Prolotherapy injection therapy is fast becoming a preferred alternative to surgery to help repair injured tissues and relieve pain. “Many people opt for prolotherapy as surgery often generates scar tissue that meshes with nerves, leading to more pain and discomfort,” affirms Dr. Sheila Mohammed, founder of Spine & Joint, LLC, in Destin, FL. “Additionally, metals placed within the body during certain surgeries can become painful in colder weather. Alternatively, prolotherapy is a less risky investment in one’s health and happiness.” 

According to Dr. Mohammed, there are different methods and solutions used in prolotherapy depending on the area being treated. Platelet Rich Plasma (PRP) Prolotherapy can help treat various joint, spine and painful musculoskeletal disorders. “Large joints such as the knees, hips and shoulders would need PRP in the prolotherapy solution injected into joints, bursae and the enthesis where ligaments and tendons attach to bones. These areas are rich in nerve tissue and are painful when micro-tears are formed from everyday wear and tear or from other injuries such as sports or motor vehicle accidents,” she says. Other areas—such as the spine, neck, elbows, ankles, feet and ribs—respond well to Dextrose Prolotherapy, where the solution injected is a mixture of dextrose and lidocaine. “Sometimes it’s necessary to add plant-derived homeopathic drops and injectable vitamins to the solution being used for more robust results, depending on how a patient presents.” 

Platelet Rich Plasma Prolotherapy

Platelet Rich Plasma (PRP) Prolotherapy is a relatively new modality that has proven beneficial in treating the above-mentioned conditions. “During treatment, a patient’s blood is drawn and the PRP is extracted out. Circulating stem cells in the blood are also extracted and injected into injured areas,” explains Dr. Mohammed. “The treatment is designed to allow the body to mend and rebuild itself naturally for the near perfect repair of the causative element of discomfort. There is no downtime, and patients continue their daily lives as usual while the body’s microsurgeons—such as fibroblasts, growth factors, and cytokines—do reparative work in the background.” 

Platelets, which are small fragments of cells that circulate in blood, are formed in the bone marrow and are much smaller than red blood cells. Their main objective is to prevent and stop bleeding. “Platelets contain proteins, cytokines and other bio-active factors that instigate the body’s natural healing process,” says Dr. Mohammed. “PRP treatments stimulate the natural immune repair mechanisms of the body and deliver the building blocks essential to build and repair damaged soft tissues, thereby accelerating the natural healing mechanism.”

Dextrose Prolotherapy

During a Dextrose Prolotherapy procedure, a high concentration of dextrose, combined with an anesthetic, is injected into the injured area. The injected solution causes a restricted, mild irritation at the site which initiates an inflammatory response. “The body then recognizes the site as damaged and initiates the healing mechanism,” says Dr. Mohammed. “This treatment method strengthens existing intact, but weakened, ligamentous and tendinous injuries, in and around areas/joints of concern. This technique raises growth factor levels at the site of injection and promotes healing and repair of local tissues, reducing or eliminating musculoskeletal pain.” 

Dr. Mohammed shares that Dextrose Prolotherapy works by increasing glucose concentration in the fluid outside cells. “This results in the movement of fluid from inside cells to the outside of cells, thereby shrinking the cells and causing temporary hyperosmolar cell damage. As the cells are being temporarily damaged, they call out for help by sending bio-signals to the rest of the body,” she explains. “This stimulates the immune system to accelerate the inflammatory process locally, resulting in increased blood circulation, fibroblast proliferation, ligament regeneration, tightening and repair.” 

The number of prolotherapy treatments varies depending on lifestyle factors and genetics. Dr. Mohammed affirms that typically a series of three to six treatments is required for healing, depending on the severity of the medical condition.