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New York Times article on prolotherapy (click to read)
therapist, wrist was successfully treated with prolotherapy.
Dr. Rosen has treated hundreds of patients with prolotherapy including:
Baseball, Basketball and Football
Music and Movie Celebrities
A: Prolotherapy (proliferative therapy),
also known as sclerotherapy, nonsurgerical ligament reconstruction therapy, and fibro-osseous injection therapy, is a recognized
orthopedic procedure that stimulates the body’s natural healing processes to strength joints weakened by traumatic or
over-use injury. Joints when ligaments or tendon attachments are stretched, torn, or fragmented become hypermobile and painful.
Traditional approaches with surgery and anti-inflammatory drugs often fail to stabilize the joint and relieve this pain permanently.
Prolotherapy, with its unique ability to directly address the cause of the instability, can repair the weakened sites and
produce new fibrous tissues, resulting in permanent stabilization of the joint.
Q: How does prolotherapy work?
A: With a precise injection
of a mild irritant solution directly on the site of the torn or stretched ligament or tendon, prolotherapy creates a mild,
controlled injury that stimulates the body’s natural healing mechanisms to lay down new tissue on the weakened area.
The mild inflammatory response that is created by the injection encourages growth of new ligament or tendon fibers, resulting
in a tightening of the weakened structure. Additional treatments repeat this process, allowing a gradual buildup of tissue
to restore the original strength to the area.
Q: What is in the solution that is injected?
A: The prolotherapy
injections contain anesthetic agents and natural substances, which stimulate the healing response. Howard Rosen, M.D. uses
a holistic solution of dextrose (a form of sugar), local anesthesia, and normal saline (salt water).
the prolotherapy treatment painful?
A: Any pain involving an injection will vary according to the structure to be treated. Howard Rosen,
M.D. uses several techniques such as spreading the skin prior to injection as well as putting sodium bicarbonate in the local
anesthetic to reduce discomfort. Oral sedation is available. Intravenous sedation can be used in a surgicenter. The treatment
may result in mild swelling and stiffness. The mild discomfort passes fairly rapidly and can be reduced with pain relievers
such as Tylenol. Anti-inflammatory drugs, such as aspirin and ibuprofen, should not be used for pain relief because their
action suppresses the desired inflammatory process produced by the injection.
Q: Can prolotherapy help everyone?
A: Each patient must
be evaluated thoroughly with a patient history and physical exam, and sometimes with X-rays and MRIs to fully access your
chances of successful prolotherapy treatment. With this information, your physician can evaluate your potential success with
this therapy. Success depends on factors, which include the history of damage to the patient, the patient’s overall
health and ability to heal, and any underlying nutritional deficiencies that would impede the healing process.
Q: What areas of the body can be treated?
A: This form of therapy can
be used to treat pain from the knees, ankles, feet, hips, elbows, shoulders, wrists, hands, temporal mandibular joint dysfunction,
carpal tunnel syndrome, headaches, arthritis including the fingers, and disc problems at almost any level of the spine including
the low back, middle back, upper back, and the neck. The therapy affects only the area treated and does not cause any problem
in any other area.
How often do I need these treatments?
A: The treatments should be administered every one, two, or three weeks, as determined by your treating physician.
Most patients will need between 1 to 6 treatments for optimum pain relief, depending on their response to each treatment.
Q: What is the
rate of success in treatment?
The anticipated rate of success depends on a number of variables, including the patient’s history and ability to heal,
and the type of solution used. In patients with low back pain with hypermobility, 85% to 95% of patients treated experience
remission of pain with this form of therapy. In comparison, the Journal of Bone and Joint Therapy reports a 52% improvement
in patients treated surgically for disc involvement.
Q: Is this form of therapy really new?
A: Prolotherapy has been used successfully as early as 500 B.C. when Roman soldiers
with shoulder joint dislocations were treated with hot branding irons to help fuse the torn ligaments in the shoulder joint.
Advances in medicines greatly improved on this process and led to the modern techniques of strengthening the fibrous tissue
rather than producing scarring to fuse tissues. In 1926, a group of physicians met with great success using injection therapy
to treat hernias and hemorrhoids. Earl Gedney, D.O., a well-known orthopedist, decreased his surgical practice and began to
inject joints with these newer injectable medicines in the 1940s and 1950s. Also, in 1950, George Stuart Hackett, M.D., wrote
a book on injection therapy. His work is still used today in training physicians. In the years since this early work, techniques
and medications have advanced to move from a scarring or fusing effect to a strengthening effect, which restores the weakened
joint to its original level of stability, without loss of flexibility and function.