Dr. Balharry is a long time practitioner of, and has considerable expertise in the treatment of soft tissue injuries by prolotherapy. This technique causes the ‘proliferation’ of tissue in ligaments that have become injured or weak. Ligaments are the ‘rubber bands’ that hold bone to bone at our joints.
How does it work?
Prolotherapy is based on the theory that pain is related to sensitive receptors in tendons or ligaments, which are activated by pressure, stretching and injury. Because ligaments and tendons have a poor blood supply, they often do not heal completely after tearing. When they do not return to their normal length and strength after an injury, they may become stretched and lax. This causes joints (including the vertebrae) to become unstable, producing excessive rubbing, arthritic changes and persistent, low-grade pain. The healing mechanisms stimulated by prolotherapy help to restore normal function in weakened joints, allowing the body to relieve the pain by healing itself.
The therapy involves injecting a simple solution of concentrated dextrose, saline, or another agent into soft tissues such as ligaments or tendons. The solution is referred to as a "proliferating agent" because it produces a "proliferation of inflammation" in the injured area. Prolotherapy is effective because inflammation leads to healing. This happens when the body's anti-inflammatory chemicals, called macrophages, rush to respond to the inflammation, stimulating a natural healing response and promoting growth factors in the cells of the affected tendons and ligaments. Connective-tissue-builders called fibroblasts lay down new fibrous tissue wherever they detect damage, while other natural substances trigger the growth of new blood vessels and the flow of nutrients.
The difference between prolotherapy and anti-inflammatory drugs (such as aspirin, ibuprofen or even cortisone) is that although these medications may relieve pain temporarily, they also block some of the natural chemicals that can repair the underlying damage. In many cases, therefore, an injury never heals completely and the pain becomes chronic and persistent. Many people with musculoskeletal pain enter a vicious cycle of pain, drugs, more pain and more drugs. By contrast, because prolotherapy involves a cycle of controlled inflammation and healing, rather than just temporarily blocking pain sensations, it actually triggers the growth of new tissue which permanently repairs the joint. With strong, tightened ligaments and tendons, the joint is restabilized, and no longer causes pain.
Although clinical research on prolotherapy is limited, a few studies reported in reliable medical journals have shown good to excellent results in pain relief in up to 85% to 90% of those who have tried it. Because the principle of prolotherapy can apply to a broad range of problems that cause musculoskeletal pain, it has been used successfully to treat many different conditions.
Back pain responds particularly well to prolotherapy, because many types of back pain are the result of injuries to the ligaments that hold the spine together. Because headache pain is often a result of similiar ligament/tendon damage, it too can often be improved with a course of prolotherapy injections. A variety of other joint problems have shown significant relief as well. These include pain in the shoulders, knees, ankles, elbows and jaws (TMJ, or temporomandibular joint pain).
Other problems that have been reported to be relieved by prolotherapy include arthritis, fibromyalgia, sports injuries, whiplash, carpal tunnel syndrome, degenerated or herniated disks, and sciatica.
It is best to avoid the use of caffeine, alcohol and anti-inflammatory drugs during prolotherapy; they may reduce its effectiveness or lengthen the number of treatments required.
How long will it take to complete a course of treatments?
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 10 or more. The average number of treatments is 4-6 for an area treated. The best thing to do is get an evaluation by a trained physician to see if you are an appropriate candidate. Once you begin treatment, your doctor can tell better how you are responding and give you an accurate estimate.
Although prolotherapy is very safe, there are some risks involved. Many years ago, there were deaths attributed to prolotherapy. This would have been related to the toxic medications that were injected at that time. Dextrose solutions are very safe and no deaths have been recorded in association with prolotherapy for in excess of thirty years. In the thoracic area (the chest) it is possible to cause a lung puncture. It is also possible to inject into the spinal canal. Because there are skin punctures, it is also possible to introduce infection at the puncture sites. It should be noted that the risk of these events is extremely low.
All risks and benefits will be reviewed with you by Dr. Balharry at your first consultation. You should also be aware that this treatment is not covered by Provincial Insurance plans or by most extended health care plans. Payment costs are the responsibility of the patient.