What is prolotherapy?
If a joint of yours keeps aching, slipping or giving way, prolotherapy is a word you will keep running into. Here is what the Portland practice that performs it says about it, and nothing more.
The short answer
Prolotherapy is an injection treatment for joints that hurt, whether the pain arrived last month or years ago. NW Regen, a Portland clinic, calls it minimally invasive, non-surgical and regenerative: the injection is meant to get your own healing process moving, so the joint is strengthened and repaired.
What is it used on? The clinic's answer is wide: most joint pain conditions, acute or chronic, with rotator cuff injuries and tears named among them.
What actually happens at the appointment
NW Regen sets out the order of events on its page about prolotherapy injections at its Portland clinic: a little local anesthetic first. Then, with ultrasound guiding the needle, a natural dextrose solution the clinic describes as safe goes straight to whatever is painful: the joint, a ligament, a tendon, muscle. What it claims for that is lasting healing, without surgery.
Will it hurt? That depends, the page says, on the area treated and the solution used. The clinic claims a great deal of experience with these injections and says it does what it can to limit the discomfort: medication beforehand in some cases, nitrous oxide (laughing gas) during the injection in others.
Why it is a course of treatment, not one visit
Because cellular remodeling and repair can be slow, the clinic writes, prolotherapy is usually performed as a series rather than one appointment. It often takes several treatments over several months to build up healthier, stronger tissue bit by bit, until it can properly hold up a joint that is damaged or degenerating.
The days afterwards
This is what NW Regen tells readers to expect, taking its prolotherapy page together with what it writes about the treatment in its article on EDS:
- Mild tissue swelling is common, as is a temporary rise in pain and stiffness, which normally passes quickly.
- Soreness that lingers is sometimes handled with an anti-inflammatory, prescription or natural.
- Swelling and bruising are a risk as well; those symptoms typically settle on their own, without anything being done about them.
- The one adverse reaction reported is pain that passes and swelling confined to the injection sites; adverse reactions overall are described as very low.
- Infection is the remaining risk, as with any interventional procedure, kept to a minimum by sterile aseptic technique.
- More serious complications do happen in rare cases: infections or nerve injuries, uncommon but needing prompt medical attention.
One of the three papers cited on the service page sits with that adverse-reaction answer rather than with the NSAID discussion below: Nguyen and Rannou (2017), a critical narrative review of the safety of intra-articular injections for knee osteoarthritis.
Why you may be asked to skip the ibuprofen
This part surprises people. NSAIDs, ibuprofen among them, are often discouraged before and during prolotherapy: the research NW Regen points to found as much as an 80% reduction in new cartilage growth. NSAIDs have also been shown to accelerate the breakdown of articular cartilage in osteoarthritis, the clinic reports, and it writes that most physicians who prescribe NSAIDs for joint health do not realize that long-term use has a negative effect and dramatically increases the risk of a total joint replacement. Two papers are cited for that: Hauser (2010) in the Journal of Prolotherapy and Dingle (1999) on NSAIDs and cartilage glycosaminoglycan synthesis.
Loose joints, hypermobility and EDS
If you are hypermobile, the page to read is NW Regen's on connective tissue disorders. Connective tissue supports the organs and holds the body's parts in position; it is built from two proteins, collagen and elastin. Ehlers-Danlos syndrome affects collagen production, so that tissue ends up less strong and less supportive than it should be. HSDs, as the same page labels them, cover an array of connective tissue disorders marked by joint instability and chronic pain, sometimes with fatigue and other systemic symptoms that affect daily functioning.
These disorders can involve cartilage, bones, blood and fat, and show up in skin, joints, muscles and blood vessels: fragile skin, loose and unstable joints. Prolotherapy can often help tighten those up, the clinic writes, grouping it with PRP and stem cell therapies as regenerative injections that support joint stability, help tissue heal and ease pain.
It also covers CCI, a condition in which neck and head ligaments are damaged or weakened, leaving laxity in the upper couple of vertebrae, around C1-C2. People with EDS, and people who have been in motor vehicle crashes, may run into it: neck pain, chronic headaches, recurrent migraines, dizziness, vertigo, brain fog and cognitive impairment. The aim stated throughout: less pain, better mobility, better overall health.
Reading further
For NW Regen's own writing at length, the prolotherapy Reading Room gathers the openings of its articles and links each to the full original, including its article on prolotherapy and EDS. What this site will and will not do is set out on about this prolotherapy site.
Sources
Everything on this page is drawn from pages published by NW Regen: