In recent years, prolotherapy has proved to be a non-surgical option for joint and back pain. This treatment has been used in clinical practices for over 80 years for treating chronic pain, but also for patients who experience joint instability stemming from ligament damage, overuse and osteoarthritis.
What is it?
Prolotherapy is an injection of irritant solutions, most often dextrose, a natural form of glucose, but may also contain combinations of zinc, ozone, glycerin, phenol, etc. In our office, we use a combination of blood, drawn from the patient, and procaine( a local anesthetic known to help reduce pain.) It is injected into the site of the painful tendon insertions, ligaments and joint spaces that are adjacent over the course of several treatments to promote growth of cells and tissues. For more severe cases, platelet-rich plasma, bone marrow or adipose tissue solutions may be needed.
In patients with chronic musculoskeletal pain and instability, the goal is to stimulate the body’s healing and regenerative processes in the joint, promoting the repair and regrowth of connective tissues, tendons and ligaments for strength and other joint stabilizing structures (i.e. labral tissue).
The body’s way of promoting healing is through inflammation and prolotherapy works by this same process. When the proliferant is injected, it causes the inflammatory response and triggers the healing process – where new ligament and tendon tissue growth is stimulated. The tendons and ligaments after using prolotherapy look the same as normal tissues but they are thicker, stronger and vary in thickness.
Cortisone vs. Prolotherapy
Cortisone injections mask joint pain and are typically very successful, however in many studies it has been shown to accelerate degenerative osteoarthritis from cartilage breakdown. It is also shown that excessive cortisone treatments can lead to chronic pain. Prolotherapy is an option to pain medications, cortisone, steroid injections, and is an alternative to surgery. It is also considered safe and affordable and the patient will be able to work and/or train during treatment.
Temporomandibular Joint or TMJ
Temporomandibular disorder is a painful disorder that affects the temporomandibular joint area – including the hinge jaw joint which connects the mandible (lower jaw). It can also affect the skull bones in front of the ears – the temporal bone and the muscles that surrounds the jaw. TMJ disorder conflicts with doing things like chewing, yawning and biting and can cause pain while doing these things. Symptoms include, pain in the jaw, tooth, face, neck, and shoulders, clicking or popping of the jaw, inability to open the mouth wide, migraine headaches or any other type of headaches, etc. TMJ is caused by a variety of things, but most commonly is can be caused by trauma or whiplash, stress, dental malocclusions, missing or bad teeth, disease and inflammation and muscle abuse/overuse.
Prolotherapy and TMJ
Prolotherapy is ideal for TMJ because it strengthens the ligaments, allowing proper movement of the TMJ. Popping of the jaw is a sign of joint instability – this is caused because the ligaments holding the joints together becomes torn or overstretched. This causes or aggravates the pain in the head, jaw and face. Prolotherapy directly addresses the joint instability and focuses on repairing the ligaments at the site of connection to the bone, making them permanently stronger.