Ever since ancient times, creating a small injury to prompt healing has been seen as a good idea. For horses, this was called “pin firing”. The technique was to take a hot poker and place it into a non-healing ligament to cause small amounts of damage to the area, which caused the body to kick up a repair response. While barbaric, it generally worked. For centuries doctors have created small injuries in a non-healing wound by “roughing” up the tissues. Physicians still use this concept today for tendons, ligaments, and joint capsules. For example, in a shoulder capsulorrhaphy a surgeon usually inserts a small catheter that heats up to prompt healing in a damaged shoulder capsule (the covering of the shoulder joint that helps control motion).
Surgeons still score ligaments with scalpels and needles in the technique called percutaneous tenotomy, also to prompt a healing response. Another example is micro-fracture surgery to fix a hole in the cartilage; this is where the surgeon pokes holes in the bone to cause the cartilage to heal. Finally, the procedure known as prolotherapy is in this same category. In this procedure, rather than a mechanical injury being initiated, the physician injects a chemical irritant to cause a chemical micro-injury. All of these types of treatment rely on the same concept that we get one bite of the healing “apple” and if something fails to heal completely the first time, we can get more bites at that apple simply by causing a small injury to the area. The big advantage to micro-injury techniques is that these basic procedures are simple and often inexpensive ways to try to get an area to heal. The downside is that while many times they work well, sometimes they don’t have enough oomph to get the right type of healing or enough healing.
X-Ray Guided Prolotherapy
It has been successful in the treatment of many disorders including neck, shoulder, knee, and ankle pain. Dr. Centeno recently published an article in The Journal of Prolotherapy in which he discusses the use of x-ray guidance with prolotherapy. This ensures that the injection is in the correct place to maximize clinical results. Dr. Centeno discusses the use of prolotherapy for the treatment of neck, knee, sacroiliac joint, ankle, ischial tuberosity, and shoulder pain. At the Centeno-Schultz Clinic x-ray guided prolotherapy is just one of the therapies utilized in the successful treatment of pain.
Do you want to be active again
Regenerative injection therapy (RIT) or prolotherapy is a natural healing alternative to drugs or surgery. RIT prompts your body to naturally heal damaged and degenerated tissues. It involves a series of simple injections into the injured area, once a month for 3-6 months. This is not a steroid, which blocks healing, but substances that heal and strengthen the ligaments and joints. The goal of RIT is to increase your activity level. More activity will allow your muscles to increase their tone and further protect the joints and nerves from injury. Research has shown that RIT is very effective for knee pain, low back pain, tennis elbow and arthritic hand pain. Our own experience shows that it’s also effective for ankle pain, shoulder pain, elbow pain, neck pain, upper back pain, and hip pain. It’s the perfect solution for active individuals looking to return to a pain-free lifestyle.
How RIT / Prolotherapy Works
RIT works by prompting your body’s natural repair mechanisms to heal damaged or degenerated tissues. While most of our daily injuries heal completely, severe ligament tears, degenerated and worn out tissues, and tissues with a poor blood supply (such as the knee) don’t usually mend themselves. RIT first starts by injecting a proliferant into the damaged area. This inflammation causes your body to release it’s own natural growth factors in the injured tissue. These go to work immediately, directing your body’s natural healing mechanisms to repair painful tissues. The first stage of healing usually takes about a week, but the tissue continues to strengthen for 4-6 weeks after an injection.
A sugar fix for joints and ligaments?
The most commonly used solution is hypertonic dextrose. This essentially means that concentrated sugar water is injected. Since the solution is very concentrated, the body immediately tries to dilute the solution. This causes a brief inflammatory healing response which kicks off a healing cycle.
Does insurance cover this?
Prolotherapy is not typically covered by insurance. Please contact us for estimated costs before you begin treatment.
What should I expect?
You should feel numb in the painful area immediately after each shot. This should last for a few hours. For the next few days you should be sore. This is a normal part of the healing process.
Are there any special instructions?
Because anti-inflammatory medications (Motrin, Alleve, Steroids, all prescription NSAID’s) block healing, you must stay off these medications while undergoing RIT. You should remain as active as possible as this will help build stronger tissues
Take time to learn more about other treatment options we offer, like PRP and bone marrow concentrate therapy in Denver. We are also the home of the CCJ Instability Institute