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Are you suffering from chronic joint pain?

Short for “proliferation therapy”, prolotherapy is a non-surgical, regenerative therapy that stimulates cell and tissue growth to assist in the healing of damaged cartilage, ligaments and tendons associated with joint pain. Developed by George Hackett, MD and his colleague Gus Hemwall, MD in the 1950s, it is used for both acute and chronic pain management, and is one of Dr. Safayan’s most sought-after therapies.

What is prolotherapy?

Prolotherapy consists of a series of injections of a high concentration of dextrose, found over many years to be a safe and effective solution.

How does prolotherapy work?

Many pain problems arise from ligament and tendon injury. The enthesis, the junction where a ligament or tendon attaches to bone, is often the site of injury, where the attachment may be disrupted. Conventional therapy aimed at reducing pain, swelling and tenderness is not helpful in repairing the enthesis because of the relatively poor blood supply in this area. Dr. Hackett theorized that injecting a high concentration of dextrose into the enthesis would force surrounding tissue to release repair factors into the injured site via an osmotic gradient. What results is an inflammatory response or proliferation aimed at repairing the damaged enthesis.

How many treatments will I need?

Patients usually require four to six successive treatments, spaced approximately one month apart to allow the proliferation (fibroblastic repair) to be complete. Therapeutic response is often appreciated within the first two sessions and the benefits may last for months to years after the treatments are complete.

Are there side effects?

Most commonly patients experience soreness and stiffness at the treatment site for several days. Other side effects may include minimal bleeding at the injection sites, and bruising which resolves after few days. Sensitivity to the proliferative agent and/or the anesthetic, exhibited in the form of headache, nausea and tiredness, are far less common, and resolve in a number of days. Very rare side-effects include infection, puncture of the lung and nerve tissue damage.

What conditions most benefit from prolotherapy?

  • Shoulder pain, especially when moving or lifting one’s arm, or when having difficulty sleeping on one’s shoulder
  • Osteoarthritis of any area of the body including neck, shoulder, elbow, wrist, fingers, spine, hips, knees, ankles and feet
  • Joint dislocation
  • Grinding, popping or clicking in a joint
  • When chiropractic adjustments help but don’t last
  • When muscle relaxants, arthritis medication, cortisone shots or nerve blocks fail to resolve the problem within 6 weeks
  • When surgery has failed, as in Failed Back Syndrome
  • Whiplash injuries as in a car accident to any part of the body, in particular the neck and lower back
  • When a joint is aided by a sling, brace or splint
  • If ligament or tendon sprains or tears have been diagnosed
  • If there is a deep aching or pulling pain in the joint
  • Shooting pains, tingling or numbness

“The technique reactivates the healing process by injecting a mildly irritating substance — commonly a somewhat concentrated sugar solution along with the painkiller lidocaine — into the area to stimulate a temporary low-grade inflammation… Among scientifically designed controlled studies, most showed a significant improvement in the patients’ level of pain and ability to move the painful joint.”
Jane E. Brody, “Injections to Kick-Start Tissue Repair”, The New York Times, August 7, 2007.

Note: Dr. Safayan received his prolotherapy training through the Hackett Hemwall Foundation, the premier prolotherapy training organization, where he is now a faculty member and clinical instructor, training physicians from around the world.

To learn more about prolotherapy, read Dr. Safayan’s blog post, A Look at Prolotherapy for Pain and visit www.GetProlo.com.