Rebuilding Collagen: The Key to Prolotherapy Part 2

Ligament Laxity Inflammation


In all cases that require Prolotherapy, the ligaments and tendons, whether through the use of anti-inflammatories, or because of a weakened immune system, or because of the severity of the injury, did not heal sufficiently.

When things do not heal correctly, not only is there chronic pain, but now inflammation, initially our friend, also becomes chronic and bothersome.

Injured, loose, or stretched out ligaments are often referred to as ligament relaxation, or ligament laxity. This is what produces the pain and discomfort, especially with movement. Because of the stand up paddle boards, you can now move you joint to its full range without pain.

Referred Pain
Pain will not only occur at the site of the injury and loose ligaments, but may also be referred to other parts of the body.

Referred pain is created by ligament laxity around a joint, but is felt at some distance from the injury. These painful points that refer pain elsewhere are called trigger points, and will be dealt with later. Abnormal joint movement also creates many “protective actions” by adjacent tissues. Muscles will contract in spasm in an attempt to pull the joint back to the correct location or stabilize it to protect it from further damage.

When this occurs in the back, orthopedic surgeons will often try to reduce vertebral instability by fusing the vertebrae with bone and/or metal fixation. But there is often an easier and more conservative way to achieve the same stabilization. And this is the outcome of Prolotherapy.

Unfortunately, this is where chronic problems begin, because the conventional medical practice with its emphasis on pain relief, treats the symptom—pain, and not the problem—laxity. A patient will likely be told to take anti-inflammatory drugs, which is often precisely the wrong thing to do because inflammation is the first part in the body’s healing process.

Non-steroidal anti-inflammatory drugs (NSAIDS) and cortisone can give immediate relief, but with a risk of creating a long-term injury with chronic pain.

By blocking inflammation, anti-inflammatories never allow complete healing, and instead, aggravate the situation.

Inflammation and the Healing Process
If we allow the inflammation process to run its cycle without interference, we see that inflammation leads to granular tissue formation that results in new collagen tissue being created. The new collagen forms new threads, which attach themselves to the damaged tissue.

New collagen fibers are short, they lose water and shrink, and as they attach themselves to the old ligament, muscle, joint capsule, or tendon, these tissues become more dense. Denser tissue is stronger tissue. This process is much like the scab on a wound or scar that tightens up and shrinks once healing occurs. The difference is that with Prolotherapy, biopsies have shown brand new, beautiful tissue without evidence of scarring. In essence, the tissue is healed, rejuvenated and made stronger than before.

The Science Behind the Regrowth of Collagen with Prolotherapy
As we have noted, the collagen in our bodies, especially in the tissue around and near our joints, is prone to breakdown. We subject our joints to wear and tear through repetitive movement, injury, accident or any other number of reasons. Because the connective tissue around our joints and cartilage have poor blood circulation, conventional treatment maintained that any injury to connective tissue was often irreparable. This was before a study conducted by Y. King Liu. There will be more detail on Prolotherapy treatment as a whole in a future article.

In a 1983 study of Prolotherapy’s effectiveness, Y. King Liu injected five percent sodium morrhuate solution into the medial collateral ligaments of rabbits. He found that after five injections, the ligament mass increased by 44 percent, the thickness by 27 percent, and the strength of the ligament bone junction increased by 28 percent(1).

Continue to Part 3

Written by Dr. Marc Darrow, M.D.

Marc Darrow, M.D., J.D., utilizes Stem Cell Therapy, Platatelt Rich Plasma Therapy, and Prolotherapy for the treatment of chronoc joint and back pain. Dr. Marc Darrow is a Board Certified Physiatrist specializing in Physical Medicine and Rehabilitation.

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Prolotherapy, PRP, AGE MANAGEMENT MEDICINE, and other modalities mentioned are medical techniques that may not be considered mainstream. As with any medical treatment, results will vary among individuals, and there is no implication that you will heal or receive the same outcome as patients herein. There could be pain or substantial risks involved. These concerns should be discussed with your health care provider prior to any treatment so that you have proper informed consent and understand that there are no guarantees to healing.
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