Prolotherapy (sometimes called ligament reconstructive therapy) is known to have been in existence for more than 2500 years when Hippocrates used a somewhat crude but successful technique to treat the injured shoulder of a javelin thrower. The more modern techniques were developed by Osteopaths (DO) and Allopaths (MD) beginning in the 1930’s.

The collagen fibers of ligaments and tendons are flexible, but they do not stretch very far. In certain instances, they are frayed or even torn by injuries. Pain is perceived when otherwise normal tensions on these collagenous structures stretches them beyond their normal limits of motion. This in turn results in abnormal tension and stimulation of pain transmitting sensory nerves, because these nerve fibers are not meant to stretch. Therefore, the chief symptom of ligament and tendon relaxation is pain. The pain is aggravated by activity, when tension is placed upon the injured ligament and tendon, and usually subsides when they are not under tension. This painful stimulation can result in muscle spasm, loss of range of motion or joint movement, and a myriad of sensations and feelings that radiate from the injury site into the arms and legs. Many times, the symptoms can lead to erroneous diagnosis of a “nerve injury.” When the ligament or tendon does not heal by itself, prolotherapy is used to assist the healing process. The treatment consists of the injection of a proliferant solution within the relaxed ligament or tendon near the attachments to the bone. The solutions cause a controlled inflammation at the site of injury to stimulate cells called fibroblasts to make more collagen fibers. This in turn “strengthens” the “weld” of the ligament or tendon to the bone, and stabilizes the formerly loose and painful connection.

As with many treatments, prolotherapy is not without risks or side effects. Since intent of the technique is to create a specifically localized inflammation, pain, swelling, redness, soreness, temporary stiffness, and bruising at the injection site are normal. Often there is temporary numbness, tingling, or itching over the injection site. Piercing the skin with a needle always allows for the possibility of infection, although very few have ever been reported. For this reason, needle placement technique is important. Four times the prolotherapy solution had been intentionally placed by practitioners into the spinal canal of cancer patients to relieve pain, without dangerous effects. In trained hands, prolotherapy as well as prolozone is a safe, effective, and highly successful technique when utilized appropriately, to give long sought relief from pain arising from over-stretched ligaments and tendons.