Prolotherapy

“Proliferation” means ‘multiplication’ and ‘therapy’ means ‘treatment’. Prolotherapy is a repair process initiated by giving specially prepared solutions to certain parts of the body with the help of “injection” (i.e. needle), causing a voluntary inflammation in that area, and the collection / proliferation of inflammatory cells with the help of the immune system that responds to this inflammation. With the voluntarily initiated inflammation, blood supply in that area increases and the healing/strengthening process begins in the tissue.
What is its history?
Prolotherapy is not a very old treatment. Therefore, it is wrong to define it as a traditional treatment and it is more accurate to look at it as a “modern complementary” treatment. This treatment was first applied for the first time by American General Surgeon Dr. George Stuart in the 1930s.
Which diseases is it used for?
Prolotherapy is a method applied in skeletal muscle system disorders. Tendons, intra-articular cartilage structures receive less blood than other body parts. For healing, growth factors and other reparative molecules in the blood are indispensable.
Some of the ailments for which prolotherapy is used; Sports injuries, back pain, neck pain, some skeletal-muscular disorders in the arms (tennis elbow, golfer’s elbow, etc.), all kinds of joint calcifications (arthrosis), ligament injuries in all kinds of joints, especially knee and shoulder ligament disorders (meniscus, cruciate ligaments, etc.), carpal tunnel syndrome, lumbar hernias, cervical hernias, heel spurs, etc.
Is Prolotherapy Alone Enough?
Prolotherapy is one of the treatment modalities used in musculoskeletal disorders. However, it is never enough on its own. The problem that occurs must be determined by a doctor’s examination, the underlying causes must be determined and measures must be taken accordingly. Especially weak joints and tendons are caused by poor nutrition and living conditions. We look at prolotherapy as an auxiliary treatment method to increase the effectiveness of treatment as well as accelerating healing with the regulation of nutrition and other living conditions and necessary herbal supplements.
How are Prolotherapy Sessions?
Prolotherapy is a treatment method that we apply 4-6 sessions depending on the patient’s condition, and we determine the session intervals between 3 weeks and 5 weeks. The quality decreases in less frequent or more frequent treatment. Since Prolotherapy is not a painkiller, but a restorative treatment, it does not show a rapid effect, the effects start to be seen after 2-3. It starts to be seen after 2-3 sessions and reaches the highest level within 1 year.
How is the Application?
Since prolotherapy is a treatment modality managed by activating the immune system in the body, your doctor will recommend nutrition and, if necessary, natural supplements to strengthen the immune system. In addition, the use of drugs that suppress the immune system may adversely affect prolotherapy. Likewise, since it is an invasive procedure, medications related to bleeding (blood thinners) may need to be discontinued.
Your doctor will evaluate your necessary tests during the examination, determine the prolotherapy protocol and start the treatment.
Prolotherapy takes 30 minutes or less in total, including pre-procedure preparation. Prolotherapy usually requires several sessions of treatment to be effective at the site of injury or weakened area. One person may receive 4 to 15 treatments (needle injections) per session. These sessions are completed over a period of 3 to 6 months. It is important that the irritant is applied correctly to the area or areas requiring repair and that the practitioner has received adequate training.
How does prolotherapy work?
After the inflammation and then proliferation (cell proliferation) stages mentioned earlier, the tendon goes through the repair process and becomes stronger than before. The strengthened tendon stabilizes (controls) the joints better. After the joint becomes stronger, it is expected that the existing pain complaints will also decrease.
What is the healing process after prolotherapy?
Mild swelling and stiffness are common immediately after the procedure. However, these resolve quickly and most people can resume normal activities the same day or the day after. Some patients may experience bruising, discomfort, swelling and stiffness lasting up to a week.
Prolotherapy should never cause severe pain. Severe pain, especially when accompanied by fever, may be a sign of infection and should be treated urgently. Multiple prolotherapy treatments may be recommended to continue to stimulate new tissue growth. Some experts recommend about 3 to 6 treatment sessions, administered every four weeks.
What are the Types of Prolotherapy?
Dextrose solution
Dextrose (a type of sugar) is a solution that triggers the release of growth factors. Dense dextrose is therefore injected in and around the injury site. The stimulated growth factors stimulate the growth and promote the repair of tendons, ligaments and other soft tissues.
PRP
PRP stands for the English term “Platelet Rich Plasma”. This means plasma (i.e. the part of the blood that remains after the cells have been separated) enriched with platelets (i.e. blood platelets that provide clotting). This fluid contains many growth factors and is commonly referred to as “stem cell therapy”. The venous (vein) blood taken from the patient is processed in a centrifuge machine (rotated at high speed) to obtain this fluid. It is then injected into the appropriate points. Platelets (platelets/blood platelets) have many secretions that promote tissue healing.
Prolozone
Ozone gas produced from oxygen gas is injected into designated points. Ozone gas also has cell regenerating and proliferating effects.
Are There Side Effects of Prolotherapy?
The biggest competitor of prolotherapy is undoubtedly surgeries. Surgeries performed in musculoskeletal disorders are serious operations that will seriously affect the functional capacity of the patient. In prolotherapy, although pain may be felt on the first day due to the injection effect and the feeling of tension caused by the liquid given, patients continue their routine life after the first day.
Prolotherapy is generally considered safe. As long as no nerve and vascular damage is caused by a trained practitioner, no extra side effects have been reported.
Injections without observing the necessary sterility conditions can lead to infections.
Is there a place for prolotherapy in the scientific literature?
There are many studies on the effectiveness of prolotherapy. Let’s share some of them here:
- General studies about prolotherapy:
- https://www.ncbi.nlm.nih.gov/pubmed/30433886
- https://www.ncbi.nlm.nih.gov/pubmed/30123064
- https://www.ncbi.nlm.nih.gov/pubmed/30107954
- https://www.ncbi.nlm.nih.gov/pubmed/30098273
- https://www.ncbi.nlm.nih.gov/pubmed/29963845
- https://www.ncbi.nlm.nih.gov/pubmed/29945842
- https://www.ncbi.nlm.nih.gov/pubmed/29319178
- https://www.ncbi.nlm.nih.gov/pubmed/28484944
- https://www.ncbi.nlm.nih.gov/pubmed/28218386
- https://www.ncbi.nlm.nih.gov/pubmed/27788902
- In disorders related to the foot and lower extremities:
- https://www.ncbi.nlm.nih.gov/pubmed/31358724
- https://www.ncbi.nlm.nih.gov/pubmed/30149850
- https://www.ncbi.nlm.nih.gov/pubmed/28717615
- https://www.ncbi.nlm.nih.gov/pubmed/28449312
- https://www.ncbi.nlm.nih.gov/pubmed/28002322
- https://www.ncbi.nlm.nih.gov/pubmed/26500703
- https://www.ncbi.nlm.nih.gov/pubmed/25239050
- https://www.ncbi.nlm.nih.gov/pubmed/23876935
- Avascular necrosis of the femoral head and other hip pathologies:
- In jaw joint disorders:
- In elbow diseases, especially epicondylitis:
- Knee osteoarthritis (Gonarthrosis, knee arthritis) and other knee pathologies:
- https://www.ncbi.nlm.nih.gov/pubmed/30688517
- https://www.ncbi.nlm.nih.gov/pubmed/30057634
- https://www.ncbi.nlm.nih.gov/pubmed/29764447
- https://www.ncbi.nlm.nih.gov/pubmed/29722769
- https://www.ncbi.nlm.nih.gov/pubmed/29696113
- https://www.ncbi.nlm.nih.gov/pubmed/27673137
- https://www.ncbi.nlm.nih.gov/pubmed/27058744
- https://www.ncbi.nlm.nih.gov/pubmed/26030118
- https://www.ncbi.nlm.nih.gov/pubmed/24596471
- https://www.ncbi.nlm.nih.gov/pubmed/23690322
- https://www.ncbi.nlm.nih.gov/pubmed/22708106
- https://www.ncbi.nlm.nih.gov/pubmed/20802815
- In shoulder diseases:
- https://www.ncbi.nlm.nih.gov/pubmed/30543266
- https://www.ncbi.nlm.nih.gov/pubmed/30318481
- https://www.ncbi.nlm.nih.gov/pubmed/30171616
- https://www.ncbi.nlm.nih.gov/pubmed/30100587
- https://www.ncbi.nlm.nih.gov/pubmed/30076801
- https://www.ncbi.nlm.nih.gov/pubmed/30057849
- https://www.ncbi.nlm.nih.gov/pubmed/29796104
- https://www.ncbi.nlm.nih.gov/pubmed/29101774
- In general muscle pain such as fibromyalgia:
- Waist and Neck Disorders:
- Pain in the sternum:
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