Osteoarthritis, Injuries and Prolotherapy: Joint Pain That Can Be Cured

Noel Peterson, ND

What is Prolotherapy?

Prolotherapy is defined in Webster’s New Collegiate Dictionary as “The rehabilitation of an incompetent structure such as a ligament or tendon, by the induced proliferation of new cells.” It was developed over fifty years ago as a natural non- surgical method of assisting the body in healing injured tendons and ligaments. Prolotherapy helps your body make new cells, which strengthen lax or torn tendons and ligaments (Ligaments are the tough tissues which connect bones to bones, and tendons are the tough tissue which connect muscles to bones).

What kinds of injuries respond to Prolotherapy?

Soft tissue injuries (strains, sprains and bruises of muscles, tendons, fascia, and ligaments ) are the most common injuries encountered in sports, auto, household, and work accidents. These injuries produce chronic pain in the hands, elbows, shoulders, hips, knees, and feet, as well as neck, ribs, back, and sacrum. The majority of these injuries heal through the body’s own internal mechanism of producing inflammation which triggers the proliferation of fibrous tissue that mends the damaged areas. However, many go on to chronic pain and dysfunction, and many common anti-inflammatory drugs used in these cases actually inhibit the repair of these damaged cells.

What about arthritis?

Osteoarthritis is the gradual degeneration of joint surfaces, caused by overuse and under repair. Over time, this wear-and-tear of cartilage progresses to the point that the cartilage is worn thin and pain results. Degenerative joint disease can progress to the point where the patient needs a total hip or knee replacement. Prolotherapy has been proven to reverse the degeneration of joints when the condition is treated early enough.

Other forms of arthritis are autoimmune mediated, such as Rheumatoid Arthritis, Lupus, and Ankylosing Spondylitis. These forms of joint disease can in some cases be helped with Prolotherapy.

How can you strengthen tendons and ligaments?

Unlike muscle tissue, exercise cannot build, strengthen, or repair ligaments or tendons. Prolotherapy has been shown to increase the size of tendons and ligaments up to 40%. It has also been shown to increase their tensile strength by as much as 200%. Prolotherapy thickens knee cartilage and relieves the pain of degenerative joint disease and no scar tissue is formed (as would be the case in surgical procedures). The tissue formed from Prolotherapy is healthy, strong, flexible ligament or tendon tissue. Once the ligament or tendon has been repaired by Prolotherapy, the nerves are no longer stretched or irritated, the pain goes away, and normal function follows.

How is Prolotherapy performed?

Prolotherapy technique consists of using a fine needle to inject a proliferative solution into incompetent tendons, ligaments, and joints for the purpose of stimulating new growth and repair, thereby promoting joint stability and reduction of pain. The most common substances used are dextrose (a kind of sugar) and glucosamine diluted with procaine (a local anesthetic). When injected into the torn tendon or ligament, the dextrose and procaine solution induces a physiologic reaction that stimulates the healing processes to resume, and induces the migration of fibroblasts (the body’s repair cells) to the site of injection. Fibroblasts lay down new connective tissue and in so doing, enlarge and strengthen the damaged tendons, ligaments and cartilage. Glucosamine injections stimulate the growth and repair of cartilage. Injections of glucosamine are considered to be over a thousand times more effective than oral glucosamine.

Do Prolotherapy injections hurt?

Prolotherapy injections are performed with a lot of care and a little local anesthetic. The pain of treatment is minor and only temporary when compared to the chronic pain of tendon and ligament injuries. Some patients experience pain and swelling at the injection sites for 1-3 days following the procedure. To counteract this, we recommend patients apply moist heat as needed, and perform moderate exercise such as walking. Often specific exercises are prescribed to follow-up the injections. The natural proteolytic enzyme bromelain can also be taken for swelling if needed. Reports of more serious complications have been extremely rare.

Case history

When Mark injured his knee playing tennis, he expected it to heal on its own. His orthopedist ruled out the all too common torn meniscus or ACL tear, and recommended ibuprofen, which helped the pain but his knee continued to be weak and unstable. After six months he still had pain which prevented him from being able to do much more than walking. His injury was getting more painful and limiting and after six months, his knee felt vulnerable and painful with any deep bend or rotational exertion.

When I examined Mark, I found an unstable tibial-fibular ligament (the connective tissue that holds the head of the fibula to the lateral condyle of the tibia), a weakened fibular collateral ligament, and a torn, weak tendon of the biceps femoris muscle attachment at the head of the fibula. We scheduled a series of Prolotherapy injections, and three months later his pain was gone and he was back on the tennis court.

Who is good candidate for regenerative prolotherapy?

A good prolotherapy case is one in which the patient has suffered either accidental trauma or chronic degeneration to the connective tissue of a joint or the ligaments and/or tendons that stabilize the joint. Patients with any of the following conditions can respond to prolotherapy:

Lateral and medial epicondylitis (tennis or golfer’s elbow).
Shoulder pain, including supraspinatus tendinosis, rotator cuff impingement syndromes, adhesive capsulitis, and calcific tendinosis.
Knee pain, including arthritis, lax or partially torn cruciate ligaments, lateral and medial collateral ligament sprains and instability, enthesopathies (origin and insertion injuries to tendons and ligaments), injuries to the tibia-fibular ligaments, ACL and PCL instability, Grade 1/2 meniscus tears, and knee cap pain.
Osteoarthritis of the knees, including chondromalacia patellae and degenerative osteoarthritis of the cartilage and meniscus.
Sacroiliac pain syndromes, including hypermobility syndromes, sciatica, and osteoarthritis.
Cervical, thoracic and lumbar vertebrae arthritis, causing chronic pain, instability and dyskinesia.
TMJ syndrome, including referred pain patterns, grinding, and clenching of the teeth.
Foot pain, including plantar fascitis and tarsal tunnel syndrome.
Hand, wrist, finger and toe pain and arthritis.
Rib pain, costochondritis, costovertebral ligament laxity and hypermobile rib.

Our focus on regenerative therapies encompasses the range of treatments which cause or encourage the growth and repair of weakened and damaged connective tissues, and restoration of optimum cell function. Our goal is to encourage optimum biological function regardless of chronological age. Prolotherapy injections, trigger point injections, hormonal support, detoxification, chelation, and nutritional support all contribute to and encourage the growth and repair of connective tissue and cell vitality.

Like all medical practices, regenerative therapy is as much an art as it is a science, and to this end Dr. Peterson and Dr. Horan take every possible opportunity to sharpen their skills and mind in the practice of prolotherapy, trigger point therapy, and other regenerative procedures.

For more information on the benefits of prolotherapy, contact the Center for Traditional Medicine.