Injecting Relief Prolotherapy Can Effectively Reduce Chronic Pain
March 17, 2011 by Dr. Marc Darrow, M.D.
Filed under Prolotherapy Medical Literature
ADVANCE MAGAZINE
By Marc Darrow, MD, JD, QME
The idea of introducing an irritant to an injured joint certainly isn’t new. In ancient Greece, Hippocrates used heated metal probes to treat dislocated and painful shoulders of javelin throwers. He believed this technique created tough scar tissue that tightened the shoulder capsule and kept the joint in place.
George S. Hackett, MD, continued to build on Hippocrates’ theories in 1939. While working with car accident survivors, he realized that patients experienced pain when ligaments and tendons were injured. He believed that repairing connective tissue could resolve most of the pain. Dr. Hackett introduced an irritating compound to activate the body’s natural mechanisms and prompt production of new collagen tissues—a proliferation process that became known as Prolotherapy.
Also known as proliferation therapy, Prolotherapy is a pain management technique that can treat degenerative or chronic injury to ligaments, tendons, muscle fascia and joint capsular tissue. It also can be effective for areas that are painful, but not tender to the touch, such as the inside of a joint.
Through injections, Prolotherapy allows rapid production of collagen and cartilage.1 Collagen, a naturally occurring protein in the body, is a crucial element to the formation of new connective tissue. And healthy connective tissue creates a solid foundation to hold the skeletal infrastructure together.
Healing Mechanisms
Prolotherapy helps produce collagen by injecting mild chemical or natural irritants, such as dextrose—sugar. The injections stimulate the immune system’s healing mechanism to create collagen naturally. This strengthens and restores joints, which provides permanent pain relief.
Consider a condition such as chronic pain, in which injured, loose or stretched out ligaments often cause ligament laxity. Laxity produces pain and discomfort, especially during movements. This occurs because the connection of ligaments and tendons to bone may be inflamed, and a joint may be moving beyond its normal range of motion.
The body, therefore, must create collagen to heal injured tendons and ligaments. But it doesn’t provide ligaments and tendons with a proper blood supply, which means lower collagen production and a poor chance for complete healing.
The same holds true in cases of degenerative disease and aging. In particular, collagen may dry out and lose its stretching ability. This process is more severe in some people, and researchers don’t know why. Theories behind this deficiency include poor genetic makeup, blood type with specific dietary requirements, viral or bacterial load, pathological conditions, body acidity or food allergies.
In healthy ligaments or tendons, collagen fibers are flexible and elastic. But injuries can stretch fibers beyond their designed lengths, and repetitive motion frays or tears them. When tissues are stretched beyond their normal limits, inflammation occurs. A patient experiences inflammation, the immune system’s response to injury, when the body tries to heal damage. However, a weakened immune system or severe injury also can restrict the ability of ligaments and tendons to heal correctly. Since connective tissue around joints and cartilage has such poor blood circulation, injuries to connective tissue are often irreparable. In a future article we will go into great detail concerning Prolotherapy Injections and PRP treatment.
The key to prolotherapy is stimulating collagen development and growing new ligament and tendon tissue. By growing stronger ligaments and tendons, you can repair the injury, and reverse the degenerative cycle of arthritis and wear-and-tear disorders.

