Prolotherapy

Prolotherapy has been defined as an injection of growth factors or growth factor production stimulants to assist in the growth of normal cells or tissue (Reeves et al. 2007). The proliferant solution and technique varies across the clinical landscape. However, the most commonly reported proliferants include 10% to 15% dextrose, P2G (phenol, glycerin, glucose), and sodium morrhuate.

The proliferant solution injected during prolotherapy is purported to work by creating a biological cascade of events that cause the increased release of pre-collagen growth factor (PGF). PGF encourages movement of fibroblasts into the injection area, which leads to increased secretion of collagen tissue. Interestingly, it is widely reported that this is a biological process that takes about 6 to 8 weeks (Reeves et al. 2007).

Patients can expect 6-8 treatments of prolotherapy up to 4 weeks apart. Initially treatment can be given fortnightly followed by monthly as symptoms start to ease. Patients should feel about 50-60% better after 3-4 treatments or should cease treatment.

Conditions that may benefit from prolotherapy include:

• Insertional tendonitis
  
• Plantar fasciitis
  
• Partial tendon tears
  
• Chronic back pain (sacroiliac joint)
  
• Cervical spondylosis
  
• Myofascial syndrome