Prolotherapy has offered non-surgical relief for chronic joint pain for over five decades. Long before our ability and understanding of PRP, doctors, Hemwell and Hackett discovered that glucose or sugar had the ability when injected into ligaments and tendons, to cause new growth or proliferation of new tissue. The end result after a stimulated healing was greater tensile strength in the ligaments or tendons, and a reduction in localized and even referred pain patterns.
In addition to the glucose which is used, they would add a local anesthetic such as procaine or lidocaine. These three ingredients are three of the safest ingredients to inject, with their risk profile in normal doses nearly non-existent. Over the years other ingredients have been added to enhance proliferation of new tissue, but the core formula has not changed.
Platelet Rich Plasma (PRP) is concentrated platelets and leukocytes (white blood cells) derived from a patient’s own blood. The platelets and leukocytes act as growth factors that stimulate local tissue just the same as glucose would, but with what appears to a much more enhanced response.
Many people wonder why Prolotherapy has not gained more popularity over the last 5 decades when it has become an amazing tool of regeneration. A few possible reasons exist and are worth stating in case one questions the value of Prolotherapy and its lack of becoming a mainstream therapy. The first reason is it has never been taught in medical schools. All doctors trained have been trained in programs outside of medical school. They have carried the burden of expense and risk in something fairly unknown. Their first exposure probably came from another doctor, who had been trained, or a patient asking about prolotherapy. My first exposure was from a fellow doctor, by whom I was treated, with tremendous success.
Another reason possibly is due to the fact that it is fairly inexpensive as a procedure. The supplies required to do the procedure mainly are lidocaine, glucose, and a syringe. The majority of the cost is in the labor itself. I think most insurance companies probably were unwilling to reimburse adequately for the doctors time and expertise. Most doctors probably felt their patients were unwilling to pay out of pocket for these procedures. If they had only known how effective it had been, patients would have gladly paid out-of-pocket as they do now.
Although not completely understood, the lack of recognition, on the whole, from the medical community, Prolotherapy has withstood the test of time. More doctors are trained more than ever before. The techniques and experience have improved upon the delivery methods and overall success of individual treatments. Even as Prolotherapy appears to take second seat to PRP, it still stands as the first truly anti-aging and regenerative therapy available to the world. A sufficiently treated ligament or tendon of a 60 year old is difficult to differentiate from that of a 20 year old. Prolotherapy is likely to be viable for years to come. Even with the advent of many newer and more advanced therapies, Prolotherapy still stands as the most efficient and affordable treatment for chronic pain.
