Prolotherapy

Prolotherapy is a simple injection technique used for some specific situations of chronic pain. The procedure may be offered or suggested by your physician. The injection stimulates the body to repair a painful area when the natural healing process needs a little assistance. 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 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 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 causes normally taut, strong bands of fibrous connective tissue becoming relaxed and weakened. The relaxed and inefficient ligament or tendon then becomes the source of chronic pain and weakness.

The greatest stresses to ligaments and tendons are where they attach to the bone, the fibro-osseous junction. This junction is contiguous with the most sensitive bone structure that produces pain-the outer covering of bone known as the periosteum. 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. Ligaments are weakest where they attach to bone. 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.