Chronic musculoskeletal pain often results when ligaments or tendons have been weakened by strains or sprains. Ligaments that connect the bones can become stretched and develop small tears, causing the joint to become overly lax. This instability increases force on the fibro-osseous junction, the location of attachment of ligaments to the bones. Bones are covered by highly sensitive tissue called periosteum, the tissue to which the ligaments and tendons attach. This attachment is generally the greatest source of pain in a joint injury. Prolotherapy injections occur at this location.
Several factors contribute to the physiological enhancement of the healing process:
- Cartilage, ligaments, and tendons often heal poorly because of poor blood supply, as is apparent in their white color. The controlled inflammation of prolotherapy also causes increased blood flow, nourishing the tissue while removing damaged cells.
- NSAIDS, like ibuprofen, inhibit the body’s healing process. Although they may give momentary relief from pain, they are counterproductive to the healing process.
- Intentionally induced inflammation caused by dextrose injection stimulates the body to deposit collagen on the injured tissue, healing and restoring tissue that otherwise takes a long time to heal and often never completely heals.
The basic mechanism of Prolotherapy is simple. A solution of dextrose (a proliferative agent), lidocaine (a mild numbing agent), in a saline solution that is injected into the damaged tissue. The dextrose acts as an irritant deliberately causing inflammation, the body’s natural way of repairing injured tissue. The controlled, localized inflammation triggers a healing cascade, resulting in the deposition of new collagen, the natural material of ligaments and tendons. As the tissue heals, the collagen hardens, often causing the tissue to be stronger than before the injury. The tightened connective tissue stabilizes the weakened joint, subsequently reducing or eliminating the pain.