What is prolotherapy? What are PRP injections?

Question: Dr. Dan, what is prolotherapy? What are PRP injections? Are they the same thing? I keep hearing about these but I’m not sure what they actually do.

Prolotherapy and platelet-rich plasma, or PRP, are all over the news these days. Mainly because professional athletes like Tiger Woods have attached their name to these increasingly popular treatments. So what is prolotherapy and PRP?

Both prolotherapy and PRP treatments, at a basic level, do the same thing: they dramatically improve the rehabilitation of injuries by laying down new, healthy tissue over a torn or unstable tendon or ligament. That’s a mouthful so let me explain.

Prolotherapy strengthens ligaments and tendons

Prolotherapy and PRP are treatments used to strengthen the ligaments and tendons around your bones. Before explaining the treatment itself, remember that your ligaments and tendons are like rubber bands that hold your bones and skeleton together, allowing you to stand upright and move around.

Over time, especially after you damage ligaments and don’t properly rehabilitate injuries, you start to get a little bit of slack in your tendons. That little bit of slack actually changes the way your bones align and wear. This is why people get bone spurs, inappropriately wear out their cartilage, wear down the meniscus in their knee, and even experience rotator cuff tears.

Prolotherapy and PRP treatments, as well as stem cell injections, allow you to strengthen these tendons and restore the biomechanics of your bones. Here’s how it works.

How does prolotherapy work?

During a prolotherapy treatment, you are given a number of injections into the painful or unstable ligaments. The injection, which is a mixture of diluted dextrose, a sugar compound extracted from corn, and numbing medicine, actually causes new tissue damage in the area. This is good because the idea is to force your body’s inflammatory process to begin.

As the prolotherapy injection site swells up and gets tender and sore, your body comes in to repair this new damage. As it repairs this minor tissue damage, it lays down new tissue over the unstable or torn ligaments and tendons. In effect, prolotherapy helps your body help itself. Rather than using a medicine to cover up chronic pain, or taking a steroid to help with an injury, we naturally and permanently strengthen the tissues and tendons by almost tricking your body to laying down new, healthy tissue.

What are PRP injections?

Platelet-rich plasma, or PRP treatments are based on the same idea: lay down new, healthy tissue over a torn or unstable tendon or ligament. During a PRP treatment, you are again given a number of injections but unlike prolotherapy, PRP injections are made up of concentrated growth factors extracted from your own blood, hence the word platelet-rich plasma treatments.

Your blood is drawn, spun down in a centrifuge, and the platelets, growth and healing factors are then extracted and concentrated. To better understand growth and healing factors, think of the things that stop the bleeding and make your skin grow back after you cut yourself. They are like fertilizer for your body, if your body was a garden.

Both prolotherapy and PRP treatments are part of an emerging field of medicine known as regenerative medicine. They work, and I highly recommend both prolotherapy and PRP treatments. A physician familiar with non-surgically managing musculoskeletal injuries can tell you which of the two is more appropriate for your injury.

Does prolotherapy and PRP work?

One thing to keep in mind is that with any new or popular treatment, prolotherapy was actually first used in the 1940s, there are practitioners who will sell it as the be-all and end-all to your musculoskeletal injuries. Prolotherapy and PRP do not work in a vacuum and must be part of a comprehensive treatment plan. Just walking in and having somebody do PRP on your shoulder, for example, isn’t likely to yield the best results.

So when you undergo PRP or prolotherapy treatments, make an effort to combine it with good rehabilitation and manipulation, so there is proper movement in the joints as you develop new tension and fascia in your soft tissues, natural treatments like acupuncture for pain control and removal of trigger points, and good nutrition that supports normal vitamin D levels. The idea is to get permanent, complete healing in your body. Good luck!


Thank you for reading!

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Dr. Dan Williams is an internationally trained doctor of osteopathic medicine (D.O.) and a certified acupuncture practitioner. Dr. Dan is based out of Indianapolis. You can find more information by visiting drdanielwilliams.com.

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