A LITTLE BIT OF HISTORY

"A joint is only as strong as its weakest ligament."
— George S. Hackett, MD

George S. Hackett, MD is considered to be the father of Prolotherapy. He started his work over forty years ago, publishing texts and presenting case histories and results to his medical peers at influential medical conferences during the 1950s. While reviewing Dr. Hackett's exhibit at the American Medical Association meeting in 1955, Gustav A. Hemwall, MD was impressed and went on to train under and practice Prolotherapy with Dr. Hackett. Dr. Hemwall is the most experienced Prolotherapist, having done well over 10,000 cases in his Chicago-based practice.

Since then, many medical and osteopathic doctors have included Prolotherapy treatment in their practices.

A CLOSER LOOK:
The Science Behind Prolotherapy

Through the normal wear and tear of our bodies over time the ligaments that help attach our musculature to bones become lax and weakened. An accelerated form of this process occurs in acute injuries from accidental trauma. Even after the healing of torn and injured musculoskeletal tissues, there may be continued evidence of this laxity. This means that the surrounding supportive muscules are working harder than they are meant to by taking on the additional supportive role of ligaments as the anchorage to bone. As time passes muscles become weary of all this extra work, and they begin to communicate with you via your central nervous system to tell you so. These muscle spasms turn on the pain receptors at the location of ligament weakness. One may also experience pain to other "referred" areas of the body near the original site of injury.

Prolotherapy can help build up and repair these ligament attachments by its ability to promote the proliferation of new tissue to this area of weakness. The substance injected into the impaired area promotes a controlled inflammatory response, a natural process that our bodies do in response to an injury. This healing occurs through the work of specialized cells called fibroblasts. During normal wound repair, fibroblasts produce the material that forms collagen, the main building block of tissue restoration. When fibroblasts are doing their repair near ligaments and bone the collagen layed down strengthens and tightens these weakened ligaments.

Prolotherapy, therefore, is a way to promote the natural healing processes within your body.

THE NEXT STEP

Now that you know this healing process works, the next step toward receiving Prolotherapy is to undergo a physical examination of the injured region. This is done to actually reproduce the pain that has been plaguing you and to establish a reference baseline. Once you and your doctor are comfortable in thoroughly understanding where the problem is and how Prolotherapy may help, your first appointment is made for treatment.

With any procedure, even a minimally invasive one such as Prolotherapy, there may be risks involved. This is an injection therapy, so the primary risks include infection and bleeding into the surrounding area treated. Such occurrences are rare, especially when there is careful attention to sterile technique and preparation.

Other risks specific to certain physical conditions are reviewed on a case by case basis. For example, if you have diabetes mellitus, your serial blood sugar readings must be stable and under control so that the process of healing will not be delayed or increase your risk for infection.

In my practice, the Prolotherapy solution used includes a mixture of sterile water, Sarapin, 1% Lidocaine and Dextrose. This combination will best promote the correct amount of controlled inflammation to attract fibroblasts that strengthen the tissues in the injected area.

Sarapin is a natural homeopathic solution that is obtained from the Pitcher Plant. Lidocaine is a commonly used local anesthetic. The Dextrose is a 50% solution that is extracted from corn and acts as the main irritant for the inflammatory healing process.

I also use an anesthetic skin prep to block many of the pain receptors on the skin surface that are stimulated when receiving injections.