By Larisa N. Likver, MD 

Back or neck pain, arthritis, tennis elbow, sprains and strains … few of us get through life without suffering some sort of joint injury. Left untreated, those injuries never properly heal, resulting in chronic pain that can be physically and psychologically debilitating. But surgical repair comes with its own set of risks.

There is a natural, nonsurgical way to repair the weakened ligaments and tendons that are at the root of joint injuries. Prolotherapy (also called reconstruction injection therapy) uses injections at the injury site to strengthen ligaments (the “rubber bands” that hold bones together in a joint and act like shock absorbers) and tendons (the “bridges” that attach muscles to bones and regulate stability during movement).

When ligaments and tendons become weak or injured, they may not regain their original length, strength and endurance. That’s largely because blood supply becomes constrained, and so healing is slow and not always complete. Also, tendons and ligaments have many nerve endings that become inflamed due to injury, causing pain at the areas where these structures are damaged or loose. Weakened tendons and ligaments can’t support normal joint movement, and eventually arthritis will develop in the affected joints, further complicating the problem and causing more pain.

With prolotherapy, a doctor injects a sugar-based solution at the site where the ligament or tendon attaches to the bone (a spot where degeneration and regeneration occur), causing localized, “positive” inflammation. Inflammation is a first stage of healing, as it increases the supply of blood, oxygen and nutrients to tissues. Also, this controlled, localized inflammation will massage the immune system in those weakened structures, triggering a self-repairing mechanism that strengthens, tightens and thereby stabilizes them. Stronger tendons and ligaments restore proper joint support, spurring regeneration of the compromised joint so the pain can finally go away.

This concept is not new, by the way. There is historical evidence that a very similar therapy was performed as early as 400 BC. The term prolotherapy is derived from the Latin word proli, which means “to regenerate or rebuild.” The nickname prolo is short for proliferation, because the treatment causes the proliferation (growth, formation) of new ligament and tendon tissue in weakened areas.

What would eventually evolve into modern-day prolotherapy began in the 1930s, when it was used as a treatment for weak ligaments. In the 1950s, Dr. George S. Hackett, a general surgeon in Canton, Ohio, began performing injections of irritant solutions in an effort to repair joints and hernias.

Today, doctors use prolotherapy to treat a wide variety of conditions, including back and neck pain; arthritis (shoulder, elbow, wrist, hip, SI joint, knee, ankle, foot, etc.); rotator cuff syndrome; tennis elbow; carpal tunnel syndrome; sprains and strains; and partially torn tendons and ligaments. 

The response to treatment varies from patient to patient, depending on healing ability, underlying medical conditions and how advanced the problem is. Some people may need just a few treatments, while others may need 30 or more. The treatment process is repeated every three to six weeks.

When comprehensive prolotherapy is administered correctly by a properly trained medical doctor, and the patient is chosen well, there is up to an 80 percent chance the patient will become pain-free, and most people have reported significantly less pain. In many cases, prolotherapy can eliminate the need for orthopedic surgery.

Larisa N. Likver, MD, was trained in comprehensive prolotherapy technique by Hackett Hemwall Patterson Prolotherapy Foundation (HHPF), one of the leading organizations in prolotherapy. HHPF was established in 1969 and is dedicated to providing medical care to people in need around the world. As a member of HHPF, she has participated in numerous trips to Honduras to provide prolotherapy treatment to patients with limited access to medical care.  Dr. Likver has offices at 315 Madison Ave., Ste. 806, NYC (212.922.9030) and 8419 Bay Pkwy., Brooklyn (718.259.0199). To learn more, visit DrLikver.com, GetProlo.com or HackettHemwall.org.