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Prolotherapy depends on
your ability to heal.
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How do we harness the body’s healing mechanism with Prolotherapy? Consider the damaged ligament we were discussing earlier. If a proliferant solution consisting of concentrated dextrose (sugar) is injected at the point of unhealed injury, it fools the body into thinking that a major injury has just occurred. The immune cells in the area send out a chemical signal that activates local fibroblasts and summons new fibroblasts to the area. These fibroblasts proliferate, then start making new collagen fibers. |
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Interestingly, instead of just making ‘scar tissue’, these cells make new tissue that is identical to the tissue that was damaged—ligament, tendon, etc. In fact, electron microscopy has shown that the tissue that is made is actually very ‘high quality’, like a marathon runner’s instead of like that of the usual weekend warrior. The healing cycle is just like that described relative to the surgical incision (above), in that it lasts six weeks. The vast majority of the new collagen is made between week two and week four. Thus, at a month, you have a good idea how much healing has occurred, and how much still needs to occur. Depending on how much of a defect there is to heal, and how fast and effectively a given person’s healing system works, it may take several cycles to completely heal the structure to full tensile strength and load bearing capacity. But, when the structure does become fully load bearing, the pain stops. Permanently.
Then another useful mechanism comes into play. If I make an incision on your abdomen that is six inches long, it will be six inches long a month later. But at three months it will be five and a half inches long, and at six months it will be five inches long. When new fibrous tissue is made, it is somewhat soft and pliable. The ‘making’ process stops at six weeks, but over the next few months that new tissue chemically matures, toughens, strengthens, AND SHORTENS. Consider the ‘stretched out rubber band’ ligament. It needs to be stronger. It also needs to be shorter. Over several months Prolotherapy treatments not only strengthen, they shorten these ligaments. This stabilizes joints, and stops the problems caused by abnormal joint mobility (disk degradation, Barre-Lieou Syndrome, muscle spasms, development of additional bony arthritis deformity, etc.)
So far, we have been looking at what happens when a single structure is damaged. But these structures are tough. It takes a lot to damage one. And we do not just have a few tendons and ligaments. We have hundreds of these structures. After a wreck, a fall, a sports injury, or years of hard work and wear and tear, we usually have a number of unhealed, injured structures. Often the worst pain-generating structures are sending out pain at, say, a level of 7 out of 10 (we often grade pain on a 1-to-10 scale). You can only feel so much pain, so you literally are not able to feel the areas that are sending out pain at level 3 or 4. If we just treat the worst areas, and stop pain there, you will suddenly start feeling ‘new pain’ in other areas. It was there all along, you just didn’t know it. But I can find those areas on physical exam. They will be tender to moderate pressure, even if they are not noticed otherwise by the patient at this time.
A proper Prolotherapy treatment will treat all the pain-generating structures in the area in question. The less-damaged areas may heal with a treatment or two, the more damaged areas may take four or six treatments. As areas heal, fewer points need to be treated. When the most damaged areas are healed, the area is pain-free.
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