China
Africa
Explore chapters and articles related to this topic
Tendinopathy
Published in Kohlstadt Ingrid, Cintron Kenneth, Metabolic Therapies in Orthopedics, Second Edition, 2018
Prolotherapy is the injection of local anesthetic and dextrose with or without other agents to stimulate tendon repair or to treat ligament laxity. A number of studies have shown efficacy in treating lateral epicondylitis, rotator cuff tendinopathy and Achilles tendinopathy (Scarpone, Rabago, Zgierska, Arbogest & Snell 2008; Rabago Arbogest
Therapeutic Use of Stress to Provoke Recovery
Published in William J. Rea, Kalpana D. Patel, Reversibility of Chronic Disease and Hypersensitivity, Volume 4, 2017
Based upon the concept that cause irritation or injury will stimulate healing, prolotherapy (also known as proliferation therapy or regenerative injection therapy) is a highly effective treatment for chronic ligament and tendon weakness. It involves injecting a mildly irritating solution (e.g., dextrose, water, and a local anesthetic like lidocaine) into the affected ligament or tendon in order to induce a mild inflammatory reaction, which will then activate the body's healing process, resulting ultimately in overall strengthening of the damaged connective tissue and alleviation of the pain. Prolotherapy is believed by several holistic practitioners to be significantly more effective than cortisone injections because these latter injections, although providing immediate short-term pain relief, will, because of the catabolic effect of steroid hormones over the long term, cause destruction of tissue and exacerbation of pain.
Biotensegrity
Published in Sahar Swidan, Matthew Bennett, Advanced Therapeutics in Pain Medicine, 2020
If remote injury without full repair represents a loss of tensional integrity, repair at that location (or locations) would restore tensional continuity in the fascial structures and allow muscles to contract only when needed as a fine-tuning mechanism. Ease of movement would return. These are the clinical observations of prolotherapists through the decades since Hackett defined prolotherapy as an injection technique for strengthening “the weld of disabled ligaments and tendons to bone by stimulating the production of new bone and fibrous tissue cells”.28 For 36 years, the American Association of Orthopedic Medicine has educated physicians in the clinical application of prolotherapy (www.aaomed.org). Since the early 2000s, the University of Wisconsin in Madison with the Hackett Hemwall Patterson Foundation has hosted a comprehensive course on prolotherapy. For years the title of the course was “Prolotherapy in the Treatment of Myofascial Pain.” An annual research conference was added in 2005 and a dedicated research collaboration established.29 Prolotherapy technique involves the injection of various agents (most commonly 15% dextrose) at numerous entheses; often these are locations where there is no pathology recognized by mainstream medicine. To many, the broad pattern of injection has been a sign that the diagnosis is imprecise. Yet, if loss of tension in the myofascial continuity is the diagnosis, only a broad intervention would address the pathology. The technique described below is an attempt to “split the difference” between widespread injection guided by palpation (as in traditional prolotherapy technique) and specific tissue pathology targets guided by ultrasound.
Injection therapies for patellar tendinopathy
Published in The Physician and Sportsmedicine, 2020
Prolotherapy is an injection technique in which a small amount of irritant solution is injected into the tendon, ligaments, joints, and joint spaces to promote normal tissue growth [48]. It has been used for decades for the management of chronic musculoskeletal pain and other tendinopathies. Although the precise mechanism is unclear, it is believed to stimulate the healing of soft tissues by inducing a local inflammatory response [49]. In prolotherapy technique, injection solution may vary by clinical severity and clinician’s preference, the key concept is that a small volume(.2ml – .5 ml) solution is injected to the tendon and adjacent areas [50,51]. Hyperosmolar dextrose is the most common agent used in prolotherapy as it is a normal constituent of human blood with concentration ranges from 12.5% to 25% [52]. It dehydrates the cells around the injected area causing local tissue trauma, which attracts granulocytes and macrophages and hence promotes the healing process [53]. A number of published studies reported its effectiveness in the management of various musculoskeletal conditions such as Achilles tendinopathy [54], plantar fasciitis [55], chronic groin pain [56], refractory tendinopathy [57], joint laxity [58], low back pain [59], and osteo arthritis [60]. Significant improvement in the pain scale, tendon structure, and vascularity were observed in patients with PT who received ultrasound guided hyperosmolar dextrose prolotherapy [61]. The therapy was given every six weeks and a follow-up of the pain scale measurement was taken on the 45th week.
Current pharmacological approaches to the treatment of tendinopathy
Published in Expert Opinion on Pharmacotherapy, 2020
Rocco Aicale, Rocco Domenico Bisaccia, Antonio Oliviero, Francesco Oliva, Nicola Maffulli
Interesting results have been reported for prolotherapy, consisting in the injection of hypertonic solution, mainly glucose, which may stimulate an acute inflammatory response, followed by collagen deposition, which should strengthen the suffering structure. This modality has shown potential improvement in pain and function, but no improvements in long-term results compared to those achieved following a typical physical therapy program have been reported [144].