Prolotherapy, also calledproliferative therapy, is an injection therapy for chronic musculoskeletal diseases. The treatment involves the continuous injection of an irritating solution into a part of the joint, for example the inside of the joint or a supporting tendon or ligament. The injected solution starts a deliberate inflammatory process in the tissue. This increases the blood supply to the functionally weakened or dysfunctional tissue. The injection of cells of various kinds into the injected area initiates the repair process. It is an effective method of pain control and is considered safe for many people. However, there are only a few studies on its overall effectiveness.
Prolotherapy is a complementary medical treatment for joint and muscle pain and damage. Prolotherapy involves injecting a mixture of fluids into damaged or dysfunctional joints, cartilage, ligaments and tendons to put these tissues back into a regenerative and self-repairing phase and is done by injecting a natural irritant into the soft structure of an injured joint. The injection of the irritant initiates the body's healing response. Proponents of this method believe that prolotherapy can provide significant relief for joint or back pain.
What are the preparations before prolotherapy?
Before the examination, the specialist evaluates the area to be treated with imaging techniques such as direct radiography, magnetic resonance imaging, computed tomography. Then, the points where the injections will be applied are determined.
Before the operation, the skin in the relevant areas is cleaned with alcohol. Then, lidocaine cream is applied to the injection site to reduce the pain. If necessary, people who experience intense pain can be sedated with sedation method.
A diet containing plenty of protein is recommended to strengthen immunity before prolotherapy. In addition, in order for the body to respond to the treatment in a healthy way, it is recommended to stop using anti-inflammatory drugs by your doctor at least 3 days before the appointment time. Blood thinners that can cause bleeding can also be discontinued under expert control a certain time before the operation.
How is Prolotherapy Applied?
With the preparation before the prolotherapy procedure, it is completed in half an hour or less in total. After local anesthesia, the affected parts are carefully injected. After the treatment, the patient can rest for 10-15 minutes by applying heat packs to the injected parts. After the temperature application, the patient can return home.
How Does Prolotherapy Work?
Prolotherapy involves injections of aqueous solutions to reduce pain in the affected joint area. This treatment is different from platelet-rich plasma (PRP) and steroid injections, which require stem cells from the individual receiving the treatment. However, some experts consider PRP injections to be a subtype of prolotherapy.
Dextrose solution is generally preferred in prolotherapy. Dextrose is a potentially irritating solution and triggers the body's healing response. This activates the body's repairing factors. These begin to strengthen and repair the damaged ligaments in the joint area. Strengthening the ligaments helps to stabilize the joint over time. When the joint is more strongly supported, the pain may disappear.
What is the recovery phase after prolotherapy?
Slight swelling and stiffness are common after the procedure. However, these get better quickly and many people can resume their usual activities the same day or the next day. Some patients may experience bruising, discomfort, swelling and stiffness that may persist for up to 1 week.
Prolotherapy should never cause intense pain. In particular, intense pain accompanied by fever may be a symptom of infection and should prompt immediate medical attention. Multiple prolotherapy treatments may be recommended to continue to guide new tissue growth. Some specialists recommend approximately 3-6 treatment sessions every 4 weeks.
What are the Types of Prolotherapy?
Prolotherapy involves the injection of various substances into the body to direct the growth of ordinary cells, tissues or organs. Various types of prolotherapy solutions are used for injection and these are chosen according to the problem being treated.
Depending on what is being treated, the specialist will recommend different types of prolotherapy treatment . Each treatment is effective in treating pain and promoting soft tissue repair.
Dextrose solution Dextrose is a solution that triggers the release of growth factors. Therefore, concentrated dextrose is injected in and around the injury site. The stimulated growth factors stimulate the growth and repair of tendons, ligaments and other soft tissues.
Platelet-rich plasma (PRP): A form of prolotherapy that involves the injection of platelet-rich plasma from the individual's own body into the site of injury. Platelets are tissue repair components that secrete various growth factors. For this purpose, a blood sample is first taken from the patient and then centrifuged. This operation separates the blood plasma and enriches its platelet content.
Prolozone: This type of injection uses an ozone solution. Ozone injection is commonly used to treat soft tissue injury, pain in joints with arthritis, back pain and sciatica.
Stem Cells: Stem cells for prolotherapy are obtained from the patient's own bone marrow or adipose tissue. The collected cells are cells that have the ability to replace other cells in various tissues and stimulate healing.
Which diseases are treated with Prolotherapy?
Prolotherapy is generally used in the treatment of injured joints and ligaments. It is most intensively applied in the glaze area. In addition, prolotherapy can also be used in the following body parts;
- Knee
- Hip
- Shoulder
- Other joints and ligaments
Some of the conditions for which prolotherapy is used;
- Injuries seen during sports
- Back pain
- Neck pain
- Carpal tunnel syndrome
- Torn tendons
- Torn ties
- Torn cartilages
However, it is not limited to these treatment areas and can be used for a wide range of musculoskeletal pains. It can sometimes be chosen to reduce pain in individuals with chronic diseases such as osteochondrosis or arthritis.
What are the risks of prolotherapy?
The risks of prolotherapy are significantly less than the dangers associated with surgical treatment. Prolotherapy usually does not require anesthesia or hospitalization. The recovery phase is considerably shorter than with surgery and the chance of infection is significantly less. Prolotherapy is generally considered safe. It has positive effects, although the fact that it is a new treatment means that there may be dangers that are not yet known.
In rare cases, infection can occur after treatment. Symptoms of infection include pain and fever. In this case, the affected person may be given antibiotics for treatment. Only receiving prolotherapy treatment from a trained and certified professional will minimize the dangers. The most important danger in prolotherapy treatment is nerve damage caused by an injection that is too close to a nerve.