Prolotherapy involves a series of injections primarily with dextrose, known as dextrose prolotherapy, is designed to produce inflammation in the injured tissue. When tissues are injured, inflammation is a common natural response. It stimulates substances carried in blood that produce growth factors in the injured area to promote healing. Ligaments, tendons and cartilage have very poor blood supplies, which can result in incomplete healing. The healing process can also be impeded when injuries are treated with anti-inflammatory medications like ibuprofen, naprosyn, or other non-steroidal anti-inflammatory drugs (NSAIDs) to relieve pain and swelling.
Unlike injections of corticosteroids, which suppress inflammation and provide only temporary relief for a chronic condition, prolotherapy injections given over the course of several months may provide a permanent benefit. Prolotherapy facilitates the body into initiating a healing response. The technique reactivates the healing process by injecting a mildly irritating substance — commonly a somewhat concentrated sugar solution along with a numbing agent -lidocaine — into the injured area to stimulate a temporary low-grade inflammation. In some cases, growth factors themselves may be injected in the form of PRP- platelet rich plasma. Prolotherapy and PRP are non-surgical treatments for joints and connective tissue damage.
With growth factors found in PRP in place at the site of inflammation, new tissue is said to be produced that strengthens lax or unstable ligaments and tendons. The technique may even support damaged or degenerated cartilage, which normally does not repair itself, by strengthening the fibrous connective tissues that stabilize the area. Prolotherapy and PRP are procedures that are used in the emerging and exciting field of regenerative medicine.
Prolotherapy cannot correct mechanical problems like spinal stenosis, in which two bones pinch a nerve, nor does it reverse arthritic changes. But it may reduce or even eliminate the discomfort associated with arthritis by tightening the connective tissues that support an arthritic joint.
Platelet Rich Plasma (PRP) Prolotherapy, like Dextrose Prolotherapy, is a method of injection designed to stimulate healing. “Platelet rich plasma” is defined as “autologous blood with concentrations of platelets above baseline levels, which contains at least seven growth factors.” Cell ratios in normal blood contain only 6% platelets, however in PRP there is a concentration of 94% platelets. Platelets contain a number of proteins, cytokines and other bioactive factors that initiate and regulate basic aspects of natural wound healing. Circulating platelets secrete growth factors, such as platelet-derived growth factor (stimulates cell replication, angiogenesis), vascular endothelial growth factor (angiogenesis), fibroblast growth factor (proliferation of myoblasts and angiogenesis), and insulin- like growth factor-1 (mediates growth and repair of skeletal muscle), among others. Enhanced healing is possible when platelet concentration is increased with PRP. Activated platelets “signal” to distant repair cells, including adult stem cells, to come to the injury site. Increasing the volume of platelets accordingly increases the subsequent influx of repair and stem cells. Because the concentrated platelets are suspended in a small volume of plasma, the three plasma proteins fibrin, fibronectin, and vitronectin contribute to a repair matrix. You could compare dextrose Prolotherapy and PRP this way: Prolotherapy is like planting seeds in a garden; PRP Prolotherapy is planting seeds with fertilizer.