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Learn about prolotherapy treatment and how it may alleviate pain from joint, tendon and ligament problems. Discover the wide variety of applications for this simple procedure from alternative medicine.

What is prolotherapy?

Prolotherapy involves injections of an innocuous irritant solution, often dextrose (sugar water) at the points where ligaments and tendons meet bone. The result is inflammation and the proliferation of collagen fibers in the treated area as well as the shortening of those fibers. In short, the treatment tricks the body into thinking it has a new injury. The body then sends in its troops to heal and rebuild the area. The result is a hardening and strengthening of the tissues treated, to the extent that the healed ligaments may be 40 percent stronger than the original ligament. It also accelerates the regrowth of cartilage. As a result, the whole joint area becomes stronger and more stable, thereby eliminating or greatly easing pain associated with that area.

Before reading any further,
see our medical disclaimer.

What is prolotherapy used for?

Although chronic pain has many causes, the great bulk of those who suffer from chronic pain have weak ligaments resulting in loose joints, the very problem that prolotherapy is specifically designed to treat. Often, joint pain is treated with cortisone injections and anti-inflammatory drugs. This approach eases symptoms but has no effect on the underlying problem. And, some of these drugs, the NSAIDs, ease the symptoms but actually accelerate the progression of the problem.

"The end result is strong, tight new connective tissue that restores proper alignment. Pressure is removed from the nerves and discs, and pain resolves. Because this treatment tackles the underlying cause of chronic pain, its effects are in most cases permanent."  This quote is from Julian Whittaker, M.D. of the Whittaker Wellness Clinic in Newport Beach, California, talking about prolotherapy for back pain. Health & Healing newsletter, February 2003.

Applications include all kinds of joint, tendon and ligament problems: neck, shoulder, elbow, wrist, hand, hip, groin, knee and ankle pain and foot pain; carpal tunnel syndrome and other repetitive stress disorders; compression fractures; degenerated or herniated discs; some kinds of fibromyalgia; certain kinds of headaches, including migraine;  iliocostalis syndrome; low back pain; lumbago; musculoskeletal pain, including partially torn tendons, ligaments and cartilage; neuroma; osteoarthritis pain; phantom pain; post-stroke pain; reflex sympathetic dystrophy (RSD); sacroiliac joint problems; sciatica; slipping rib syndrome; spastic torticollis; spinal cord injury pain; sports injuries;  tailbone pain; tendonitis; TMJ; vaginal and testicular pain; whiplash injuries and more.

Prolotherapy success rate

C. Everett Koop, M.D. and former surgeon general of the U.S., writes the preface to the book Prolo Your Pain Away, by Ross A. Hauser, M.D. In the preface he describes how he had what was described as incurable pain. Dr. Koop was treated by Gustav Hemwall, M.D. "To make a long story short," says Dr. Koop, "my intractable pain was not intractable, and I was remarkably improved to the point where my pain ceased to be a problem."

Dr. Koop goes on to say that he observed Dr. Hemwall "and witnessed the unbelievable variety of musculoskeletal problems he was able to treat successfully. Many of his patients were people who had been treated for years by all sorts of methods, including major surgery, some of which had left them worse off than they were before. Many of his patients had the lack of confidence in further treatment and the low expectations that folks inflicted with chronic pain frequently exhibit. Yet I saw so many of them cured that I could not help but become a 'believer' in Prolotherapy."

Dr. Koop believes that the reason this alternative treatment is not more widely used is that it seems so simple a procedure as to defy belief that it could work. But it does work. It is not a cure-all for all types of pain, and it doesn't work for everyone, but the technique enjoys a success rate of 80 to 90 percent. He also says, "The nice thing about Prolotherapy, if properly done, is that it cannot do any harm. How could placing a little sugar-water at the junction of a ligament with a bone be harmful to a patient?"

Dr. Koop's support is the reason prolotherapy is often called the Koop pain technique.

Does prolotherapy really work?

In his book, Prolo Your Pain Away, Ross A. Hauser, M.D, talks about the effects of this method of alternative healing. Hauser observed Dr. Hemwell treating his patients, and says that "Almost all the patients I observed improved after one or two Prolotherapy treatments. Many said they wished they had known about Prolotherapy years ago."

Dr. Bruce West, author of Health Alert newsletter, says: "It is a safe, effective, tested, legal, nonsurgical treatment that strengthens joints, tendons, muscles and ligaments. And the major side effect of this treatment is the elimination of pain. This therapy will increase musculoskeletal (joint) mobility and strength and stop its pain regardless of how many years the stiffness, weakness, and severe pain have existed."

Prolotherapy: What is it?

According to Robert Jay Rowen, M.D., in his report Brand New Joints Without Drugs or Surgery, the cause of osteoarthritis and other musculoskeletal pain is "deficiency of connective tissues, the lack of collagen and weakness in ligaments, tendons and muscles."  He says that by dealing with this deficiency, "even people with apparent spinal degeneration (a condition previously thought irreversible) can be cured of their pain!"

The ligaments around each of your joints determine the stability of those joints. Unlike muscles, which have a good blood supply and heal quickly, ligaments have a poor blood supply. Thus, healing can be incomplete. Ligament problems are the cause of most chronic pain.

This treatment works because it eliminates the cause of the pain: relaxation of ligaments and tendons, which causes joints to loosen, causing pain. Even the muscles surrounding the area may be painful, as they try to take up the slack to keep the joints stable.

Each treatment results in more proliferation of collagen, more tissue being added to the treatment area, strengthening and stabilizing it. With each treatment, the joint area becomes stronger and patients may again engage in activities they formerly thought they had to give up forever.

Is prolotherapy effective?

  • In 1974, Dr. Hemwall reported to the Prolotherapy Association a study of 1871 patients who completed treatment with prolotherapy. A total of 6000 treatments were administered. Of the 1871 patients, 1399 (75.5 percent) reported complete recovery and cure. Another 413 patients (24.3 percent) reported general improvement. Twenty-five patients (0.2 percent) showed no improvement. So, more than 99 percent of the patients who completed treatment found general improvement or complete relief from their pain.
  • Harold Wilkinson, M.D., professor and former chairman of the Division of Neurosurgery at the University of Massachusetts Medical Center, ended a 16-year study on this treatment in 1995. In the study, Wilkinson found that "a sizeable portion of people with unresolved chronic pain had more that a year's pain relief with only one prolotherapy injection." 

    (Note that most treatment plans involve multiple injections given in each of one to ten or more treatments, with most people finding relief in three to six sessions per area.)

  • Repeated studies at the University of Iowa showed an increase in size of the treated area of 35 to 40 percent from the rebuilding of the ligaments and tendons and the consequent strengthening of the treated areas

  • A 19-year study  by George S. Hackett, M.D., completed in the 1950s with 656 patients, found that twelve years after the treatment was completed, 82 percent of the patients considered themselves cured.

    Dr. Hackett, in two separate analyses of over 250 cases of undiagnosed low back disability, found that 94 to 97 percent of patients had ligament weakness resulting in joint disability. Many patients had already had back surgery for a previous diagnosis of a disc problem. Prolotherapy produced an 80 percent cure rate overall, including those who had already had surgery.
  • Robert Klein, M.D. and Thomas Dorman, M.D. did a double blind study of patients suffering for 10 years or more with difficult, continuous low back pain—patients who had already had a variety of treatments. They divided the 81 patients into two groups. One group was given manipulation and prolotherapy. The other was given fake manipulation and saline injections. Of the group given prolotherapy, 88 percent reported improvement.

  • The x-rays of a 61-year-old dentist with severe neck pain showed advanced degeneration of the cervical vertebrae. Within eight treatments, his pain was reduced by 80 percent.

  • A 28-year-old woman suffering from severe headaches following a whiplash injury got rid of those headaches with prolotherapy.

Is it safe?

When properly administered by a trained practitioner (an M.D. or osteopath who has taken special training) prolotherapy is a low-risk, no-side-effects, highly successful procedure for the easing or elimination of musculoskeletal pain.

Is prolotherapy painful?

I was treated for pain in my elbow, knees, and for tendonitis in my right foot, with great success. I also had one injection for my carpal tunnel syndrome, with amazing results.  My doctor, Merle Janes, M.D., who practices in Spokane Valley, Washington, and also at the Tahoma Clinic of Jonathan Wright, M.D., in Renton Washington, is a specialist in rehabilitative medicine. With regard to the pain after the treatment, from the induced inflammation, I take a pain pill (prescribed by Dr. Janes) an hour before the treatment and another one just before bed that night to make sure I can sleep. In the following days I found some stiffness, combined with relief from the acute pain.

With regard to the treatment itself, hey, getting stuck with a needle is never fun. Dr. Janes uses really thin needles, and he shoots Lidocaine at the spot first to decrease the discomfort, but I am a real wimp with a needle phobia, so I take some diazepam (prescribed by Dr. Janes at my request) about thirty minutes before the procedure, and I get through it. I would go through a lot more to get the relief from pain that I have experienced!

This technique, which has been used successfully for decades by enlightened physicians, holds so much promise for those whose pain might be related to weak tendons or ligaments or tense muscles that have tried to take up the slack. If that could be you, please consider getting one or more of Dr. Hauser's books for more details and testimonials.

Hauser also wrote Prolo Your Arthritis Pain AwayProlo Your Sports Injuries AwayProlo Your Back Pain AwayProlo Your Headache and Neck Pain Away, and Prolo Your Fibromyalgia Pain Away.  Another good source is Dr. William Faber's book, Pain Pain Go Away

Prolotherapy was first used in the late 1930s. At this time, several hundred doctors in the U.S. are offering this treatment, which may accelerate the growth of cartilage and which strengthens joint structure. To locate a doctor in your area, contact the America College for the Advancement of Medicine at www.acamnet.org.

Interestingly, Dr. Hauser, in his book, Prolo Your Pain Away, recommends the same four newsletters that I have subscribed to for many years, from which I took much information for this report. They are Alternatives, by Dr. David Williams, medical researcher, Health & Healing, by Julian Whitaker, M.D., Nutrition and Healing, by Jonathan Wright, M.D., and Second Opinion, by Robert Jay Rowen, M.D., which has now been taken over and is being written by Frank Schallenberger, M.D. 

As always, be careful. Check out your doctor. My doctor, Dr. Janes, trained hands on with Dr. Hemwall during a mission in Honduras, and he has been practicing the technique since 1993. Dr. Janes told me:

My first (of four) medical missionary trips to Honduras was with Dr. Hemwall.  He taught me how to treat knees.  I didn't realize until later that this was to be his final trip to Central America; he'd started in 1956; 40+ years of regular trips, often single-handed in the early years, except for his wife as assistant.

He also says:

I once made a rough estimate of the number of patients I've treated since 1993 and it came out to over 30,000. Nobody ever has gotten infected or had a pneumothorax (lung collapse). Total treatment failures: three. Partial treatment failure: under 20%. Nearly everyone got at least some pain relief and 80% get a lot! ...I have been using a K-Laser as part of treatment, to improve results. The laser's dual frequencies of far-infrared light stimulate ATP production in the mitochondria. More ATP is like having more $ in your pocket as far as cell metabolism is concerned.  More ATP means the cell can do more, in this case, heal faster.

My comment: Dr. Janes is always trying to heal better and faster. But for me, hey, four to six weeks to heal (between treatments) is just fine with me, considering the great results I've gotten. --Joanna

This site has more information about prolotherapy.


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