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10 Articles in Volume 7, Issue #6
Clinical Bioethics: Pain and Psychopathology in Military Wounded
Diabetic Neuropathy Study
Electromedicine: Use of TENS In Pain Management
Howard Hughes and Pseudoaddiction
Imaging: Osteoporosis Testing: DEXA Method
Interventional Therapy: Occipital Nerve Stimulation for Treatment of Migraine
Laser Therapy: Infrared Photo Energy May Reduce Neuropathic Pain
Pharmacotherapy: Pharmacologic Management of Opioid-Induced Adverse Effects
Prolotherapy: Prolotherapy For Knee Pain
Viewpoint: The OxyContin

Prolotherapy: Prolotherapy For Knee Pain

Prolotherapy is a method of injection treatment designed to stimulate healing.1 Many musculoskeletal injuries and pain syndromes lend themselves to prolotherapy treatment including low back and neck pain, chronic sprains and/or strains, whiplash injuries, tennis and golfer’s elbow, knee, ankle, shoulder or other joint pain, chronic tendonitis/ tendonosis, and musculoskeletal pain related to osteoarthritis. Prolotherapy works by raising growth factor levels or effectiveness to promote tissue repair or growth.2 It can be used years after the initial pain or problem began, as long as the patient is healthy.

This month’s article focuses on the use of prolotherapy for knee pain and injuries, including ligament and meniscal injuries, tendonitis and tendonosis, patellofemoral syndrome, and osteoarthritis pain including degenerative joint disease.

Prolotherapy Mechanism of Action Review
Prolotherapy works by causing a temporary, low grade inflammation at the site of ligament or tendon weakness (fibro-osseous junction), “tricking” the body into initialing a new healing cascade. Inflammation activates fibroblasts to the area, which synthesize precursors to mature collagen, reinforcing connective tissue.2 This inflammatory stimulus raises the level of growth factors to resume or initiate a new connective tissue repair sequence to complete one which had prematurely aborted or never started.2 Prolotherapy is also known as “regenerative injection therapy (RIT),” “non-surgical tendon, ligament, and joint reconstruction” or “growth factor stimulation injection therapy.”

Ligament Injuries Lead to Degenerative Arthritis
Osteoarthritis almost always begins as ligament weakness.3 Unresolved ligament sprains (overstretching) results in ligament relaxation and weakness. Relaxation of the ligament results in joint instability and a change in joint biomechanics which eventually results in osteoarthritis of that joint as bones glide over each other unevenly. The observation that bones remodel and grow in response to their mechanical environment is best explained in Wolff’s Law which states: “Bones respond to stress by making new bone.”4 Tendon injuries, if unresolved, over a long period of time also have an influence on joint biomechanics and can contribute to the development of osteoarthritis.

Please refer to the Jul/Aug 2007 issue for the complete text. In the event you need to order a back issue, please click here.

Last updated on: June 25, 2020
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