What is Prolotherapy/C-fiber Neurolysis?

Prolotherapy is a type of injection. First, it is important to understand what the word prolotherapy itself means. “Prolo” is short for proliferation, because the treatment causes the proliferation (growth, formation) of new ligament tissue in areas where it has become weak. Ligaments are the structural “rubber bands” that hold bones to bones in joints. Ligaments can become weak or injured and may not heal back to their original strength or endurance. This is largely because the blood supply to ligaments is limited, and therefore healing is slow and not always complete. To further complicate this, ligaments also have many nerve endings and therefore the person will feel pain at the areas where the ligaments are damaged or loose. Tendons are the name given to tissue which connects muscles to bones, and in the same manner tendons may also become injured, and cause pain.

Prolotherapy uses a dextrose (sugar water) solution, which is injected into the ligament or tendon where it attaches to the bone. This causes a localized inflammation in these weak areas which then increases the blood supply and flow of nutrients and stimulates the tissue to repair itself. This does nearly the opposite of a what a steroid injection does (blocks the immune system by decreasing blood flow). Steroid injections can be harmful and are associated with rupture of tendons and in the case of tennis elbow, a worse long term outcome (British Medical Journal September 2006)

Historical review shows that a version of this technique was first used by Hippocrates on soldiers with dislocated, torn shoulder joints. He would stick a hot poker into the joint, and it would then miraculously heal normally. Of course, we don’t use hot pokers today, but the principle is similar—get the body to repair itself, an innate ability that the body has. Prolotherapy has been studied for many different conditions, but research has been hampered by a lack of funding (no money in selling dextrose). A recent review article in the peer reviewed journal Physical Medicine and Rehabilitation looked at the evidence and concluded that prolotherapy may be helpful in treating chronic low back pain and osteoarthritis, is clearly effective in tendonopathies/ tendonitis.

The injections may be useful for many different types of musculoskeletal pain, including arthritis, back pain, neck pain, fibromyalgia, sports injuries, unresolved whiplash injuries, carpal tunnel syndrome, chronic tendonitis, partially torn tendons, ligaments and cartilage, degenerated or herniated discs, TMJ and sciatica. The response to treatment varies from individual to individual, and depends upon one’s healing ability. Some people may only need a few treatments while others may need 5 or more. The average number of treatments is 4-6 for an area treated. Once you begin treatment, we can tell better how you are responding and give you an accurate estimate of treatment course.