Enhancing the body's innate ability to heal

North Texas Musculoskeletal Medicine

Regenerative Orthopedics Osteopathic Manipulation



Dextrose Prolotherapy

“Prolotherapy” is derived from the Latin word “prolo” meaning offspring, due to the proliferation of cells caused by the procedure. The dextrose acts as an irritant, causing the body to regenerate tissue at an accelerated rate. Dextrose Prolotherapy enhances the process the body naturally uses to stimulate the healing system... inflammation.

Chronic musculoskeletal pain often results when ligaments or tendons have been weakened by strains or sprains. Ligaments that connect the bones can become stretched and develop small tears, causing the joint to become overly lax. This instability increases force on the fibro-osseous junction, the location of attachment of ligaments to the bones.

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Bones are covered by highly sensitive tissue called periosteum, the tissue to which the ligaments and tendons attach. This attachment is generally the greatest source of pain in a joint injury. Prolotherapy injections occur at this location.

Deteriorated cartilage is also a common source of joint pain. Articular cartilage acts as a shock absorber, lubricating and cushioning the space between the bones to allow them to function more freely. When this tissue degenerates due to injury, osteoarthritis, or just plain aging, the bones grind together rather than moving freely. Cartilage tissue itself has no sensory nerve endings. When cartilage is damaged, ligaments are generally the source of pain.

The basic mechanism of Dextrose Prolotherapy is simple. A solution of dextrose, lidocaine, and saline, a proliferative agent and a mild numbing agent, is injected into the damaged tissue. The dextrose acts as an irritant deliberately causing inflammation, the body's natural way of repairing injured tissue.

The controlled, localized inflammation triggers a healing cascade, resulting in the deposition of new collagen, the natural material of ligaments and tendons. As the tissue heals, the collagen hardens, often causing the tissue to be stronger than before the injury. The tightened connective tissue stabilizes the weakened joint, subsequently reducing or eliminating the pain.

Several factors contribute to the physiological enhancement of the healing process:

  • Cartilage, ligaments, and tendons often heal poorly because of poor blood supply, as is apparent in their white color. The controlled inflammation of prolotherapy also causes increased blood flow, nourishing the tissue while removing damaged cells.
  • NSAIDS, like ibuprofen, inhibit the body's healing process. Although they may give momentary relief from pain, they are counterproductive to the healing process.
  • Intentionally induced inflammation caused by dextrose injection stimulates the body to deposit collagen on the injured tissue, healing and restoring tissue that otherwise takes a long time to heal and often never completely heals.
 

 

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Dextrose Prolotherapy: Procedure Snapshot

The doctor first cleans the area that will be injected with a solution of dextrose, saline, and lidocaine. The needle is very small to minimize pain. There may be mild discomfort lasting for several days after the procedure. Usually more than 1 treatment is needed for healing to take place.

Applications

  • Patients with unresolved chronic tendon or ligament pain resulting from injury or degeneration, or those have suffered a recent painful injury should consider this therapy. There is a wide of array of conditions that respond to dextrose prolotherapy, including:
  • Osteoarthritis
  • Degenerative joint disease
  • Spine arthritis
  • Meniscus tears
  • Tendon tears
  • Tendinitis
  • Labrum tears
  • Ligament sprains, strains, and tears
  • Tennis and golfers elbow
  • Plantar fasciitis
  • SI joint problems
  • Tendon pain on thumb side of wrist (De Quervains Tenosynovitis)