Prolotherapy is an injection technique to stimulate the growth of healthy, strong connective tissue to help eliminate many chronic painful conditions. “Prolo” is short for proliferation, which means the growth or formation of cells. The treatment helps to strengthen weakened tendons, ligaments, and connective tissue structures.
When sprains or strains occur, the joint becomes unstable which causes pain. Not only is there local pain at these sites, but referred pain to sites that are often quite distant from the original injury.
Traditional treatments for injuries include ice, rest, and anti-inflammatory medication which helps relieve the pain, but does nothing for damaged tissue. Due to the poor blood supply, these structures do not heal well and continue to be loose, causing further pain and resulting in a chronically weakened joints that are easily re-injured. Prolotherapy helps strengthen the weakened tissues and reduce pain.
Prolotherapy causes proliferation of fibroblasts (a type of cell that forms connective tissue) resulting in the strengthening of stretched or weakened ligaments and tendons. The solution most veterinarians use for injection includes Dextrose, lidocaine or procaine and Vitamin B12 (in humans, some practitioners also include Sarapin, an extract of the pitcher plant, or sodium morhuate, an extract of cod liver oil).
The solution acts as an irritant which triggers inflammation and helps stimulate the healing process through the growth of healthier tissue. With stronger tendons and ligaments for support, pain decreases.
After the prolotherapy solution is injected, there is a 2 to 4 day period of inflammation as the area is infiltrated with white blood cells. Your pet may be more sore during this period and need additional analgesics to provide comfort. The treated tissue moves into a strengthening and healing phase for the next 4 to 5 weeks. Once this healing period is complete, your pet can be re-evaluated for joint laxity and pain - if needed, the treatment is repeated.
Patients are generally treated with prolo once a month for 3 to 6 treatments. Because prolotherapy relies on inducing inflammation which leads to healing, the patient cannot take NSAIDs, Prednisone or strong anti-inflammatory supplements (ginger, curcumin) while being treated with prolotherapy. For pain control, we have the other kinds of pain medications we can use.
Common injuries which respond well to prolotherapy include:
Cranial cruciate injury “ACL tears” (partial or complete tears)
Chronic spinal pain
Prolotherapy is most effective where there hasn't been a lot of degenerative joint disease. In these cases the pain is more likely due to chronic joint inflammation and bone spurs rather than simply a loose joint.
Dr. Kirsten Williams and Dr. Kristi Peterson are the on-site veterinarians who provide this service. Dr. Williams is here once a week, on Thursdays, and Dr. Peterson is in the office Tuesday through Saturday.
The first step involves scheduling a consultation exam to discuss the process and determine if your pet is a good candidate. If it is determined that your pet would benefit from the treatment, the first session is scheduled. About 30% of pets need sedation so the first appointment lasts an hour and your pet must fast for 12 hours prior. If it is determined that your pet does not require sedation, follow up appointments are scheduled for 30 minutes.
For more information on prolotherapy, a useful human-medicine website is www.getprolo.com.