Prolotherapy: A Regenerative Treatment for Joints, Ligaments and Tendons

What is Prolotherapy?
Prolotherapy is short for proliferation therapy. By this, we mean that we are trying to proliferate (increase) the healing cells of your body. In this case, this is specifically related to the ligaments, which surround and support joints in the body. It can also be used for muscle attachments that have become damaged and pain-sensitive.
What do the ligaments do?
Ligaments surround all our joints. They stabilize and protect the joint by allowing normal but not abnormal range of movement. They also have a large number of nerve endings so that if they are stretched, they cause pain. This tells our body to change something to protect the joint from damage.
How are the ligaments stretched or injured?
Our ligaments become slackened (laxity) just with the passage of time and the stress on the ligaments from our posture and from daily activities. They can also be injured by trauma. Sometimes they do not heal fully.
Will I benefit from this treatment?
First, we have to find out if you are a candidate for treatment by Prolotherapy. It is important that you see your naturopathic doctor or physiotherapist for proper assessment. This may take more than one visit. The more information I have when you visit me, the better judgment I can make about your treatment.
What are the injections?
The injections most often used consist of a mixture of a local anesthetic and Dextrose. The contents of the injection are very safe. The Dextrose solution is a strong enough concentration to irritate the ligaments. This sets off a response in the area, which is needed to start the healing process. I am very careful to be sure I am injecting only into the ligament where it attaches to bone. Ligaments only grow where they are attached to bone. I therefore have to feel the bone with my needle, meaning that I know exactly where the injection is going.
Are there any risks?
The potential risks when puncturing the skin, namely infection and bleeding, are very rare due to the small diameter of the needle and the procedure that I use. Please report any excessive pain, redness, or swelling of the area. Some people have expressed a concern about ligaments becoming too tight after the injections. With Prolotherapy, the body produces new collagen, which is normal ligament tissue. The ligament will become stronger and tighter, but it does not become tighter than a healthy ligament.
The remainder of possible risks depend on the area being injected. For areas outside of the spine, such as the jaw/head region, the shoulder/arm region, or the hip/leg/foot region, there are few other risks. It is possible to touch a nerve with the needle which could give a brief shooting pain. The local anaesthetic can also cause some nerves to go numb temporarily. Prolonged numbness or weakness is rare. For injections in the spine area, it is possible to enter the spinal canal, but I stay away from the midline and always double check to avoid this before injecting. If this were to happen, it may result in a significant headache for 2 – 4 days. Laying flat alleviates the headache. For injections in the rib or chest area, there is a possibility of puncturing a lung (pneumothorax). This is rare. If you feel any change in your breathing, please notify me or my staff immediately.
A very small percentage of the population is allergic to local anesthetics. If you think you are, please let me know. An even smaller percentage of people are allergic to sugar, which is the source of medical Dextrose.
Is this painful?
Most people find the injections mildly painful. The local anesthetic removes the pain quite quickly. In spite of this, or if you are having many areas or levels injected, you may have difficulty tolerating the pain. If so, we will discuss other ways to minimize the pain. This may mean that you take a painkiller by mouth (e.g. Tylenol 3) or a numbing cream for the skin one hour before your appointment time. You may ask your MD for a mild relaxant, such as Ativan.
If the spine or rib area is being treated, or if you have taken a pain-reliever or medication which affects your alertness, it is not advisable to drive yourself home. If you are not driving, it is easier to change position. You should have less pain for 1 to 2 hours after the injection, but you may feel a little stiff. When the freezing wears off the injected area will feel funny, perhaps achy, but not necessarily painful. However, it may help to bring with you a painkiller or painkiller/muscle relaxant combination that you can take on the way home.
Please do not use anti-inflammatory painkillers (Ibuprofen, Advil, ASA, Celebrex etc). Many people find that heat on the area helps afterwards.
How Many Injections Will I Need?
For Prolotherapy in areas outside of the spine, number of treatments needed depends on the amount of ligament looseness or damage and the individual’s response. For the spine region, most men require three to six treatments. Women often require six to nine treatments. Treatments may be done as often as once a week for three weeks then repeated in one-month time if needed. For some conditions, treatment will be done every two to four weeks. You can expect to see some reduced pain after one or two treatments, but the healing process actually continues for one to two months after the last injection.
Dr Frances has completed training with the American Osteopathic Association of Prolotherapy for the extremities (knee, hip, ankle, shoulder, wrist, hand), lumbar/ SI area or low back as well as the upper spine, cervical, thoracic and ribs.
Get back to the activities that you enjoy, book an assessment in Calgary with Dr. Frances today!
Prolotherapy is short for proliferation therapy. By this, we mean that we are trying to proliferate (increase) the healing cells of your body. In this case, this is specifically related to the ligaments, which surround and support joints in the body. It can also be used for muscle attachments that have become damaged and pain-sensitive.
What do the ligaments do?
Ligaments surround all our joints. They stabilize and protect the joint by allowing normal but not abnormal range of movement. They also have a large number of nerve endings so that if they are stretched, they cause pain. This tells our body to change something to protect the joint from damage.
How are the ligaments stretched or injured?
Our ligaments become slackened (laxity) just with the passage of time and the stress on the ligaments from our posture and from daily activities. They can also be injured by trauma. Sometimes they do not heal fully.
Will I benefit from this treatment?
First, we have to find out if you are a candidate for treatment by Prolotherapy. It is important that you see your naturopathic doctor or physiotherapist for proper assessment. This may take more than one visit. The more information I have when you visit me, the better judgment I can make about your treatment.
What are the injections?
The injections most often used consist of a mixture of a local anesthetic and Dextrose. The contents of the injection are very safe. The Dextrose solution is a strong enough concentration to irritate the ligaments. This sets off a response in the area, which is needed to start the healing process. I am very careful to be sure I am injecting only into the ligament where it attaches to bone. Ligaments only grow where they are attached to bone. I therefore have to feel the bone with my needle, meaning that I know exactly where the injection is going.
Are there any risks?
The potential risks when puncturing the skin, namely infection and bleeding, are very rare due to the small diameter of the needle and the procedure that I use. Please report any excessive pain, redness, or swelling of the area. Some people have expressed a concern about ligaments becoming too tight after the injections. With Prolotherapy, the body produces new collagen, which is normal ligament tissue. The ligament will become stronger and tighter, but it does not become tighter than a healthy ligament.
The remainder of possible risks depend on the area being injected. For areas outside of the spine, such as the jaw/head region, the shoulder/arm region, or the hip/leg/foot region, there are few other risks. It is possible to touch a nerve with the needle which could give a brief shooting pain. The local anaesthetic can also cause some nerves to go numb temporarily. Prolonged numbness or weakness is rare. For injections in the spine area, it is possible to enter the spinal canal, but I stay away from the midline and always double check to avoid this before injecting. If this were to happen, it may result in a significant headache for 2 – 4 days. Laying flat alleviates the headache. For injections in the rib or chest area, there is a possibility of puncturing a lung (pneumothorax). This is rare. If you feel any change in your breathing, please notify me or my staff immediately.
A very small percentage of the population is allergic to local anesthetics. If you think you are, please let me know. An even smaller percentage of people are allergic to sugar, which is the source of medical Dextrose.
Is this painful?
Most people find the injections mildly painful. The local anesthetic removes the pain quite quickly. In spite of this, or if you are having many areas or levels injected, you may have difficulty tolerating the pain. If so, we will discuss other ways to minimize the pain. This may mean that you take a painkiller by mouth (e.g. Tylenol 3) or a numbing cream for the skin one hour before your appointment time. You may ask your MD for a mild relaxant, such as Ativan.
If the spine or rib area is being treated, or if you have taken a pain-reliever or medication which affects your alertness, it is not advisable to drive yourself home. If you are not driving, it is easier to change position. You should have less pain for 1 to 2 hours after the injection, but you may feel a little stiff. When the freezing wears off the injected area will feel funny, perhaps achy, but not necessarily painful. However, it may help to bring with you a painkiller or painkiller/muscle relaxant combination that you can take on the way home.
Please do not use anti-inflammatory painkillers (Ibuprofen, Advil, ASA, Celebrex etc). Many people find that heat on the area helps afterwards.
How Many Injections Will I Need?
For Prolotherapy in areas outside of the spine, number of treatments needed depends on the amount of ligament looseness or damage and the individual’s response. For the spine region, most men require three to six treatments. Women often require six to nine treatments. Treatments may be done as often as once a week for three weeks then repeated in one-month time if needed. For some conditions, treatment will be done every two to four weeks. You can expect to see some reduced pain after one or two treatments, but the healing process actually continues for one to two months after the last injection.
Dr Frances has completed training with the American Osteopathic Association of Prolotherapy for the extremities (knee, hip, ankle, shoulder, wrist, hand), lumbar/ SI area or low back as well as the upper spine, cervical, thoracic and ribs.
Get back to the activities that you enjoy, book an assessment in Calgary with Dr. Frances today!