proliferation therapy,” prolotherapy is also known as nonsurgical ligament and tendon reconstruction, or regenerative injection therapy. Prolotherapy works by stimulating the body’s own natural healing mechanisms to repair injured musculoskeletal tissue. The treatment originated in the 1930’s when Dr. Earl Gedney, an osteopathic surgeon successfully treated his own severe hand injury.
The concept of creating irritation or injury to stimulate healing has been recorded as early as Roman times where hot needles were inserted into the shoulders of injured gladiators. In the 1950s Dr. George S. Hackett, a general surgeon in the United States, began performing injections of irritant solutions in an effort to repair joints and hernias. This practice is what would eventually evolve into modern day prolotherapy, which is being used to help with low back pain, tendinitis and osteoarthritis.
Prolotherapy involves the injection of an irritant solution into a joint space, weakened ligament, or tendon insertion to relieve pain. Most commonly, hyperosmolar dextrose (a sugar) is the solution used; glycerine, lidocaine (a commonly used local anesthetic), phenol, and sodium morrhuate (a derivative of cod liver oil extract) are other commonly used agents. The injection is administered at joints or at tendons where they connect to bone. Prolotherapy treatment sessions are generally given every two to six weeks for several months in a series ranging from 3 to 6 or more treatments. Many patients receive treatment at less frequent intervals until treatments are rarely required, if at all.
Patients receiving prolotherapy injections have reported generally mild side effects including: mild pain and irritation at the injection site (often within 72 hours of the injection), numbness at the injection site, or mild bleeding. Pain from prolotherapy injections is temporary and is often treated with acetaminophen or in rare cases opioid medications. Studies of prolotherapy in people with low back pain have had mixed results. A combination of prolotherapy and spinal manipulation or back exercises seems to be more effective than is prolotherapy alone.
Prolotherapy offers a potentially promising approach to pain management and is steadily gaining adherents in the medical community, including at the Mayo Clinic.