When injuries to the connective tissues (ligaments, tendons, and muscles) occur, the normal healing process may be incomplete, usually due to lack of proper treatment. This incomplete healing process is revealed under microscope by a deficiency of connective tissue cells called fibroblasts. The lack of fibroblasts leads to loose ligaments and weakened tissues. As a result, the normal supportive function of the ligaments which was present prior to injury is lost. Joint stability is therefore reduced.
 

Small pain fibers in these damaged ligaments transmit pain impulses to the brain when stretched. Through a subconscious reflex, the surrounding muscles go into a tight and painful spasm in an attempt to stabilize the joint. This causes the region to feel tight, stiff, achy, burning, tingling, numb, fatigued, and painful. The individual will often notice painful knots in the affected muscles. These muscles become tight and painful as they try to compensate for the weak and damaged underlying tissue structures. The muscle spasms reduce blood flow, causing even more pain. Not only are these symptoms local, but they are often referred (transmitted) through nerve pathways into the legs and feet, arms and hands, and head (headaches). In other words, pain felt in the head, arms, or legs may be due to instability in the neck or back.
 

For example, weakness or injury to the ligaments in the neck may interfere with the sympathetic (automatic) nervous system, causing a group of symptoms called Barre-Lieou syndrome. This syndrome consists of one or more of the following: dizziness, visual blurring, loss of balance, ringing in the ears, runny nose, salivation, trouble swallowing, hoarse voice, nausea, vomiting, nervousness and headaches. These symptoms are caused by instability in the neck and can be eliminated by prolotherapy.
 

Medications and other forms of passive treatment such as ultrasound, ice, heat, massage, acupuncture and manipulation may give minimal lasting benefits because the primary problem is not being addressed - the loose and injured ligaments. Stretching and strengthening exercises usually can provide some relief from chronic pain, but this is often only temporary. When these exercises have failed to increase the support sufficiently to diminish pain and improve function, the chronic pain cycle ensues. Prolotherapy should be initiated as soon as possible, before the problem becomes wide-spread.