Prolotherapy 3

State of the Art Prolotherapy Theatre

Prolotherapy 1

Sclerosant Injections to Ligaments

Prolotherapy 2

Reduces the Risk of Recurring Back Pain

Prolotherapy 4

Neural Prolotherapy

Prolotherapy Injections

Prolotherapy injections

prolotherapy-3Prolotherapy injections were previously known as 'sclerosant injections'.

In your body, the ligaments help to provide stability to joints. They prevent the joint from moving more than the 'normal range' (though what is 'normal' varies from one individual to another). Some people have lax or loose ligaments that allow greater than normal movement in the spine and elsewhere. After the treatment of prolapsed discs or chronic back pain, instability may be a significant cause of recurrent problems. The use of prolotherapy reduces the risk of recurrence and helps people return to activities faster.

In the spine there is a complex arrangement of ligaments, both between each vertebral segment and between the spine and pelvis, which allows flexibility in some directions and produces restraint in others. Sometimes ligaments can be overstretched, or even torn (as in a sprained ankle). The ligament may then not control the joint adequately – thus leading to 'instability' which may put abnormal stresses on the joints and discs in the spine.

In women, the pelvic joints need to be supple for child bearing and so the ligaments soften and stretch more readily. Sometimes they do not tighten up after childbirth and therefore allow too much movement – hence 'sacroiliac instability'.

Prolotherapy works by stimulating the body to make new fibres which are laid down within the substance of the ligaments, thickening and strengthening them. The solution used (P2G) contains dextrose, glycerol and 1% phenol mixed with local anaesthetic. A small amount is injected into each end of the ligament close to its attachment to the bone. We occasionally use a 25% solution of dextrose with local anaesthetic, if required, for peripheral joints. This solution initially provokes inflammation, attracting the cells that make collagen fibres to the area. Over the ensuing weeks, the fibres are incorporated into the existing ligament. Each ligament has to be injected three times, at intervals of a week, in order to produce sound fibrous development. Hence three injections are given as a course of treatment. The interval can be up to three weeks.

Prolotherapy for ligaments is widely practised in America, but less so in this country. It has been used safely in this country for the last 50 years but as yet it has not been licensed for this particular type of treatment. However, our 50% glucose ampoules are provided by a licensed manufacturer as are the ampoules of P2G. Because the organic compounds in the solution are rapidly disposed of by the body, it is safe to have a repeat course of treatment – should it be necessary. There have been several widely published clinical trials on its usefulness in low back pain with positive results. These are available on request.

Prolotherapy does not create scar tissue but thicker, healthy collagen fibres in the lax ligaments. Injections are commonly given in the lumbar region, sacroiliac region, thoracic and cervical spine. They are also useful in the ankle and shoulder region.