The what, how and why of Prolotherapy!

WHAT IS PROLOTHERAPY?
Joints weaken when ligaments and tendons are stretched, torn or fragmented, causing the joint to become hyper-mobile and painful. Traditional approaches with anti-infl ammatory drugs and surgery often fail to stabilize these joints and relieve pain permanently. Prolotherapy has the unique ability to directly address the cause of instability and repair weakened sites, resulting in permanent joint stabilization. Also known as ligament reconstructive therapy, prolotherapy is a recognized human orthopedic procedure that stimulates the body’s natural healing processes to strengthen joints weakened by trauma or arthritis.

HOW DOES IT WORK?
When precisely injected into the site of pain or injury, prolotherapy creates a mild, controlled inflammation that stimulates the body to lay down new tendon or ligament fibers, resulting in a strengthening of the weakened structure. Tendons and ligaments have immature cells known as fibroblasts. These are kind of like dormant “baby” cells, and when stimulated, they grow and create new tendon fribrils, which themselves grow and create new tendon. Electron micrographs actually show this growth and transformation. When the ligaments and/or tendons becomes strong, the joint will stabilize and the pain will be relieved!

WHAT IS A PROLOTHERAPY INJECTION COMPOSED OF?
Ingredients may vary, but the basic principles are to use a mixture of an irritant, such as 50% dextrose solution, along with a local anesthetic, such as lidocaine or procaine. This helps with the pain of injection and increases pain thresholds. Some holistic practitioners will use homeopathic solutions to create the inflammation and/or the fibroblast stimulation.

HOW EFFECTIVE IS IT?
The success of prolotherapy depends on a number of variables, including the patient’s history and ability to heal. In humans, some 85% to 95% of patients suffering from low back pain experienced remission when treated with prolotherapy. In contrast, the Journal of Bone and Joint Therapy reports only a 52% improvement in human patients treated with disc surgery! Similar studies have not been done in dogs and cats, but tendons, ligaments and joints are very much the same in all species. Since the success we had with Jona’s case (see sidebar), we have used prolotherapy many times in hip cases where there is still a growing joint – I firmly believe we can prevent hip dysplasia from developing in these types of cases. We also use prolotherapy routinely in partial cruciate tears, with an almost 90% success rate. It is important to note that if the tendon or ligament is fully and completely torn away, then prolotherapy will not work and surgery will be required.

IS PROLOTHERAPY PAINFUL?
The pain of an injection will vary depending on the structure to be treated and the choice of solution involved. In any case, animal patients need to hold still as we are injecting into the joint, so sedation is usually needed; they are admitted for a couple of hours to have the procedure done.
Because prolotherapy uses inflammation to heal the body, it can result in some swelling and stiffness, or even a temporary increase in pain. This can be treated with pain relievers, but we cannot use anti-inflammatories as they will negate the “good” inflammation we are trying to cause.

HOW OFTEN ARE TREATMENTS ADMINISTERED?
This is determined on an individual basis, but it’s usually every two to three weeks. The length of the treatments is variable and depends on several factors, including the dog or cat’s nutritional
status, ability to heal and the degree and site of the injury involved. Some animals may experience complete relief from pain, along with restoration of full function, after only two or three treatments. Generally, however, most problems require from three to six treatments, depending on severity. The dog or cat must avoid any heavy duty exercises, but normal walking and short runs are fine.

Prolotherapy is an effective part of a comprehensive approach to controlling and/or curing chronic pain. In all cases, dietary and nutritional medicine and specific supplements should be added to help maximize health and the body’s ability to heal. Rehabilitation and physical therapy programs, including underwater treadmill therapy, will also be specifically designed to aid in healing.

Whether your animal has arthritis, hip dysplasia, an injury or other related issue, prolotherapy may be able to give him relief by helping his joints heal themselves.

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