A man walked into my office complaining of a very sore knee that he had sought various forms of treatment for over the past ten years but which was now getting to the point of unbearable pain with every step he took. He was having to consider knee replacement but at 50 years of age and still quite active he was not looking forward to it. Beside that he knew he would need it redone after about 5 years or so and this prospect did not excite him. He decided after much research to explore prolotherapy as a last resort. Prolotherapy is also known as Injection Reconstruction Therapy. It is used to treat damaged connective tissue such as ligaments, tendon attachments and cartilage. In short it holds the promise of restoring normal joint function even from an old injury.
The MRI report indicated a thinning of the weight bearing cartilage to the point of there being “bone on bone” along with a partial tear in the anterior cruciate ligament. It was especially painful walking up and down stairs as his knee felt like it was going to “give out” from under him.
The prolotherapy consisted of injecting a solution of 20% dextrose , local anaesthetic and normal saline into the joint especially targeting the bony attachment of the cruciate ligament. Studies show that this stimulates regrowth and nourishment of connective tissue. After the first treatment there was a significant improvement in mobility and a sharp decrease in pain. The process was repeated twice more a month apart. The end result was a normalisation of gait, increased endurance and vastly reduced pain levels. The benefits have remained after a six month follow up. This is typical though not guaranteed.
The mechanism of action employs the normal physiological response of inflammation and repair. The dextrose acts as an irritant causing inflammation at the point of damage thus stimulating blast cells to make more connective tissue. This connective tissue attaches to bone thus repairing the injury. In the case of cartilage it stimulates regrowth whilst providing nutritional support and improved circulation. It also acts as a liquid shock absorber in the joint giving immediate ease.
There are not many interventions that can repair damaged ligaments and thus many people seek help over long periods of time to ease their pain. A full thickness tear usually requires surgery for re-attachment but partial tears can generally be resolved with the less invasive prolotherapy. Once the attachments are back to full strength the associated muscles can get stronger after a period of atrophy and the possibility of rehabilitation presents itself.
As long as the underlying cause of the problem is torn or relaxed connective tissue this approach has merit and a history of 60 years in use going back to George Hackett who reported a success rate of over 80% in 10,000 cases of chronic joint pain.
Worth a look into if everything else you have tried has helped but not resolved the problem, which keeps recurring and never goes away. Torn ligaments usually ache at night when the weight of your body ends up on them after your muscles have relaxed. They are also the first part to hurt as you work or work out.
The most common areas treated with prolotherapy are knees, rotator cuff and low back or sacro-iliac joint discomfit. The cycle of repair takes 3-6 weeks to get to full strength after the injections. The improvements are long lasting or permanent depending on various factors but there is an increasing number of people who are experiencing relief for problems that they believed were caused by old age or osteoarthritis but which in fact were attributable to ligament/tendon injuries all along.
For a prolotherapy consultation for injuries, call Global Health Clinics on (09) 488 0208.