The doctors at The Center for Foot and Ankle Care strive to be on the cutting edge of technology and medical knowledge. There are times that surgery is warranted such as for dislocations, fractures or tendon ruptures. But there are other complaints that can be treated by holistic means such as chronic ankle pain, chronic plantar fasciosis (fasciitis for acute inflammation) and chronic Achilles tendonsis (tendonitis for acute inflammation). The basic principle is to allow your own body's amazing healing properties to help repair itself.
The injection is considered mild to moderately painful and there is typically a "flare" of soreness for 3 - 7 days following the injection. A mild pain medication, such as Tylenol, is usually sufficient to control the discomfort. Rarely a stronger medication is necessary.
Because the effect of Prolotherapy is to initiate a "healing cascade" which requires inflammation, you are advised to avoid anti-inflammatory medications such as ibuprofen or naproxen. Aspirin may also interfere with the process to some degree, but if an individual is taking Aspirin to reduce risk of stroke or heart attack, a small amount of Aspirin, such as a "Baby Aspirin" (81 mg) is acceptable.
Using the current solutions and techniques, there have not been any reported side effects. There is occasionally some bruising. The procedure has been used for over 60 years.
The Dextrose is actually quite irritating in the standard 50% concentration. This is then diluted with saline water, anesthetic such as Lidocaine is added along with Sarapin (a natural plant extract that also helps with inflammation) to a concentration of 12 - 20%. This is thought to "dehydrate" the injected tissues, causing an injury signal for the body, and thereby initiating the healing process. Dextrose has been shown to be a growth stimulant on it's own as well.
The ligaments, which connect bones together, may be stretched and torn. Tendons attach muscles to bone and may also be torn. The capsule surrounding joints may become lax (loose) and also contribute to pain. All of these may be strengthened and "tightened" with Prolotherapy, reducing the "play" in the joints, reducing arthritis, and bonding the structures in a way that is much more functional and normal. Cartilage has been shown to be repaired and thickened after a series of planned prolotherapy injections.
Not usually. Occasionally, our doctors will try a steroid injection first, as this is a mainstream, accepted approach for these types of injuries. If this is not curative with 1-2 efforts, then repeat steroid injections are unlikely to resolve the problem and Prolotherapy is a safe, alternative solution. Steroid injections, as with any type of medication, can have complications, although usually mild but occasionally significant. Repeating them unnecessarily can increase the risk.
Each steroid injection can possibly weaken the underlying connective tissue, which may result in the need for additional Prolotherapy injections.
Many foot and ankle problems can be treated with Prolotherapy. The most common and notable are plantar fasciitis, achilles and peroneal tendonitis as well as chronic ankle sprains. Each of these involves the stretching of ligaments and joint capsules, which respond well to prolotherapy. If steroid injections do not provide long-term relief for these, Prolotherapy should be considered. Prolotherapy can achieve a great deal of success without the risks of surgery.
The signature finding is pain that you can put a finger on. If you can precisely point to your source of pain, there is a very good chance that Prolotherapy will resolve or at least greatly improve it.
Of course not. Many diseases and illnesses are not resolvable with Prolotherapy. Pain can originate in many tissues, and a complete, thorough examination is absolutely essential. The physician who practices Prolotherapy is usually one who has a great deal of experience with the treatment of musculoskeletal disorders, and should also examine and test the patient for other causes of pain using appropriate studies, lab tests and other means of testing to ensure that your condition is correctly managed. At times, consultation with other specialists may be necessary to ensure that your evaluation is complete.
Prolotherapy has been shown to increase the ligament strength and mass around joints by approximately 30 - 40%. This can remarkably improve torn ankle and other ligaments. Even if there is minimal pain with some of these injuries, the weakness can ultimately tear further and create greater dysfunction. Many athletes utilize Prolotherapy to strengthen their weak ligamentous tissues to reduce future risk of tears and injury.
Most conditions are treated with 4 - 8 visits, but may take more. The timing of visits varies from weekly to every 4 - 6 weeks or more. Rarely, 1 - 15 visits may be required as long as progress is being appreciated. Studies suggest a success rate ("greater than 50% improvement in pain level") of 80 - 90%.
We recommend careful resumption of activity as tolerated. This can include normal exercise routines, walking, sports and other activities. Physical therapy, massage, chiropractic and other treatment does not usually need to be stopped and in fact may assist with the overall progess.
Read: The Thinking Person's Guide to Perfect Health by Ron Kennedy, M.D.