My Prolotherapy Experience

Are you dealing with chronic pain that just will not go away? Instead of jumping to medications or surgery maybe you should be looking at regenerative injection therapies like Prolotherapy.

Hi everyone Floyd Meyer here I am a Physician Assistant with a Masters in Public health and I am currently working in an Integrative Physical Medicine and Rehabilitation clinic.

I recently started doing prolotherapy injections on my low back due to some chronic numbness in my left foot and I thought that by sharing my own journey with you that you might be able to solve your own issues as well.

A pub med search of “Prolotherapy” shows over 200 different articles and trials.  Starting as early as the 1960s a physician named George Hackett was publishing research on the treatment of ligament and tendon “relaxation” by prolotherapy.

The basic idea is this. Prolotherapy solutions are injected into painful areas to repair damaged tissue.

The injections create a localized inflammatory response triggering the immune system to create the building blocks of ligaments, tendons, cartilage, and bone that make up the joint.

Prolotherapy, through a series of injections, REBUILDS the tissues from within by restarting the healing process.

More precisely, a systematic review on prolotherapy states, “Prolotherapy is a nonsurgical regenerative injection technique that introduces small amounts of an irritant solution to the site of painful and degenerated tendon insertions (entheses), joints, ligaments, and in adjacent joint spaces during several treatment sessions to promote growth of normal cells and tissues.” (Hauser et al., 2016)

The most common injection solution is dextrose or D-glucose which is a form of sugar found naturally in our bodies.  Other solution options include things like glycerin, phenol, or ozone. Sometimes additional proliferants may be used to increase the healing response. These include stem cells from bone marrow, adipose tissue, or amniotic tissues, or PRP (Platelet Rich Plasma Therapy).

Generally, treatments include several sessions of injections given anywhere from 1 week to 2 months apart depending on the tissues being treated, the health status of the individual getting the injections, and the proliferant used.

The reason that I started getting prolotherapy injections myself is due to some chronic numbness in my left foot that has been bothering me for a little over a year. I have done physical therapy, chiropractic, traction, acupuncture, massage, all kinds of things but it just won’t go away.

So I just started getting injections of 12.5% dextrose with lidocaine a couple weeks ago. The first set of injections went really well. The procedure didn’t hurt at all while it was happening. I did have some increased soreness in my low back for about 2 days following the procedure, but nothing some heat and topical pain cream couldn’t control.

So far I have not noticed an improvement in the numbness, but I am hopeful that it will resolve in the coming months. I am planning on going in for another session of injections in about a week. If I do not see the improvements that I am looking for then I will start to add in some PRP to increase the healing response. PRP also has some data showing a positive effect with neurogenic inflammation which could prove to be helpful for what I have going on.

I hope that you have found this helpful. I just wanted to share with you all this part of my journey to optimize my body.  If you have any questions please leave them in the comments below. I will be doing a follow-up video here in the next month or so hopefully with some good news.

Again this is Floyd Meyer reminding you to Heal Better so you can Do More!

 

 

References

Arias-Vázquez, P.I., Tovilla-Zárate, C.A., Legorreta-Ramírez, B.G. et al. Prolotherapy for knee osteoarthritis using hypertonic dextrose vs other interventional treatments: systematic review of clinical trials. Adv Rheumatol 59, 39 (2019) doi:10.1186/s42358-019-0083-7

Catapano, M., Zhang, K., Mittal, N., Sangha, H., Onishi, K., & SA, D. (2019). Effectiveness of Dextrose Prolotherapy for Rotator Cuff Tendinopathy: A Systematic Review. PM&R. doi:10.1002/pmrj.12268 

Cianca, J. C., & Jayaram, P. (2017). Musculoskeletal Injuries and Regenerative Medicine in the Elderly Patient. Physical Medicine and Rehabilitation Clinics of North America, 28(4), 777–794. doi:10.1016/j.pmr.2017.06.010 

Cole, B., Lam, P., Hackett, L., & Murrell, G. A. C. (2017). Ultrasound-guided injections for supraspinatus tendinopathy: corticosteroid versus glucose prolotherapy – a randomized controlled clinical trial. Shoulder & Elbow, 10(3), 170–178. doi:10.1177/1758573217708199 

Cusi, M., Saunders, J., Hungerford, B., Wisbey-Roth, T., Lucas, P., & Wilson, S. (2008). The use of prolotherapy in the sacroiliac joint. British Journal of Sports Medicine, 44(2), 100–104. doi:10.1136/bjsm.2007.042044 

Dagenais, S., Yelland, M. J., Del Mar, C., & Schoene, M. L. (2007). Prolotherapy injections for chronic low-back pain. Cochrane Database of Systematic Reviews. doi:10.1002/14651858.cd004059.pub3

Dumais, R., Benoit, C., Dumais, A., Babin, L., Bordage, R., de Arcos, C., … Bélanger, M. (2012). Effect of Regenerative Injection Therapy on Function and Pain in Patients with Knee Osteoarthritis: A Randomized Crossover Study. Pain Medicine, 13(8), 990–999. doi:10.1111/j.1526-4637.2012.01422.x 

Farpour, H. R., & Fereydooni, F. (2017). Comparative effectiveness of intra-articular prolotherapy versus peri-articular prolotherapy on pain reduction and improving function in patients with knee osteoarthritis: A randomized clinical trial. Electronic Physician, 9(11), 5663–5669. doi:10.19082/5663 

Fullerton, B. D., & Reeves, K. D. (2010). Ultrasonography in Regenerative Injection (Prolotherapy) Using Dextrose, Platelet-rich Plasma, and Other Injectants. Physical Medicine and Rehabilitation Clinics of North America, 21(3), 585–605. doi:10.1016/j.pmr.2010.06.003

Hackett, G. S. (1960). Prolotherapy in Whiplash and Low Back Pain. Postgraduate Medicine, 27(2), 214–219. doi:10.1080/00325481.1960.11712804 

HACKETT, G. S., HUANG, T. C., & RAFTERY, A. (1962). PROLOTHERAPY FOR HEADACHE. Pain in the Head and Neck, and Neuritis. Headache: The Journal of Head and Face Pain, 2(1), 20–28. doi:10.1111/j.1526-4610.1962.hed0201020.x 

Hauser, R. A., Lackner, J. B., Steilen-Matias, D., & Harris, D. K. (2016). A Systematic Review of Dextrose Prolotherapy for Chronic Musculoskeletal Pain. Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders, 9, CMAMD.S39160. doi:10.4137/cmamd.s39160 

Hoffman, M. D., & Agnish, V. (2018). Functional outcome from sacroiliac joint prolotherapy in patients with sacroiliac joint instability. Complementary Therapies in Medicine, 37, 64–68. doi:10.1016/j.ctim.2018.01.014 

Hung, C.-Y., Hsiao, M.-Y., Chang, K.-V., Han, D.-S., & Wang, T.-G. (2016). Comparative effectiveness of dextrose prolotherapy versus control injections and exercise in the management of osteoarthritis pain: a systematic review and meta-analysis. Journal of Pain Research, Volume 9, 847–857. doi:10.2147/jpr.s118669 

Krstičević, M., Jerić, M., Došenović, S., Jeličić Kadić, A., & Puljak, L. (2017). Proliferative injection therapy for osteoarthritis: a systematic review. International Orthopaedics, 41(4), 671–679. doi:10.1007/s00264-017-3422-5

Kuffler, D. P. (2013). Platelet-Rich Plasma and the Elimination of Neuropathic Pain. Molecular Neurobiology, 48(2), 315–332. doi:10.1007/s12035-013-8494-7 

Neph, A., Onishi, K., & Wang, J. H.-C. (2018). Myths and Facts of In-Office Regenerative Procedures for Tendinopathy. American Journal of Physical Medicine & Rehabilitation, 1. doi:10.1097/phm.0000000000001097 

Ongley, M., Dorman, T., Klein, R., Eek, B., & Hubert, L. (1987). A NEW APPROACH TO THE TREATMENT OF CHRONIC LOW BACK PAIN. The Lancet, 330(8551), 143–146. doi:10.1016/s0140-6736(87)92340-3 

Rabago, D., Mundt, M., Zgierska, A., & Grettie, J. (2015). Hypertonic dextrose injection (prolotherapy) for knee osteoarthritis: Long term outcomes. Complementary Therapies in Medicine, 23(3), 388–395. doi:10.1016/j.ctim.2015.04.003 

Reeves, K. D., Sit, R. W. S., & Rabago, D. P. (2016). Dextrose Prolotherapy. Physical Medicine and Rehabilitation Clinics of North America, 27(4), 783–823. doi:10.1016/j.pmr.2016.06.001 

Seven, M. M., Ersen, O., Akpancar, S., Ozkan, H., Turkkan, S., Yıldız, Y., & Koca, K. (2017). Effectiveness of prolotherapy in the treatment of chronic rotator cuff lesions. Orthopaedics & Traumatology: Surgery & Research, 103(3), 427–433. doi:10.1016/j.otsr.2017.01.003 

Sit, R. W., Chung, V. C., Reeves, K. D., Rabago, D., Chan, K. K., Chan, D. C., … Wong, S. Y. (2016). Hypertonic dextrose injections (prolotherapy) in the treatment of symptomatic knee osteoarthritis: A systematic review and meta-analysis. Scientific Reports, 6(1). doi:10.1038/srep25247 

Topol, G. A., Podesta, L. A., Reeves, K. D., Giraldo, M. M., Johnson, L. L., Grasso, R., … Rabago, D. (2016). Chondrogenic Effect of Intra-articular Hypertonic-Dextrose (Prolotherapy) in Severe Knee Osteoarthritis. PM&R, 8(11), 1072–1082. doi:10.1016/j.pmrj.2016.03.008 

Yelland, M. J., Mar, C. D., Pirozzo, S., & Schoene, M. L. (2004). Prolotherapy Injections for Chronic Low Back Pain. Spine, 29(19), 2126–2133. doi:10.1097/01.brs.0000141188.83178.b3

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