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Regenerative Medicine: Prolotherapy

drZaman excited to bring you the latest procedures and techniques in prolotherapy. Just what is prolotherapy?

Prolotherapy is a minimally invasive and natural treatment option for those living with the chronic pain of many common joint, tendon and ligament injuries.

Prolotherapy is also known as Proliferative Injection Therapy or Regenerative Injection Therapy (RIT). Prolotherapy is sparking renewed interest, particularly with regard to treating muscle or ligament strains or partially torn tendons and ligaments in professional athletes. It may be helpful when ligament or tendon pain fails to respond to prescribed physical therapy alone, or in conjuction with other “traditional” treatment modalities. Prolotherapy uses injections of natural solutions that stimulate a mild inflammatory response at the site of injury to allow the body to heal itself. This works by facilitating an increased blood supply and nutrients to the area, and causing the release of growth factors from the blood to stimulate tissue repair.

Prolotherapy has been used as a “non-traditional” treatment option for more than fifty years; however, it has been more recently recognized in the scientific literature as an effective and safe means of healing.

Ask drZaman if you are a candidate for prolotherapy!,

Prolotherapy Injections

-Prolotherapy stimulates the body’s healing response

Ever since ancient times, creating a small injury to prompt healing has been seen as a good idea. For horses, this was called “pin firing”. The technique was to take a hot poker and place it into a non-healing ligament to cause small amounts of damage to the area, which caused the body to kick up a repair response. While barbaric, it generally worked. For centuries doctors have created small injuries in a non-healing wound by “roughing” up the tissues. Physicians still use this concept today for tendons, ligaments, and joint capsules. For example, in a shoulder capsulorrhaphy a surgeon usually inserts a small catheter that heats up to prompt healing in a damaged shoulder capsule (the covering of the shoulder joint that helps control motion). Surgeons still score ligaments with scalpels and needles in the technique called percutaneous tenotomy, also to prompt a healing response. Another example is micro-fracture surgery to fix a hole in the cartilage; this is where the surgeon pokes holes in the bone to cause the cartilage to heal. Finally, the procedure known as prolotherapy is in this same category. In this procedure, rather than a mechanical injury being initiated, the physician injects a chemical irritant to cause a chemical micro-injury. All of these types of treatment rely on the same concept that we get one bite of the healing “apple” and if something fails to heal completely the first time, we can get more bites at that apple simply by causing a small injury to the area.

The big advantage to micro injury techniques is that these basic procedures are simple and often inexpensive ways to try to get an area to heal. The downside is that while many times they work well, sometimes they don’t have enough oomph to get the right type of healing or enough healing.

Do you want to be active again ?

Regenerative injection therapy (RIT) or prolotherapy is a natural healing alternative to drugs or surgery. RIT prompts your body to naturally heal damaged and degenerated tissues. It involves a series of simple injections into the injured area, once a month for 3-6 months.

This is not a steroid, which blocks healing, but substances that heal and strengthen the ligaments and joints. The goal of RIT is to increase your activity level. More activity will allow your muscles to increase their tone and further protect the joints and nerves from injury.

Research has shown that RIT is very effective for knee pain, low back pain, tennis elbow and arthritic hand pain. Our own experience shows that it’s also effective for ankle pain, shoulder pain, elbow pain, neck pain, upper back pain, and hip pain. It’s the perfect solution for active individuals looking to return to a pain-free lifestyle.

How RIT / Prolotherapy Works


RIT works by prompting your body’s natural repair mechanisms to heal damaged or degenerated tissues. While most of our daily injuries heal completely, severe ligament tears, degenerated and worn out tissues, and tissues with a poor blood supply (such as the knee) don’t usually mend themselves. RIT first starts by injecting a proliferant into the damaged area. This inflammation causes your body to release it’s own natural growth factors in the injured tissue. These go to work immediately, directing your body’s natural healing mechanisms to repair painful tissues. The first stage of healing usually takes about a week, but the tissue continues to strengthen for 4-6 weeks after an injection.

You should feel numb in the painful area immediately after each shot. This should last for a few hours. For the next few days you should be sore. This is a normal part of the healing process.

A sugar fix for joints and ligaments?

The most commonly used solution is hypertonic dextrose. This essentially means that concentrated sugar water is injected. Since the solution is very concentrated, the body immediately tries to dilute the solution. This causes a brief inflammatory healing response which kicks off a healing cycle.

What should I expect?

You should feel numb in the painful area immediately after each shot. This should last for a few hours. For the next few days you should be sore. This is a normal part of the healing process.

Are there any special instructions ?

Because anti-inflammatory medications ( Steroids, all prescription NSAID’s) block healing, you must stay off these medications while undergoing RIT. You should remain as active as possible as this will help build stronger tissues

Platelet Rich Plasma (PRP) and Stem Cell Therapy – increasing blood flow and nutrition for healing.

Coming Soon

drZaman offer the latest procedures and techniques for PRP and Stem Cell therapy for a wide array of musculoskeletal conditions! Will this be a pain relieving option for your pain?

What do PRP and Stem Cell therapies entail?

Platelet rich plasma therapy or (PRP therapy) and Stem cell therapy are advanced prolotherapy treatments used to repair injured tissues. They are minimally invasive and offer a natural approach to repairing damaged or weak structures in the body.

Blood is withdrawn from the patient’s arm, spinned down in a centrifuge, and the platelet rich plasma is removed. This solution is then injected into these painful areas and is used to initiate our body’s healing powers. Platelets create an inflammatory response, and contain growth factors that are released to allow for this healing and regenerative process to take place.

The stem cells are taken out from the patient’s abdominal fat or bone marrow, and can be used often with PRP. They can be combined in a mixed solution to give the injured tissue an inflammatory response with the needed growth factors and immature cells that help heal and strengthen the weak and damaged ligaments and tendons.

One to three injections are usually needed to alleviate inflammation and provide long-term resolution of your injury and pain.

Platelet Rich Plasma – PRP

The next level of sophistication beyond just creating a healing micro injury (like prolotherapy) is making the conditions in the area more conducive to healing or “anabolic”. You may have heard this term associated with body builders that use steroids. This is not the same use here, although body builders “build” muscle, so this is why they use “anabolic” steroids (literally steroids that build”). Here the term means making an area pro-repair or better able to heal.

Creating an anabolic healing environment is not a new concept in medicine. For centuries, physicians have known that some people have better innate abilities to heal, while others have less healing capabilities. Physiatrist have always understood the basics, like good nutrition, young age, high levels of fitness, good blood supply, etc. PRP is a simple example of how we can improve the healing environment. The blood has platelets which contain growth factors that help to ramp up healing.

PRP means that the healing platelets have been concentrated. Injecting the patient’s own blood can often accomplish the same thing, as it’s also rich in platelets. During this time the platelets are directed to produce certain natural growth factors that are important in specific types of healing.

Thank you for your interest in the drZaman'sFCPS Interventional Pain, Arthritis & Spine center –POPULAR MEDICAL COLLEGE HOSPITAL, DHAKA, BANGLADESH leaders in Pain Management