“Prolotherapy” is derived from the Latin word “prolo” meaning offspring, due to the proliferation of cells caused by the procedure. 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.
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.
Dextrose Prolotherapy: Procedure Snapshot
The basic mechanism of Dextrose Prolotherapy is simple. A solution of dextrose (a proliferative agent), lidocaine (a mild numbing agent), and magnesium (a natural muscle relaxant) are combined in a saline solution that 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.
- Q. What types of conditions can be treated?
A. Dextrose prolotherapy is particularly beneficial to torn or strained ligaments, tendons. It is also helps to restore cartilage that has degenerated due to injury or osteoarthritis. Although not as effective as other forms of regenerative cellular treatments, such as PRP or stem cell procedures, many conditions that are not severe respond well, making dextrose prolotherapy a cost-effective choice.
- Q. Why prolotherapy instead of cortisone?
A. Cortisone injections (also known as corticosteroid injections) and prolotherapy injections are both very effective at reducing joint pain, but for very different reasons. They are essentially opposite ends of the same spectrum. Corticosteroid injections stop the inflammatory process. The problem is that if you have a small tear in the tissue that needs to heal, you have essentially stopped the healing process. In addition, the corticosteroids are well known for breaking up collagen bonds. Tendons are a huge cable made of collagen. Corticosteroid injections can weaken the tendon and make it more likely to rupture or completely tear.
- Q. Is dextrose prolotherapy covered by insurance?
A. No, insurance does not cover prolotherapy. We try to mitigate costs, however, by billing for the office visit.
More Information on Dextrose Prolotherapy
- Alderman D. Prolotherapy for musculoskeletal pain. Practical Pain Management. 2007;7(1).
- Hauser RA, Meddela HS, Alderman D, et al. Journal of Prolotherapy International Medical Editorial Board Consensus Statement on the Use of Prolotherapy for Musculoskeletal Pain. Journal of Prolotherapy. 2011;3(4):744-764.
- Rabago D, Slattenfren A, Zgierska A. Prolotherapy in primary care practice. Prim Care. 2010;37(1):65-80.
- Sit RWS, Chung VCH, Reeves KD, et al. Hypertonic dextrose injections (prolotherapy) in the treatment of symptomatic knee osteoarthritis: A systematic review and meta-analysis. Scientific Reports. 2016;6 (Art # 25247). doi:10.1038/srep25247
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:
- Degenerative joint disease
- Spine arthritis
- Meniscus tears
- Tendon tears
- 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)