A friend of mine messed up some ligaments in his ankle and it’s a chronic injury. He thinks Prolotherapy can heal him and emailed me this information on it. I’m no Doctor, but I did stay at the Holiday Inn Express, so I’ll post and ask if any of you have had it done to treat an injury.
I’m a bit skeptical - seems almost too good to be true and with risks too.
Prolotherapy is also used to treat such injuries as ankle sprains when the overstretched ligaments are not effectively repairing themselves. A substance containing glucose or dextrose alone or in combination with glycerin and phenol is injected into the affected ligaments or tendons, which leads to local inflammation. The localized inflammation triggers a wound healing cascade, resulting in the deposition of new collagen, the material that ligaments and tendons are made of.
Prolotherapy is a non-surgical injection procedure used to treat connective tissue injuries of the musculoskeletal system that have not healed by either rest or conservative therapy.The injections promote a healing response in small tears and weakened tissue, with the goal of alleviating back pain and improving function. Prolotherapy is also referred to as sclerosant therapy, sclerotherapy, regenerative injection therapy, “proliferative” injection therapy and nonsurgical ligament reconstruction.
Prolotherapy works by exactly the same process that the human body naturally uses to stimulate the body’s healing system, a process called inflammation. The technique involves the injection of a proliferant (a mild irritant solution) that causes an inflammatory response which “turns on” the healing process. The growth of new ligament and tendon tissue is then stimulated. The ligaments and tendons produced after Prolotherapy appear much the same as normal tissues, except that they are thicker, stronger, and contain fibers of varying thickness, testifying to the new and ongoing creation of tissue. Yes, you heard me right. The ligament and tendon tissue which forms as a result of Prolotherapy is thicker and stronger than normal tissue, up to 40% stronger in some cases!
It is pretty good mojo, but it is not a cure. I’ve been receiving prolotherapy injections in the tendons of my levator scapulae (origin and insertion), and in my SI joints regularly for 6 or so years. It has helped reduce pain and dysfunction significantly. The specific injuries that I sustained to require such therapy are as follows: 1) Head-on car wreck that overstretched/tore the ligaments in my neck (whiplash) creating ligamental laxity. The levators try to pick up the slack and stabilize the neck, but it overstresses them - they’re just not cut out for that particular job. 2) I have a completely herniated disc L5-S1 with ligamental weakness of the SI joints. The shots help to strengthen the ligaments and stabilize the SI’s and low back. The Dr. who treats me is one of the team physicians for FSU varsity sports teams. As far as the “juice” that is injected - I was told that it is dextrose and lidocaine (“caine” for the pain. Sugar burns like fire when injected).
I don’t have too much experience with prolotherapy, however, I have worked with a very good sports physician who does it in limited circumstances. (This is the key…as someone wrote above, it is not a cure-all by any means.) However, she does get pretty good results when she uses it…I was impressed, anyway, since at first my level of skepticism was pretty high.
Primarily, prolotherapy seems to be good for soft tissue/ligamentous injuries. It is something to be used when other more conventional treatments have failed, and this is exactly how it is used by good physicians. In my experience, it does in fact work quite well in these instances. It is done with an injection (sometimes, several) of concentrated dextrose (sugar). Someone above mentioned phenol, which I have never seen used.
You should know that the medical literature on the subject is limited. Some studies show benefit, and some are equivocal or show no improvement. I am unaware of any studies showing a detrimental effect.
I enjoy correcting MD’s as much as I did in grad school, punishing pre-meds in Org Chem!
Phenol is Carbolic acid, or Hydroxybenzene, and is not a ‘carboxylic acid’. It is used as disinfectant, and in medicinal products such as ear and nose drops, throat lozenges, and mouthwashes. Not too toxic, but is probably a significant irritant.
But I agree, I don’t necessarily want to be injected with it.
Seriously, it is great to have you Dr’s here on the forum, I had never heard of this before.
Hey thanks Mark! (Where have you been BTW). Carbolic/Carboxylic - OK I was close.
The diff is: book studies of the drug vs. clinical experience with its use. Since I have vials of 89% Phenol (in light block bottles) in each of my offices and use it on an almost daily basis, I can assure you that at high concentrations it is EXTREMELY CAUSTIC! I once had an assistant spill some on her wrist - she had a nasty burn and watch mark (hit along her wrist) for about 3 months, and the stuff was only on there for a few secs before aggressively washing and flushing with alcohol (I know this doesn’t “neutralize” it, but no base was readily available). I use it to cauterize and chemical destroy tissues at this concentration. Used to be used on appendectomies after remove the appendix as well. Nasty stuff. Must be fairly safe at low concentrations since the EPA allows some small PPM in our water and it is commonly seen in throat lozenges and sprays.
See 'ya around Mark! Too damn many chemists (about 5 PhDs) in our cycling club!
When I was doing my internship, I worked with a doc who is the team physician for a MLB team and he uses prolo often. It’s not the magic bullet, but I think it has a place in medicine.
It’s kind of the other end of the spectrum from conditions that could be allieviated/treated with NSAIDs or other anti-inflammatory meds. Where NSAIDs decrease inflammation in acute conditions, prolo therapy induces inflammation in chronic conditions where not much healing is occuring otherwise.
Like all treatment options, it is just one tool in the toolbag. The good thing about it is it’s pretty safe, so you probably won’t get worse.
