The term originated with George S. Hackett, MD, in 1956 in a publication titled “The rehabilitation of an incompetent structure by the generation of new cellular tissue”. He applied the term prolotherapy from the words “proli’” (Latin), meaning offspring, and “proliferate”, meaning to produce new cells in rapid succession.
Prolotherapy (Proliferative Therapy), also know as Non-Surgical Ligament and Tendon Reconstruction and Regenerative Joint Injection, is a recognized orthopedic procedure that stimulates the body’s healing processes to strengthen and repair injured and painful joints and connective tissue. It is based on the fact that when ligaments or tendons (connective tissue) are stretched or torn, the joint they are holding destabilizes and can become painful.
Most of the time, patients who are suffering from chronic musculoskeletal conditions which is not responding to common treatment such as; pain medications, physiotherapy, chiropractic and acupuncture, may have tendon and ligament issues and patient’s condition can be dramatically improved by prolotherpy.
Pathophysiology of chronic musculoskeletal conditions due to tendon and ligament issues.
1. Single trauma or cumulative microtrauma causes subfailure injury of the ligaments and injury to the mechanoreceptors embedded in the ligaments.
2. When the injured joint performs a task, or it is challenged by an external load, the transducer signals generated by the mechanoreceptors are corrupted.
3. Neuromuscular control unit has difficulty in interpreting the corrupted transducer signals because there is spatial and temporal mismatch between the normally expected and the corrupted signals received.
4. The muscle response pattern generated by the neuromuscular control unit is corrupted, affecting the spatial and temporal coordination and activation of the muscle.
5. The corrupted muscle response pattern leads to corrupted feedback to the control unit via tendon organs of muscles and injured mechanoreceptors, further corrupting the muscle response pattern.
When single trauma or cumulative microtrauma causes subfailure injury of the ligament and tendon, it will induces instability of the joint. Even if patient does the movement what normally perform daily before, due to instability of the joint, the body thinks that external load is overwhelming therefore, it will creates constant muscle contraction which is spasming of the muscle. Muscle spasm will leads to lack of blood and oxygen supply to the muscle tissues and it will promotes even more damages to the muscles tissues. This is how vicious cycle of pain begins.
Prolotherapy, with its unique ability to directly address the cause of the instability, can repair the weakened sites and produce new collagen tissue, resulting in permanent stabilization of the joint. Once the joint is stabilized, pain usually resolves. Traditional approaches with surgery have more risk and may fail to stabilize the joint and relieve pain, and anti-inflammatory, other pain relievers and muscle relaxants only act temporarily.
1. Hackett, GS (1956). Ligament and tendon relaxation treated by prolotherapy. Springfield, IL: Charles C. Thomas.
2. Rabago, D; Nourani, B (2017). "Prolotherapy for Osteoarthritis and Tendinopathy: a Descriptive Review". Current Rheumatology Reports. 19 (6): 34. doi:10.1007/s11926-017-0659-3.
3. Panjabi, M. M. (2005). A hypothesis of chronic back pain: ligament subfailure injuries lead to muscle control dysfunction. European Spine Journal,15(5), 668-676. doi:10.1007/s00586-005-0925-3
4. Health Advice, News & Information. (n.d.). Retrieved March 03, 2018, from https://www.health24.com/
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