Prolotherapy, also known as proliferative therapy, ligament reconstruction therapy, or fibro-osseous injection therapy, is a procedure that stimulates the body’s natural healing processes. This is a recognized orthopedic treatment which stregnthens joints weakened when ligaments are stretched, torn or fragmented due to a traumatic injury, or become hypermobile and painful secondary to over-use. Because of prolotherapy’s unique and direct approach, joint instability can be permanently stabilized through the production of new fibrous tissue. By strengthening weakened connective tissue we can often alleviate musculoskeletal pain, improving function and mobility.

Q: How does prolotherapy work?

A: A gentle irritant (anesthetic agents and natural substances) is injected, creating a mild, controlled injury which stimulates the body’s natural healing processes to lay down new tissues on the weakend area. This mild inflammatory response encourages growth of new ligament or tendon fibers, with additional treatments facilitating a gradual build up of restorative tissue.

Q: What areas of the body can be treated?

A: This form of therapy can be used to treat any region in the body that has ligaments or capsule, some examples are: shoulder, elbow, wrist, hand, hip, knee, ankle, foot, cervical/thoracic/lumbar spine, sacroiliac, TMJ, and ganglion cysts. Also, because prolotherapy involves a precise injection directly to the site of discomfort, other areas are not affected.

Q: Is Prolotherapy painful?

A: Factors affecting the painfulness of any injection include the structure being treated, the choice of solution(s) injected, and the skill of the attending physician. The skin is numbed prior to each injection. Afterwards, you may experience some mild swelling and stiffness, but any discomfort resolves fairly rapidly and can be reduced with OTC pain relievers such as Tylenol within a few days. Anti-inflammatory medications such as aspirin, ibuprofen (Advil, Motrin), or Naproxen and/or anti-inflammatory herbs such as curcumin, boswellia, bromelain, etc. should not be used, as these can suppress the desired inflammatory process produced by the injection. Please let us know if you are on any blood thinners such as warfarin (Coumadin). We may still be able to utilize this treatment depending on the condition and the area being treated.

Q: How often do I need treatments?

A: The treatments are typically administered every 3-6 weeks.

Q: What activity can I do after the treatment?

A: We suggest very light activity (range of motion of the area) after the injections to disperse the prolotherapy throughout the tissues. This seems to decrease the amount and duration of pain from the injections. No excessive activity in the hours immediately following the injection. Avoid the temptation to overdo it because the numbness is still in effect. Please rest. No heavy lifting. No strenuous physical activity for one week after your injection. We suggest waiting 4-6 weeks before returning to full strength activities unless instructed otherwise by Dr. Leiber. You may be advised to begin a physical therapy program.