Download Regenerative Injection Therapy (Prolotherapy)

Regenerative Injection Therapy (Prolotherapy)
Deborah Angersbach, ND
Chronic musculoskeletal pain is one of the main causes of disability in America
and the leading reason for patient visits to their physician. Treating
musculoskeletal pain can be difficult, and conventional treatment options are, at
times, insufficient to reduce pain and restore function. Physical therapy, exercise,
chiropractic manipulation, medication, corticosteroid injections, and surgery can
be beneficial in many circumstances. However, when they are not successful,
patients may be left without options.
Regenerative Injection Therapy (RIT), also known as Prolotherapy, is a treatment
for joint pain that has been studied and practiced by physicians since the 1930’s.
RIT is performed by orthopedic, osteopathic and naturopathic medical doctors.
Many clinical studies have been done on RIT using more than 500,000 patients
so far, with current studies being done at the National Institute of Health, among
others. Over time, knowledge of RIT has increased and it is now being used at
Yale University Hospital, The Mayo Clinic in Rochester, and Scripps Institute in
California. The American Academy of Pain Management endorses RIT for
chronic unresolved musculoskeletal pain.
RIT gives ligaments and cartilage a second chance at healing and is often
described as “anti-aging medicine” for the joints. When a joint is injured,
ligaments and tendon insertions are strained, causing an inflammatory response
- a critical part of healing. Inflammation at an injury site clears dead cells,
promotes capillary growth and restores damaged tissue. However, not all
sprains and strains will heal completely. In fact, after an injury ligaments and
tendons may retain only 50-70% of their pre-injury strength. When ligaments
have been overstretched, joints become unstable and degenerative changes
occur, which cause osteoarthritis. For example, if one of the ligaments in the
knee were injured, that joint may be predisposed to early onset of arthritis.
Because RIT gives the ligament and cartilage a second chance and healing, the
ligament is strengthened, the joint is stabilized, and the course of arthritis is
stopped.
Commonly, NSAIDS or cortisone shots are used for joint pain. These do reduce
inflammation in acute injuries, but chronic pain is degenerative, not inflammatory,
so steroids often don’t resolve the problem. Also, studies show that NSAIDS
interfere with healing of injured tissues if used repeatedly. In comparison, RIT
triggers the body’s natural healing response allowing for regeneration of
damaged tissue.
RIT is defined as: “tissue regeneration and repair leading to restoration of
elasticity, tensile strength, increased mass and greater load bearing capacity of
the affected connective tissue.”
RIT treats degenerative or overuse conditions of the musculoskeletal system
associated with problems in the tendons, ligaments, or cartilage. Indications for
use are: chronic pain secondary to sprains or strains; osteoarthritis of the hips,
knees, shoulders, hands, wrists, ankles, feet, and spine; overuse injuries known
as “repetitive motion disorders”; rotator cuff injuries; chronic postural pain of the
spine; spinal pain that improves only temporarily with manipulation; and
sacroiliac pain. RIT may be the treatment of choice if the patient fails to improve
with physical therapy, manipulation, steroid injection, surgical intervention,
medications, or if these treatments are contraindicated.
To determine if a person is a candidate for RIT a complete history and physical
exam are done along with laboratory tests and x-rays, as needed. The joint is
evaluated and the problem area is determined. If there are no contraindications,
a solution of dextrose, procaine, and B12 is introduced to the ligament or the
joint. Dextrose is a type of sugar and stimulates the healing response. Procaine
is an anesthetic that increases circulation, and B12 is nutritive and healing to
injured tissues. The healing cascade is launched leading to deposition of new,
better organized collagen and restoration of tissue health and function. An
average patient requires 3 treatments spaced one month apart – some problems
require more treatments and some less. After treatment the patient is instructed
to continue gentle exercise and stretching and avoid anti-inflammatory
medications temporarily. Optimizing nutrition and hydration are extremely helpful.
Contraindications to RIT include: allergy to procaine, Novocain or dextrose;
autoimmune types of arthritis, use of the medications Coumadin, warfarin, Plavix,
or other bleeding disorders, uncontrolled diabetes, metal in the joint to be worked
on, suppression of the immune system, and needle phobia. Smokers, those over
85 years old, and patients with poor tissue healing may have less than optimal
responses. These people may benefit from a course of nutritional repletion prior
to treatment with RIT.
Clinical success rates for RIT are 85% for resolution of chronic pain and
dysfunction. This makes RIT a treatment with great potential benefit for many.
Please contact Yellowstone Naturopathic Clinic at (406) 259-5096 or see our
website at www.yncnaturally.com for more information, or to schedule an
appointment for evaluation.