What is prolotherapy? How does instability cause pain? Are there any risks involved? Prolotherapy is a form of injection treatment for A weak ligament causes the joint it supports to All procedures have possible risks. The type of pain caused by weakened ligaments and tendons. become loose or unstable. When this happens, risk often depends on the location of the body the muscles around the joint will try to support it. part that is being treated. This leads to spasm and early fatigue due to "Prolo" is short for proliferation. The treatment overwork of the muscle. Eventually, the tendons causes the proliferation (growth/formation) of The most common risks include: no will weaken and other muscles will be recruited improvement, bleeding under the skin, infection, new ligament or tendon in areas where it has to help support the joint, causing widespread become weak or injured. increased pain or swelling at the injection site and pain and spasm. temporary or permanent nerve damage. Ligaments are the structures that connect bones What is injected? to bones and support joints. The most serious risk of treatment in the upper back and chest is a pneumothorax (collapsed Many different proliferant solutions are available. lung), which could lead to hospitalization and Tendons are the structures that connect muscles to Each stimulates the body’s healing response in a need for further treatment. bones and move joints. different way. A solution will be selected based on the type of injury or the area being treated. Great care is taken so that these do not happen, When ligaments or tendons are injured, they and in fact the more serious risks are very rare. don’t always heal to their original strength or Glucose (sugar water) combined with phenol and However, it’s important for you to be aware of endurance due to limited blood supply where glycerin (irritants) is the most common solution. these risks. If you don’t feel that the possible they attach to the bone. These attachments have benefits of this treatment are worth the risks, many small nerve endings and will cause pain then prolotherapy might not be right for you. when they are injured. A local anesthetic such as procaine is usually added to decrease the pain during injection. How long will it take to complete Prolotherapy involves injection of a solution a course of treatments? (proliferant) into the area that the ligament or Will the injections hurt? tendon attaches to the bone. This causes The response to treatment varies from person to localized inflammation in the injured area. There is a wide variation in the discomfort level person, and depends upon one's own healing Inflammation increases the blood supply and flow of experienced by patients receiving prolotherapy. ability. Some people may only need a few nutrients to the area, stimulating the body to The needles used are very thin and tend to not treatments, while others may need as many as 10 repair itself. The result is a stronger bond cause much pain. Most of the discomfort is felt or more. The average number of treatments is 4 between the ligament or tendon and the bone. when the solution is injected and it is usually to 6 for an area treated. The usual time between described as a “pressure sensation” rather than a treatments is 3 or 4 weeks. This is the time Prolotherapy is not a new technique. In ancient true pain. needed for the body to repair the area after the times, Hippocrates first used a version of this injection stimulates the healing response. technique on soldiers and Olympic javelin If you are interested in having prolotherapy but A typical course of injection treatment will take throwers who often dislocated their shoulders. are very nervous or concerned about the pain, 3-6 months. Rehabilitation exercises may be medications can be prescribed that can be taken recommended to continue even after injections In the past 60 years, research has helped doctors before your appointment to help ease some of are finished. (MDs and DOs) improve injection techniques to the discomfort and anxiety. successfully treat pain caused by instability. What can I expect after injection? www.prolotherapy.com www.correctivecare.com Pain and swelling at the injection site are normal for about 3-4 days after a treatment. The amount of pain experienced may vary with each injection or use of different proliferant solutions. The swelling is a result of the increased blood supply to the area and the body’s healing process at work. Pain medication will usually be prescribed for the first few days. Do not take any anti-inflammatory PROLOTHERAPY medications (ibuprofen, aspirin or arthritis medicines), since they will make the treatment for Chronic Pain less effective. Prolotherapy is an injection treatment for What else can I do to get better? chronic pain and is also known as sclerotherapy, regenerative injection technique, stimulated Exercise, physical therapy and postural retraining ligament repair and non-surgical ligament will usually be prescribed during and after a course George Pasquarello, D.O., reconstruction. of injections. It is critical to retrain muscles that have F.A.A.O. been weakened and injured so they can return to the This treatment may be useful for many job of moving joints during normal activities. Neuromusculoskeletal Medicine different types of chronic pain including: Osteopathic Manipulative Medicine Ergonomic evaluation and workstation changes may • Rotator cuff injuries be necessary to help avoid further repetitive motion Dr. Pasquarello has been teaching injuries. prolotherapy nationally since 1999. He has • Tennis elbow lectured, authored several articles and co- Supplementation recommendations or dietary authored a textbook on prolotherapy. changes may be made to help support healing • Wrist pain from repetitive motions ligaments, tendons and joints. • Partially torn tendons and ligaments Nicotine use may slow the normal healing process. Prolotherapy will work better if you stop smoking or using tobacco products. 1351 South County Trail Building 2 • Low back pain East Greenwich, RI 02818 Is Prolotherapy right for me? 401-886-5907 • Sciatica Prolotherapy is not for everyone. Doctor Pasquarello can answer questions you may have • Chronic knee pain about prolotherapy treatment for chronic pain. For more information: Some of the common conditions that may benefit • Foot and ankle pain from prolotherapy are listed on the front of this brochure.