Chronic Joint, Tendon or Ligament Pain? Have You Tried Prolotherapy?

When you ask your doctor what you can do about your arthritic knees, painful Achilles tendon or torn rotator cuff, you’re likely to be told about using ice or pain medication. Your physician might even discuss surgical options. But there is a very effective, non-surgical treatment that your medical provider may not mention -– prolotherapy. Why isn’t it discussed? Prolotherapy technique is difficult to learn and requires extensive specialized training; thus very few doctors are familiar with its benefits and even fewer are truly qualified to administer the procedure.

That having been said, if you are suffering from chronic joint pain or a muscle, ligament or tendon injury, you should at least consider prolotherapy. “Why?” you might ask.

“Because it’s a safe, efficient, and non-surgical way of healing the micro-tears in the fibrous tissue that connects joint capsules, tendons and ligaments to bone. This connective tissue supports the proper functioning of every joint and muscle in the human body”, explains Dr. David Wang. “When, through trauma or disease, these attachments are damaged, the joint can become weak and unstable, leading to increased pain and potentially further injury. Furthermore, the body’s ability to heal these injuries is not great because tendons, ligaments, and cartilage have a poor, natural blood supply.”

How does it work? With prolotherapy (short for “proliferative therapy”), a proliferant, often dextrose (sugar), is injected into the injured area, causing a proliferation, or increase, of growth factors that activate the body’s cells to heal the injury. A more recent innovation, platelet-rich plasma (PRP) therapy, is considered by many to be a particularly powerful type of prolotherapy, and has seen growing success among many professional athletes as well as the general public. PRP directly harnesses the body’s own growth factors by concentrating the platelets, which are where the growth factors are stored and released to activate tissue healing. MRI and sonography studies have clinically demonstrated the regeneration of healthy tissue in areas treated with prolotherapy.

Says Dr. Wang of the resulting benefits, “The result of the injection process is that the injured tendons and ligaments heal more completely, which in turn strengthens the entire joint area, allowing people to return to their normal activities faster, with less pain and greater confidence than they would ever be able to do otherwise.”

Can you benefit from prolotherapy? If you have pain that you can localize and literally “put a finger on” (e.g. inner edge of the knee, base of the skull, etc.), then there is an excellent chance that prolotherapy can help you. Some common painful conditions involving the network of joints, muscles, ligaments, tendons, and other connective tissue that can improve with prolotherapy include:

• Arthritis, affecting any joint, including the knees, hips, hands, feet, and the spine
• Neck, back and sacroiliac pain
• Headaches, especially tension headaches that begin with neck pain
• TMJ (temporomandibular joint) disorders of the jaw
• Coccydynia (pain in the tailbone)
• Sciatica, when leg pain is referred from an injured ligament or tendon in the low back, rather
• than being caused by a pinched nerve
• Rotator cuff tears or labral tears in the shoulder
• Elbow tendinitis (i.e., Tennis and Golfer’s Elbow)
• Wrist and hand sprains, such as those caused by falls and climbing injuries
• Hip and groin pain, due to muscle and tendon strains from running, kicking, biking, etc.
• Knee sprains, small meniscal tears, and ACL or PCL partial tears (full tears often do require surgery)
• Ankle and foot pain from ankle sprains, Achilles tendinitis, plantar fasciitis, flat feet or hammertoe
• Whiplash related neck pain

Prolotherapy is not a cure-all, but it can offer a minimally-invasive, non-surgical way of relieving, and in some cases resolving, chronic pain conditions. When performed in combination with advanced imaging technology such as diagnostic musculoskeletal ultrasound (sonography), the treatment can be delivered with an unparalleled precision of about 0.2 mm, thereby maximizing safety and effectiveness.

The best way to find out if you are a good candidate for prolotherapy is to receive a comprehensive evaluation from a physician who is an expert in treating musculoskeletal pain of all types, and who also has extensive training in prolotherapy. A knowledgeable physician can rule out other possible causes of your pain through appropriate medical testing, and can provide you with an accurate diagnosis first before recommending the most effective treatment.

– David Wang, D.O.