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Proliferative Therapy (aka regenerative injection therapy, prolotherapy, ligament reconstructive therapy or sclerotherapy)

CURRENT COMMON USES

• Arthritis 
• Backaches 
• Carpal tunnel syndrome 
• Compression fractures 
• Knee conditions 
• Herniated discs 
• Chronic headaches 
• Tennis elbow 
• Shoulder pain 
• Varicose veins 
• Temporal mandibular joint dysfunction 
• Work-related injuries 
• Sports-related injuries

HOW IT WORKS:   

Prolotherapy uses a mild local anesthetic in combination with one of the proliferative agents listed to the right in 4-6 sessions over 2 weeks injected via a very thin needle into tendons, ligaments, or joints.  These injections cause a mild inflammatory response in the body, and the chemotaxis (bringing in from the blood stream) fibroblasts.  These fibroblasts then thicken the tendon or ligament or cartilage, causing an improvement in strength and function, thereby reducing pain. 

PROLIFERATIVE SUBSTANCES USED

  • Chemical irritants include mild chemical irritants and chemotactic agents.

  • Mild chemical irritants, such as phenol or tannic acid, trigger the healing process by attaching themselves to the walls of the cells wherever they are injected. This causes an irritation/inflammation that stimulates the body to produce collagen and start the healing process.

  • Chemotactic agents are proliferants that attract macrophages directly to the injected area (e.g., Morrhuate Sodium, which is a fatty acid derived from cod liver oil and is the most commonly used). These macrophages (cells in the body) “clean up” debris associated with inflammation.

  • Osmotic agents work by causing cells to lose water, which leads to inflammation and the subsequent stimulation of the healing response. Dextrose and glycerin are two of the main ingredients in standard prolotherapy solutions.

  • Particulates such as pumice flour are microscopic particles that attract macrophages. The macrophages secrete growth factors that result in collagen production.

Sometimes cofactors, such as the anti-oxidant mineral manganese or a combination of glucosamine sulfate and condroitin sulfate, are believed to aid in the repair of arthritic joints or degenerative discs.

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