There are a growing number of options in our arsenal when it comes to treating chronic pain caused by soft tissue injuries.
For a long time, we relied on medications or steroid injections to dampen our pain, and surgery to cut out or repair more serious issues.
The conventional approach limited us to ‘band-aid’ solutions with little attention paid to addressing the root cause and strengthening the damaged tissues for long-term health.
Physiotherapy, chiropractics, and exercise rehab have been an excellent tool to identify patterns of movement dysfunction, muscle weakness, and postural imbalance. Alongside a recognition that our nutrition, sleep, and stress played a role in our healing response, we had found an evidence-based approach to tackling the root cause of our pain patterns.
Another tool, often underutilized, in the quiver of pain management options is Prolotherapy. Highlighted in ‘Prolotherapy – A Missing Piece to your Recovery’, Prolotherapy is a safe and effective injection therapy used for damaged tendons, ligaments, and joints. Prolo stimulates a controlled inflammatory response in the targeted tissue, causing a cascade of healing mechanisms that are typically stimulated when we initially have an injury.
Prolo is performed by Naturopathic Doctors and Medical Doctors who have additional training in Regenerative Therapies (Prolotherapy and PRP) and other injection treatments for pain management. For optimal results and safety, Prolo is best performed using ultrasound imaging to guide treatment. This ensures that treatments are done in the correct site, and to ensure that major nerves and vessels are avoided.
Despite the increasing awareness of use of Prolo, there remains some misconceptions about this therapeutic. Below are the 5 greatest myths of Prolotherapy treatment.
1. Prolotherapy is Unsafe
A Prolotherapy solution contains dextrose (sugar) and a local anaesthetic. This is a generally safe solution (unless you have a known allergy to lidocaine/procaine) that when used alongside Ultrasound guidance is very safe. Multiple studies investigating the effects of Prolotherapy have consistently shown it to be a very safe treatment when done by an experienced practitioner. If you have concerns, make sure you ask your Naturopathic Doctor or MD what their experience is with treating your condition, and whether or not they use Ultrasound.
2. There Isn’t Evidence That Prolotherapy Works
Many studies have looked into Prolotherapy against other treatments, including PRP, cortisone, and placebo. Consistently, Prolotherapy has been proven to be beneficial in lowering pain and improving function. Despite the supportive evidence, there remains some skepticism around this treatment that will not be resolved until more and larger studies are performed.
3. Steroids "Work Better" Than Prolotherapy
Steroids are a proven option with a long history of use that are effective in reducing pain. Studies comparing Prolo to steroid injections have demonstrated they are both effective options, but the time it takes for them to take effect can differ. Steroids tend to have a faster onset of action, while Prolotherapy appears to have a longer duration of benefit; specifically pain levels 6 months after treatment lean towards a greater benefit from Prolo. Considering the risks of long-term repeat steroid use (tendon rupture, cartilage damage, blood sugar dysregulation, skin whitening, etc.), which Prolo doesn’t have, Prolo becomes a great option for chronic injury recovery.
4. If Your Not Better After One Treatment, It Didn’t Work
Prolo often takes multiple treatments to take full effect – trials of Prolo vary in the number of treatments needed, but typically a benefit will be seen after the first few treatments, and for optimal recovery around 3-6 treatments are often needed.
5. ‘I tried ‘Blind’ Prolotherapy And It Didn’t Help; It Must Not Work For Me.
If you’ve tried Prolo before, and it was performed without ultrasound-guidance, it’s possible that your treatment missed the target. 1 in 5 Prolo treatments performed ‘blind’ (without Ultrasound-guidance) misses the intended target, even when performed by an experienced Naturopathic or Medical Doctor. This just emphasizes the benefit of finding someone who can offer this method of treatment. If you had Prolotherapy before, and it was performed ‘blind’, you can’t guarantee the treatment was done in the correct location.
Prolotherapy is a safe and often very effective option for managing a wide number of different injuries and sources of chronic pain. It is important that if you are looking into Prolo as an option for treating your pain/injury, you need to find an experienced practitioner who has experience treating your condition, ideally treats under ultrasound guidance, and has a plan for supporting your Prolo treatments with active rehab and sound nutritional guidance to maximize its benefits.
