With the advancement of technology and medicine, new procedures and treatments for orthopedic conditions have come along, including orthobiologic therapy, smart implants, 3D printing technology, minimally invasive surgeries, and more. Yet, regenerative prolotherapy, a non-surgical regenerative injection treatment, is still an effective and low-cost treatment option for musculoskeletal injuries to muscles, tendons, and ligaments.
In this article, we’ll discuss the origins of regenerative prolotherapy and the role it has played in regenerative medicine for centuries.
Before getting into the origins of regenerative prolotherapy, it’s important to know what it is and exactly how it works. Regenerative prolotherapy, which is short for proliferation therapy, is a non-invasive treatment that involves injecting an irritant solution into a weak or damaged part of the body to aid in the healing process. This solution, which often consists of dextrose (sugar), lidocaine (a local anesthetic), and sterile water is injected into tendons, joints, ligaments, and in adjacent joint spaces during several treatment sessions. This is to promote growth and improve the health of normal cells and tissues.
Regenerative prolotherapy works by the same process the body uses to stimulate the natural healing system. That process is called inflammation. The irritant that’s injected into the body during regenerative prolotherapy causes an inflammatory response, which helps enhance the healing process.
So to understand regenerative prolotherapy, imagine what happens when you get a cut or sprain an ankle. Your body initiates an inflammatory response to heal whatever is “broken”. With a cut, your body works to form a scab and regenerate new skin cells. With an ankle sprain, your body initiates an inflammatory response, which causes the formation of blood clots. Then, your blood vessels trigger redness, swelling, and warmth. Finally, your body begins to produce new cells in the ligaments of your ankle.
In a nutshell, regenerative prolotherapy results in the same response your body undergoes after an injury. It involves injecting an irritant, which your body recognizes as a foreign invader. As a result, inflammation occurs. This aids in healing injured ligament and tendon tissue. These ligaments and tissue grow back thicker and stronger. This creates a stronger bond at these attachment points, which means a decreased load on individual fibers. After regenerative prolotherapy, patients often experience significantly less pain, improved range of motion, and improved function in the treated area.
The Ancient Egyptians used a form of regenerative prolotherapy to treat lame animals. They would use branding or hot iron cautery to stimulate muscles and ligaments that weren’t functioning. Regenerative prolotherapy was first used on humans by Hippocrates. The Greek physician used a hot poker in the axilla (armpit) to repair a dislocated shoulder. From the 1830s to the 1920s, Regenerative prolotherapy was a common treatment for hernias, varicose veins, and hemorrhoids During the 1940s and 1950s, the use of prolotherapy for the musculoskeletal system other than hernias became more popular. Regenerative prolotherapy can be used to treat a variety of conditions:
Before your physician begins the procedure, he or she will discuss the potential risks and benefits of regenerative prolotherapy. Once you provide consent to undergo the procedure, your physician will position you on an exam table as well as prep and sterilize the treatment area, Your physician will then inject a local anesthetic, followed by the prolotherapy injection(s). Your physician will then cover the area to prevent infection. Overall, treatment of a single area of the body may take 10 to 15 minutes per session.
On average, patients receive 4 to 6 injections, The injections are usually administered 4 to 6 weeks apart. After the procedure, you may be sore for a few days. It’s also common to experience aching, burning, swelling, muscle spasms, numbness, and bruising after your visit. This is due to the fact that the injection produces irritation and inflammation that is intended to repair, strengthen, and heal the affected tissue.
It may take a little while for patients to see a significant improvement in the areas of treatment. Most patients should see some improvement in pain or functioning after two or three treatments. If a patient does not respond after 2 or 3 treatments, they will have to discuss future care plans with Dr. Janiga.
Some more severe painful conditions will require stronger regenerative prolotherapy solutions. There are many forms of regenerative prolotherapy. Any injection method that strengthens or repairs a patient’s ligaments or tendons is prolotherapy. Examples of stronger prolotherapy solutions: platelet-rich plasma (PRP) which utilizes a patient’s own growth factors from their own blood or utilizing amniotic allograft growth factors, or even using a patient’s own stem cells from their bone marrow.
Platelet-rich plasma (PRP) injections involve injecting a concentration of your own platelets to accelerate the healing of injured tendons, ligaments, muscles, and joints. To put it plainly, PRP injections use your own healing system to improve orthopedic problems. If you have chronic musculoskeletal pain, PRP therapy may be right for you. PRP therapy works similarly to prolotherapy in that it initiates the body’s natural healing process, the difference is, PRP involves the use of your own platelets instead of an injected irritant solution. For example, when an injury occurs, the body sends platelets — small, colorless cell fragments in our blood that form clots to stop or prevent bleeding — to the site of the injury in an effort to fix the damage. PRP therapy helps harness and boost your body’s natural healing ability.
Bone marrow concentrate (BMC) is another regenerative procedure that can be used to treat a number of orthopedic conditions. Bone marrow contains healing cells taken from your own body. These cells are concentrated and reinjected into the area of need to bolster the healing response and help new tissue formation. Bone marrow concentrate is usually for patients with osteoarthritis, or moderate to severe orthopedic injuries.
If you’re looking for a trusted doctor to treat your orthopedic condition, we’re here to help. Dr. Mark Janiga specializes in prolotherapy injections for patients in need. Schedule an appointment today for an evaluation of your condition.
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