What Is ProloTherapy?

“Gateway drug for regenerative autologous ortho-biologics (stem cells and PRP)”

“Prolo” is shorthand for proliferative therapy. Its origins can be traced as far back as the ancient Egyptians and Hippocrates when they used cauterization to induce scaring for laxity.  Modern day prolotherapy was first described for orthopedic use in the 1930 when an orthopedic surgeon injured his thumb and was told his surgical career was over.  Dr. Earl Gedney DO, sought out an alternative therapy that was used for abdominal hernia via using an irritating substance. Dr, Gedney later published the first article, “The Hypermobile Joint” published in 1937 – and termed the treatment “sclerotherapy.”

Prolotherapy was named by Dr. Hackett in the 1950s when he published a series of articles describing injection techniques for various musculoskeletal injuries such as ligamentous laxity and enthesiopathy.  In short, Prolotherapy is the injection of an irritating solution that stimulates an inflammatory response, producing a localized healing stimulus. Early injectates used were sodium morrhuate and various concentrations of hypertonic dextrose.

Neural-Prolo

Neural-Prolo, is also known as Neurofascial Prolotherapy (NPT).  Born from traditional prolo-therapy, Neural-Prolo is described as: Subcutaneous peri-neural injection of 5% dextrose. It was created by a New Zealand physician, Dr. John Lyftogt while he was treating a series of Achilles tendon injuries. Similar to how traditional prolotherapy helps strengthen loose ligaments and damaged tendons, Dr. Lyftogt discovered that a low concentration of dextrose (5%) in the subcutaneous tissue can help in resolving chronic nerve inflammation and restoring the normal physiology of the nerve cell.

Neuritis is also thought to be a contributing factor to chronic pain syndromes and why sometimes the pain continues even after the tissue has healed!  Nerves are the central processor of our bodies and our bodies respond one way or the other based on what the nerves are telling it to do. 

What Is Neural-Prolo?

Neuritis can create a vicious cycle of inflammation: inflammation neuritis messes with the regular flow of impulses, switching direction of nerve impulses in the wrong direction and cause confusion!  These are transmitted vià blood vessels in nerves and surrounding tissues stimulating a release of excess neurohumoral mediator substance (the nerves are over-reacting as in panic) which cause a neurovascular vasdilation-edema-sterile inflammation neuritis.

When Do We Use Neural-Prolo?

NPT is a great treatment option that is typically used in conjunction with other Ortho-biologics. A good example of this is a knee injury to an ACL or MCL, which creates local tissue edema and intra-ligamentous neuritis. As an adjunct therapy we can utilize Neural-prolo at the same time as treating the underlying issue such as sprain in other ligaments to address the original injury and subsequent neuritis that resulted from the injury.  We can also use it as a solo treatment, example: post operative pain after an invasive surgery often creates chronic neuritis and patient continue with pain – this is a good time to use NPT as a solo therapy to help calm the nerves down to allow for pain reduction.

What Is Neural-Prolo?

Upside

At the Centeno Schultz Clinic, our physicians are armed with years of expertise in musculoskeletal medicine. We know that no 2 patients are alike!   We take the time to examine, listen and understand your unique injury or condition to develop a comprehensive personal treatment plan designed to get you back to living your best life!


References
  1. Alderman D. A history of the American College of Osteopathic Sclerotherapeutic Pain Management, the oldest prolotherapy organization. J Prolotherapy. 2009;1(4):200-204.
  2. Gedney E. Special technic: hypermobile joint: a preliminary report. Osteopathic Prof. 1937;9:30-31
  3. Hackett GS. Ligament Uninhibited reversible antidromic vasdilation in brochiogenic pathophysiologic disease. Lancet. 1966;86:398-404.
  4. Hackett  GS. Ligament relaxation and osteoarthritis, loose jointed versus close jointed. Rheumatism. 1959;15:28-33.
  5. Hackett GS, Huang TC, Raftery A. Prolotherapy for Headache. Pain in the Head and Neck and Neuritis. Headache. 1962;3-11.
  6. Hackett GS, Huang TC. Prolotherapy for sciatica from weak pelvic ligaments and bone dystrophy. Clinical Medicine. 1961; 8:2301-2316.
  7. Hackett GS. Uninhibited reversible antidromic vasdilation in pathophysiologic diseases: arteriosclerosis, carcinogenesis, neuritis and osteoporosis. Angiology. 1966;17, 2-8.

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