Surrey Prolotherapy Treatments, Pain, Ligament Tendon Injuries, Naturopathic Doctor, South Surrey Vancouver, BC, White Rock

Introduction to Prolotherapy

Dr. Navi Badesha, N.D.



What is prolotherapy?

Prolotherapy is an injection therapy that is a natural non-surgical method of stimulating the body to heal injured tendons and ligaments that has been used for over 60 years. The word ‘prolo’ is short for proliferation. Quite often, chronic pain is the result of instabilities in joints and weaknesses in muscles cause by damaged ligaments and tendons.

How does prolotherapy work?

Prolotherapy involves the injection of an irritant solution into the area where the ligament or tendon is damaged. The solution, a mixture of dextrose (sugar) and pocaine (local anesthetic), is injected at specific points where ligaments and tendons meet bones. This causes a localized inflammatory response which increases blood supply, immune cells and nutrients to the weak area. This is the first step in the wound healing process and the step that is inhibited by anti-inflammatories such as NSAIDS and cortisone. Basically, you are tricking your body into thinking that it has been injured. However, this “new” injury promotes a far greater immune response than the original injury because of the injection of the irritant solution. The end result is that your own immune system sends connective tissue building cells to the area causing the proliferation of new collagen, thereby strengthening damaged tendons and ligaments. New collagen shrinks as it matures. The shrinking collagen tightens the ligament that was injected and makes it stronger.

Why kind of structures can be treated with prolotherapy?

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.

What happens to ligaments and tendons after injury?

During an injury, the collagen fibers that make up the ligaments and tendons are torn. The body heals these tears through the process of inflammation which is characterized by redness, swelling, tenderness, and stiffness in the joint. During the first days after injury, white blood cells flood the area to clean up the tear. Over the next few weeks, additional white blood cells migrate to the junction of the ligament and bone to begin building news collagen fibers. If the inflammation process is successful the new collagen fibers wind about each other becoming shorter and tighter. This healing process can take several months.

Why don’t injured tendons and ligaments always heal properly?

Healing can be disrupted if the injury is too severe or painful, or if the inflammatory process is interrupted with medications or abnormal activity. In addition, a lack of blood supply to tendons and ligaments deprives them of nutrients needed to heal properly. Due to these interferences, the tendons/ligaments heal in an elongated and disorganized fashion leaving the ligament lax and the nerves irritated. This causes restricted movement, excessive pain, and leaves the area prone to re-injury. This incomplete healing results in these normally taut, strong bands of fibrous or connective tissue becoming relaxed and weak. The relaxed and inefficient ligament or tendon then becomes the source of chronic pain and weakness.

How can ligaments and tendons be strengthened?

They do not respond to exercise in the same way muscles do. Medications and manipulations can help reduce the pain only temporarily. In some cases, surgery can repair some injuries but is invasive and leaves scar tissue. Prolotherapy stimulates the body’s natural healing mechanisms to repair tendons and ligaments to their original strength without scar tissue.

How painful is prolotherapy?

In order to create the inflammatory response desired, there must be a certain amount of disruption of the ligament. This is done by inserting a needle at the point where the ligament comes into contact with the bones. There is pain involved with introduction of the needle and the contact of the needle and bone.

How many treatments are needed?

Every person has a different healing time. That is, until pain and function have normalized and the signs of joint instability and dysfunction are no longer detected. For some people only one injection is needed and other people need several. Repeated injections are performed between 1 and 6 weeks depending on the healing process.

What are the risks associated with prolotherapy?

As with any injection, there are certain risks. However the true risks are relatively minor. Some of the risks are pain at the injection site, infection, temporary bruising of the nerve, dizziness, numbness, and pneumothorax (air on the outside of the lung). Most of the side effects will effects will subside over the 2 to 10 days following treatment.