Prolotherapy Treatment for Pain
Prolotherapy’s basic premise: Sprains, strains or tears of ligaments and tendons. It effectively trigger inflammation and new collagen. This can strengthen and eventually shorten ligaments. Hence, if ligaments shortening occurs the joint is more stable and the ligament returns to normal, full function.
How does it work?
It involves the injection of glucose (sugar/ dextrose solution) and lignocaine (local anaesthetic) into ligaments, nerves and tendons which triggers inflammation and new collagen. The process causes a healing cascade in which fibroblasts and collagen are produced to aid the healing process and pain reduction in joints. The good thing is, overtime it can help to eventually shorten ligaments, restoring effective ligament function and improved joint stability. After prolotherapy treatments, microscopic studies have demonstrated an increase in collagen fibril size and number. It has been noted within studies of 30-40% increase in strength of tendon attachment to bone of patients who have undergone prolotherapy compared to patients who have not had prolotherapy. Prolotherapy can also be utilised in the cartilaginous joint as a growth factor to increase cartilage growth.
Indications for use
- Sprained ankle
- Tibialis posterior dysfunction
- Achilles tendinopathy
- Plantar fasciitis
- Osteoarthritis of the foot
- Morton’s neuroma
- Osgood Schlatters (front knee pain)
- Shin splints
- Compartment syndrome
- Knee osteoarthritis
- Persistent pain after fracture of ankle or foot.
Prolotherapy Treatment for KNEES
Pain along the joint line of the knee can indicate meniscal injury or osteoarthritis. Research with the use of prolotherapy has shown decrease pain and increase the range of movement in the joint. Subsequently, prolotherapy has shown signs of healing of the worn cartilage and injured meniscus.
Knee Cap Pain
Other knee pathologies that can benefit from prolotherapy include patellofemoral mal-tracking with or without chondromalacia injury. This simply means injury of the cartilage at the back of the knee cap due to the knee cap not tracking along the groove of the knee correctly. This mal-tracking of the knee cap causes damage to the cartilage at the back of the patella. With prolotherapy we can treat the surrounding knee joint tendons and ligaments to improve support of the knee along with exercises to improve muscle function of the quadriceps to aid correct movement of the patella at the knee joint.
Prolotherapy can treat runner’s knee and patella tendinosis. This is irritation at the patella tendon or the ligament which runs from the knee cap to the front of the lower leg bone. Patella tendinosis is degeneration along the tendon which causes pain after long periods of standing. Prolotherapy can aid regeneration and repair of the patella tendon. This treatment at the patella tendon can include treatment into the knee joint space at the knee stabilizing ligaments such as the anterior cruciate ligament or posterior cruciate ligament if there is instability within the joint. The Instability within the joint can increase pressure over the patella tendon. Your podiatrist will need to do a full examination before prolotherapy commences to ensure the area requires injections.
Osgood Schlatter’s Disease
Growth Plate pain at the top of the shin bone is Osgood Schlatter’s disease. Jumping sports and growth spurts in adolescence can bring on the pain. Muscle imbalance in the core muscles and quadricep muscles can also impact the disease. Patella tendon and gowth plate pain is treated with Prolotherapy. This effectively reduces knee pain and increases stability at the tendon.
Knee Joint Instability
Pain inside the knee joint can be caused by knee osteoarthritis. The later often presents with reduced range of motion and stiffness after sitting, and pain along the joint line or under the knee cap. Some of the stiffness is caused due to the reduction of the normal amount of joint fluid. Prolotherapy can increase the amount of synovial fluid within the joint which aids in keeping the joint healthy and increases mobility within the joint.
Increasing knee joint stability can aid in reducing the risk of developing osteoarthritis. Joint instability means excessive movement of the two bones which make up the joint. This movement is really which causes symptoms which is often pain. Joint instability causing a cascade of issues including overuse of muscle recruitment which can cause muscle spasms, swelling within the joint and bone spur growth.
Treatment for this instability of the joint can be the use of prolotherapy to increase the tension within the ligaments along with exercising the Ligaments and muscle surrounding the joint. Ligaments are the sensory organ for the joint which tells the body there is a problem at the area. Prolotherapy aids the development and strengthening of these ligaments through the proliferation of cells.
Coupled with strength and conditioning work, Prolotherapy aids stability of the joint and decreases the cascade of changes which lead to joint pain.
Prolotherapy Treatment for FOOT & ANKLE
Prolotherapy can also be utilized for the foot and ankle to treat
- Intermetatarsal bursitis
- chronic ankle osteoarthritis
- bunion pain
- laxity in the ankle ligaments after a bad ankle sprain
- Plantar Fasciitis
- Achilles tendonitis
Treatment of the laxity of the ankle ligaments which commonly can occur after an ankle sprain can help to create cell regeneration and along with exercise prescription can strengthen the ligaments and reduce the laxity of the joint.
Ankle joint and Bunion joint deformities can be helped with Prolotherapy injections. Prolotherapy injection into the joint can increase joint fluid which aids cartilage regeneration and the bodies natural synovial fluid which keeps the joint strong and healthy whilst enabling movement with reduced pain.
A common forefoot pathology which we see is inflammation of the small fluid sacks which sit between the metatarsals or long toe bones in the forefoot. This pain occurs as a feeling of a lump or rock under the front of the foot during walking.
This pain comes from the small fluid filled sacks between the toe bones becoming irritated from compression a pathology known as intermetatarsal bursitis. Injections with prolotherapy can sooth the pain by decreasing the inflammation within the bursa sacks along with correcting any tight footwear and sometimes orthosis therapy to aid foot position and reducing compression.
Plantar Fasciitis & Achillies Tendonitis
Plantar fasciitis and Achilles tendonitis are where there is pain where the tissue connects to bone or along its length. They are common pains and affect more than 10% of the population. These large tendinous or fascial areas become overworked and sometimes degenerative with microtears in the tissues fibers and can cause a great deal of pain with simple walking, running, and standing.
Orthotic therapy works well in combination with prolotherapy to help re-distribute loading of overstrained tissue . Prolotherapy takes the support of the tissue to another level by encouraging repair of the affected tendon and fascia through cell proliferation which aids to build the strength and function of the tendons and fascia along with aiding in decreasing pain at the area.