Prolotherapy is an injection technique that targets, and accelerates normal inflammation at the site of an unresolved injury. This is most often torn connective tissue. Examples are ligament from bone, tendon attachments and fascial attachments. These injuries are variously called sprains, strains, fascitis and chronic pain. Syndromes consisting of constellations of these hot spots are labeled but poorly understood.
Healing is our goal. We expect the pain to resolve in most cases as a result of the body completing repair of the injury. The injury can be the result of acute trauma or cumulative trauma over decades. A program of regular inspection and repair is expected to extend functional life of the musculoskeletal system. Stimulation of fibroblasts to produce collagen, their programmed function, results in deposition of this reinforcing material in the area of concern. Patterns of deposition appear to be linear suggesting force-vector determination. This, along with the contractile nature of maturing collagen, appears to result in a literal “tightening” of the necessary connections in a pattern that results from the unique loading characteristics of the treated system.
Our human body is a thermodynamic system like a steam engine. They are both physical systems subject to the development of “Entropy” or wear and tear. Excess kinetic energy not used for effective work becomes disorder. This excess energy, a well recognized part of the stress reaction, is especially destructive in the face of delayed repair. Repair, when defined in cellular terms, is equivalent to normal inflammation.
Aging results in cellular efficiency declining. Repair activity, carried out by our cells, also slows. Delayed healing, however, can also be due to other factors including stress, inadequate nutrition, toxins and injudicious use of anti inflammatory medication.
The adrenal gland is the transducer shifting energy from the repair systems to the body’s musculoskeletal system. The sleep we enjoy at night is a “pit stop” in our race to survive. Under prolonged stress our body reduces the energy consumption of all processes other than that required for our “fight or flight”, repair suffering greatly. If the excess energy associated with stress persists with prolonged reduction in energy available for repair, the result is inevitable and confirmed by any intelligent, observant adult.
Mobility is a prerequisite for a completely fulfilling life. Unlike the popular ads touting artificial mobility, we focus on maintaining natural mobility. Systematic maintenance of a thermodynamic system allows longer function. Prolotherapy is a valuable tool.
Successfully treated for a back condition, the result of an auto accident, by Dr Jack Smith who is a recognized pioneer in the field, I became his apprentice for over a year. Additional knowledge and understanding was obtained through study of works such as Hacketts original textbook and the works of Cyriax. Twenty five years experience in Critical Care Medicine, placing needles and devices under critical circumstances, provided confidence when in 1995 began the practice of Prolotherapy. Courses provided by the American Association of Orthopedic Medicine (AAOM) and The Osteopathic Pain Management and Sclerotherapy, provided hands on experience with both cadavers and live patients. Prolo-related adjustments of musculoskeletal relationships are applied to ensure the “tightening” occurs while maintaining the proper functional and anatomic relationships. Osteopathic or Chiropractic follow-up is often encouraged.
A decade of successful practice of this discipline has prepared me to offer my growing experience to you. A chronic pain of musculoskeletal origin that persists, despite the best efforts of your physicians, may well respond to this approach.
An acute injury of connective tissue that is being treated with anti-inflammatories and coricosteroids beyond the first week needs my attention.