Treatments

Regenerative Injection Therapy - Prolotherapy

Regenerative injection therapy (RIT) or Prolotherapy is an interventional technique for treatment of chronic pain due to connective tissue diaphysis by induction of collagen, chemo modulation through inflammatory, proliferative and regenerative/reparative responses mediated by multiple growth factors.

For decades a small group of Allopathic (M.D.) and Osteopathic (D.O.)physicians has been practicing a methodology known as REGENERATIVE INJECTION THERAPY (RIT) also known as prolotherapy. There have been many pilot, retrospective, prospective, and double-blind placebo controlled studies that have clearly indicated the effectiveness of prolotherapy in the treatment of chronic musculoskeletal pain arising from posttraumatic and degenerative changes in the connective tissue such as ligaments, tendons, fascia, tenio periosteal attachments and the intervertebral disc.

Clinical and experimental microscopic studies have proven that structurally, the newly formed connective tissue had biomechanical properties similar to those normal ligaments and tendons that were treated with RIT or Prolotherapy. Preliminary results of clinical prospective trials for chemonucleo-annuloplasty with proliferations causing substances showed significant promise to disc disorders.  Prolotherapy is effective for a number of chronic painful disorders and conditions.

Many conditions can be treated with Regenerative Injection Therapy or Prolotherapy such as cervicogenic headaches, cervical sprain/strains, temporomandibular joint pain, torticollis, cervical segmental dysfunctions, whiplash injuries, spinal (facet joint syndromes) of the cervical, thoracic and lumbar spines, cervical, thoracic, and lumbar sprain/strains, rib dysfunctions, all peripheral joint dysfunctions such as tendinosis and bursitis and arthritis, sacroiliac pain, myofascial pain, failed back surgical syndrome, foot and ankle problems, ligamentous laxity syndromes.

Growth factor stimulation, Regenerative Injection Therapy or prolotherapy; injection of something that causes the body to produce growth factors. Non inflammatory (10% or less) Dextrose is an example of this. Two double-blind studies have now shown that simple 10% dextrose injection is effective with arthritis (large and small joints). Human cells exposed to as little as 0.3% dextrose produced growth factors such as platelet-derived growth factor, transforming growth factor-Beta, epidermal growth factor, basic fibroblasts growth factor and connective tissue growth factor. This causes an inflammatory reaction and activation of the inflammatory cascade to stimulate the healing cascade to regenerate the tendon, ligamentous, muscle cells. These solutions are benign and often include dextrose for growth factor stimulation, but the inflammatory signals that result cause a more vigorous growth response. Examples of these solutions in current use are 25% Dextrose, Phenyl containing solutions and sodium morrhuate containing solutions.

Despite this, the inflammatory proliferant groups did better except for one study in which the technique that was used was questionable. Inflammatory prolotherapy will likely be the most cost effective form of regenerative injection therapy in the future as it is a very inexpensive medical technique for stimulation of the natural healing cascade.