Prolotherapy Injections

Prolotherapy is a method of regenerative injection therapy designed to stimulate healing in injured parts of your body that may be slow to heal or may not have healed completely.

Prolotherapy is used to treat injured ligaments, tendons, cartilage, joints and neuropathic pain.

Prolotherapy has been used by health professionals for many years.  It was first developed by a USA surgeon, George Hackett in the 1940s and has since been researched by many other doctors and refined to what it is today:

A safe, effective injection treatment that provides increased strength in joints, ligaments, and tendons by making new connective tissue.

The term prolotherapy is short for proliferation therapy, as it stimulates the proliferation and repair of injured tissue.

What is involved with Prolotherapy?

A thorough history and palpation of pain around the area of injury will determine the injection site/s. Prolotherapy is an injection of dextrose/glucose and lignocaine (local anaesthetic). The local anesthetic in the solution takes effect immediately, relieving pain for a short duration. This can be useful diagnostically, especially if there has been some doubt about where the pain is coming from. The glucose solution injected then causes the body’s own inflammation process to begin and start the healing process.

Usually 4 appointments placed 2 weeks apart is required initially. Depending on the individual case maintenance appointments may be required 3-6 months apart (for midfoot arthritis as an example).

Improvement in symptoms usually occurs after 1-3 treatments.

How does Prolotherapy work?

• Prolotherapy works by stimulating a temporary, low-grade inflammation at the site of ligament or tendon weakness, “tricking” the body into initiating a new healing cycle cascade.

• Prolotherapy increases fibroblast and collagen production which repairs and strengthens tendons and ligaments which can then stabilise joints.
• Prolotherapy stimulates cartilage growth to reduce joint pain and arthritis.

• Perineural Injection therapy (PIT 5% dextrose) restores normal function in nerves which reduces neurogenic pain.

So in short, prolotherapy reduces pain, promotes soft tissue and cartilage repair, normalises irritable nerves, strengthens tendons, strengthens, thickens and shortens ligaments and stabilises joints.

How does Prolotherapy differ to Corticosteroid injections?

Steroid injections only address inflammation. Steroid injections weaken ligaments and tendons and delay bone healing, whereas prolotherapy strengthens soft tissue and assists tissue and joint repair, hence prolotherapy is a form regenerative medicine.

Precautions with Prolotherapy Injections

Some patients may experience dull pain and soreness at the injection site for 1-3 days after. 

Avoid strenuous exercise for 2 days post-injection. However non-painful activity and movement such as gentle stretching and gentle exercise are important for the laying down of normal collagen in the healing of ligaments or tendons. Therefore, use common sense and pain levels to guide you in your daily activities and exercise.

AVOID using ice over the affected area whilst having prolotherapy treatment. Also try to avoid Anti-Inflammatory medications and topical treatments as they may interfere with the inflammation and healing process.

Conditions treated with Prolotherapy Injections at Foundation Podiatry:

• Ligament strain – acute and chronic pain from ankle sprains and ankle instability. Strengthening ligaments in the lower limb and many other injuries, has been the primary goal of prolotherapy treatment for years.
• Tendinopathies – Injury to tendons occur when the tendon has become overloaded. The usual treatment for lower limb tendinopathy is managing training loads and strengthening exercises, which can take months. Tendinopathies often become chronic and fail to heal due to excess of a specific growth factor called VEGF. Prolotherapy treatment allows the healing to occur much quicker as the glucose in the prolotherapy solution inhibits VEGF. Prolotherapy is effective for achilles tendinopathy, peroneal tendinopathy, posterior tibialis and anterior tibialis tendinopathy. Prolotherapy (in a lower dosage) is very helpful if a tear is present in the tendon. Hayley has been getting great results with posterior tibialis tendinopathy/tenosynovits, tibialis anterior, peroneus brevis and longus and achilles tendinopathies.
• Plantar fasciopathy (chronic + plantar fascia tear) - Prolo is particularly helpful on stubborn cases of heel pain which do not respond to other treatments, especially when an interstitial tear is present.
• Sinus Tarsi Syndrome
• 1^st MTPJ (big toe joint) synovitis / hallux limitus
• Morton’s Neuroma
• Arthritis (ankle, subtalar, midfoot, 1^st MTPJ)
• Neuropathic pain, radiculopathy
• Shin splints (MTSS), Compartment Syndrome and calf muscle issues