Prolotherapy and Regenerative Injection Therapy

RIT and Prolotherapy can be useful in many types of joint pain, especially those related to joint instability and ligament laxity. This includes rotator cuff injuries, knee pain, low back and SI pain, sciatica, recurrent joint dislocations, ankle and wrist pain and more.

Prolotherapy comes from the term “proli” as in proliferate or “to grow”. Injecting a solution – the proliferant – into injured tissues initiates a local immune and inflammatory response that is responsible for healing. New blood vessels form, nutrients and oxygen arrive, damaged tissue is removed and over time new tissue is laid down and restructured creating a stronger end product. Strengthening and tightening the injured structures allows the muscles to relax and pain signals to shut-off. NPT appears to work by blocking specific pain receptors and allowing anti-inflammatory mediators to be released. Because the same nerves that supply the deep structures also supply the surface structures, superficial injections may be used to affect the deeper nerves.

Ligaments are connective tissue fibers that attach across a joint to stabilize it. Tendons are made up of similar material and are the bridges or end points of muscles that attach them to the bone. So, tendons and muscle move joints and ligaments stabilize them. But what happens when the ligaments get loose – either from a traumatic injury or repetitive use – and can’t perform their job? Nerve fibers in the damaged ligaments send out pain signals to the brain. Subconscious reflex mechanisms cause surrounding muscles to tighten in an attempt to stabile the joint. Muscle tension and the mal-aligned bony structures can also irritate or compress nerves resulting in chronic pain signaling. This attempted but inadequate compensation leads to structural changes, chronic pain, and further instability.

Think back to any anatomy diagram you’ve seen – with the red muscles and white or grey ligaments and tendons. It’s the same way in the body. Muscles are red because they have a rich blood supply while the white structures have very little. It is because of this poor blood supply that ligaments and tendons are notoriously poor healers. They often just don’t receive enough oxygen and nutrients that are required for healing. This is why even if you’ve done “all the right things” that some injuries may not have healed completely or properly

RIT is not a cure for all types of pain. Nor does it always eliminate 100% of one’s pain. It is, however, very good at addressing pain due to joint and ligament instability, neurogenic pain, and muscle tension. Because multiple systems are ultimately connected – the knee bones connected to the hipbone – and a problem in one area can actually present itself in another it takes a skilled practitioner to determine the underlying cause. While many injuries or pain may respond to physiotherapy or chiropractic, those due to chronic or traumatic injury where the tendons, ligaments or joint capsules are weakened, or where chronic pain signals stuck “on” may require the structural cause to be addressed. RIT techniques truly get to the root cause in these cases.