Prolotherapy

Prolotherapy is an evidence-based* injection technique that uses inflammation—the body’s natural method of healing—to help heal acute and chronic sprain injuries of ligaments and tendons.

The word, “Prolotherapy”, is derived from the term “proliferative therapy”.  

The standard technique consists, basically, of injecting small amounts of a dilute solution of Procaine™ and glucose into the injury site. Other substances besides glucose may be used on a case-by-case basis. The proliferant solution irritates the ligament or tendon tissue just enough to cause a very localized inflammatory response at the specific site of the sprain injury.

These injections are often ultrasound guided. 

The inflammation resulting from the proliferant injection selectively activates the fibroblastic cells of the target ligament or tendon. These stimulated fibroblasts then begin to lay down (or cause the proliferation or regeneration) of new ligament or tendon tissue in the form of newly generated collagen fibers. The regenerated collagen mends the acute or chronic sprain injury—restoring joint function and removing the structural cause for joint pain and disability.

Because each ligament and muscle has at least two attachments—proximal and distal—either one or both attachment may need to be treated in order to heal a sprain injury.

Platelet-Rich Plasma (PRP) Therapy is an advanced form of standard Prolotherapy.  This newer technique incorporates the collection of the patient’s own platelets and the injection of the platelet-rich plasma into the site of significant ligament or tendon tearing.
These injections are often ultrasound guided.
* Random-Controlled Trial Evidence
The following peer-reviewed journal articles have resulted in healthcare insurance reimbursement for lateral epicondylosis (tennis elbow):
1. The efficacy of prolotherapy for lateral epicondylosis: a pilot study. Scarpone, M, et. al. Clinical Journal of Sports Medicine 2008 May;18(3):248-54.

2. The systematic review of four injection therapies for lateral epicondylosis: prolotherapy, whole blood and platelet rich plasma. Rabago D, et al. British Journal of Sports Medicine, 2009 Jan 21. [Epub ahead of print]

Prolotherapy Informed Consent

For more Prolotherapy procedural details, click on consent.

Gary B. Clark, MD, MPA | 1790 30th Street, Suite 230, Boulder, CO | (303) 444-5131