provide only temporary relief for a chronic condition, prolotherapy injec-tions given over several months are meant to provide a permanent benefit. In effect, prolotherapy tricks the body into initiating a healing response. The technique reactivates the heal-ing process by injecting a mildly irri-tating substance – commonly a some-what concentrated sugar solution along with the painkiller procaine or lidocaine – into the injured area to stimulate a temporary low-grade in-flammation. In some cases, growth factors themselves may be injected. With growth factors in place at the site of inflammation, new tissue is said to be produced that strengthens lax or unstable ligaments and tendons. The technique may even support damaged or degenerated cartilage, which nor-mally does not repair itself, by strengthening the fibrous connective tissues that stabilize the area. Several excellent studies published in the last few years in respected specialty journals have shown benefi-cial results to prolotherapy. v, vi, vii, viii In addition, the Mayo Clinic Health Letter spoke positively about prolo-therapy and its future. ix The clinic stated that when chronic ligament or tendon pain fails to respond to more conservative treatments like physical therapy and prescribed exercises, “prolotherapy may be helpful.” There have been two review articles recently published indicating signifi-cant benefits from prolotherapy and chapters are included in two newly published pain management text-books. x, xi, xii, xiii Prolotherapy has proved incredibly helpful for addressing musculoskeletal pain for several reasons: 1. It is safe, comparable to the safety of acupuncture if physicians have been fully training in needle placement methods. xiv 2. It uses very low cost and readily available sterile dextrose solutions. 3. 4. 5. 6. It can be used to treat complex cases that require treatment of many areas simultaneously for benefit. Dextrose has a proven ability to grow normal ligament tissue. xv, xvi, xvii, xviii Dextrose has a unique analgesic effect that occurs in seconds with-out an anesthetic. xix, xx Dextrose has been shown to stim-ulate some cartilage cell growth. Note, this does not resurface joints, but the goal is to stabilize and calm the joint surface in ar-thritis. xxi In clinical practice, I have found that judiciously combining prolotherapy with other modalities, such as chiro-practic, active release technique, mas-sage and physiotherapy, results in a more comprehensive treatment ap-proach in which the entire source of pain is completely identified and treated. 20 Chiropractic and Naturopathic Doctor March/April 2021 CND_Designs for Health_MarApr21_CSA.indd 1 www.Cndoctor.ca 2021-03-09 3:00 PM
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