Prolotherapy Revisited: a Therapeutic Adjunct For Tmds (original) (raw)
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The most commonly reported chronic pain conditions are corresponding with musculoskeletal dysfunction and degeneration. The most important cause of joint instability is the ligament injury, which leads to symptoms like pain. However, standard therapeutic regimens have failed to be effective in chronic conditions as they do not treat the under lying cause. Hence, this is where prolotherapy comes into picture. Prolotherapy is also known as nonsurgical ligament/tendon reconstruction, or sclerotherapy. The ligaments and tendon become weak over a course of time which leads to inflammation. Prolotherapy by using a sugar based solution is injected into the affected area whereby it causes increase in the blood supply and nutrients which stimulate the tissue repair. Through this review we are trying to highlight that prolotherapy can be regarded as an alternative therapeutic modality that can reduce or eliminate pain by stimulating the natural regenerative processes.
Prolotherapy: A Clinical Review of Its Role in Treating Chronic Musculoskeletal Pain
PM&R, 2011
Prolotherapy is a technique that involves the injection of an irritant, usually a hyperosmolar dextrose solution, typically in the treatment of chronic painful musculoskeletal conditions. Despite its long history and widespread use as a form of complementary therapy, there still are disparities over its optimal indications and injection preparations. There are, however, numerous studies available regarding the use and efficacy of prolotherapy for various musculoskeletal conditions. The most frequently published indication is in the treatment of chronic low back pain, but there are recent studies that examined its use in the management of refractory tendinopathies as well as osteoarthritis. There is growing evidence to suggest that prolotherapy may be helpful in treating chronic low back pain when coupled with adjunctive therapies, such as spinal manipulation or corticosteroid injections. There is also evidence to suggest that prolotherapy is effective in treating refractory tendinopathies, particularly for lateral epicondylosis and Achilles tendinopathy. Additional larger, randomized controlled trials are needed to make specific recommendations regarding ideal protocols and indications. There is emerging evidence for the use of prolotherapy as a treatment option for osteoarthritis; however, further studies are needed to conclusively demonstrate its efficacy. Overall, prolotherapy remains a promising option for the treatment of painful musculoskeletal conditions, particularly when other standard treatments have proved ineffective.
Current Concepts of Prolotherapy in Orthopedic Surgery
Archives of trauma research, 2016
Context: Prolotherapy is a popular injection-based complementary treatment, which has shown promising results in the treatment of sprained and degenerated ligaments, and damaged dense connective tissues' structures. More research was conducted in this area and many authors declared successful results for different indications. Evidence Acquisition: The purpose of this study was to present a literature review regarding the current concepts of prolotherapy injections and improvements in the orthopedic clinical care practice. The Medline and PubMed databases were searched for the articles related to prolotherapy injections in the field of orthopedic surgery and additionally the reference list of each article was also included to provide a comprehensive evaluation. Results: Numerous studies have been conducted on prolotherapy injections for different indications for orthopedics clinical care practice. Prolotherapy injections have successfully used for major orthopedic procedures in terms of rotator cuff lesions, knee ligamentous lesions, osteoarthritis-cartilage defects, and ligament-tendon injuries. Most of the studies showed that prolotherapy provided faster and better healing of tissues. Conclusions: There is a great interest to prolotherapy in orthopedic clinics, especially to manage musculoskeletal lesions. More research conducted in this area and many authors declared successful results in their studies. In spite of this increasing trend for prolotherapy injections, there were only one or two clinical studies investigated prolotherapy injections for different indications and most of them have limited participants, short-term follow-up or poor quality studies. There is still need for further high-quality studies investigated optimal strategy of the injections of prolotherapy.
PLOS ONE, 2021
Introduction Prolotherapy and other injections, primarily acting on pathways associated with maladaptive tissue repair, are recommended for recalcitrant chronic soft tissue injuries (CSTI). However, selection of injection is challenging due to mixed results. This network meta-analysis (NMA) aimed to compare prolotherapy with other therapies, particularly injections, for CSTI and establish robustness of the results. Methodology Pubmed, Medline, SPORTDiscus and Google scholar were searched from inception to 4th January 2021 for randomised controlled trials (RCTs) involving injection therapies (e.g. blood derivatives, corticosteroid, hyaluronic acid, botulinum toxin) for CSTI. The primary and secondary outcomes were pain and function, respectively, at (or nearest to) 6 months. Effect size (ES) was presented as standardised mean difference with 95% confidence interval (CI). Frequentist random effect NMA was used to generate the overall estimates, subgroup estimates (by region and measur...
Efficacy of Prolotherapy for Osteoarthritis: A Systematic Review
Journal of Rehabilitation Medicine
Objective: Current treatments for osteoarthritis do not resolve the underlying cause. Dextrose prolotherapy is an alternative method that has been proposed for treatment of osteoarthritis, due to its ability to aid tissue regeneration, improve clinical manifestations, and repair damaged tissue structures, which are pathological conditions in osteoarthritis. The aim of this systematic review was to evaluate the efficacy of dextrose prolotherapy compared with other interventions in the management of osteoarthritis.Methods: Electronic databases PubMed, Google Scholar, Cochrane, and BioMed Central were searched from inception to October 2021. Search terms included [(prolotherapy) OR (prolotherapies) OR (dextrose prolotherapy)] AND [(osteoarthritis) OR (osteoarthritides) OR (knee osteoarthritis) OR (hip osteoarthritis) OR (hand osteoarthritis) OR (shoulder osteoarthritis)]. Randomized controlled trials that compared the use of dextrose prolotherapy with other interventions (injection, pl...
From Conventional to Innovative Approaches for Pain Treatment, 2019
Pain is a symptom caused by a disease process and/or tissue injury. With the prolongation of life expectancy in humans, the incidence of degenerative joint diseases and as a result pain has increased. Unfortunately, a method of treatment that stops or reverses progression by affecting the pathogenesis in these diseases has not been developed. Physical therapeutics such as medicine and physical rehabilitation often are prescribed for patients suffering with pain. Recently, in addition to these routine therapies used in pain treatment, many regenerative injection-based therapies, including prolotherapy (PrT) or platelet-rich plasma (PRP) have been widely used. PrT is using for damaged or degenerated connective tissue healing, such as ligaments, tendons, and cartilage. The combination of local inflammatory effect, stimulation of local growth factor release, and down regulation of neuropathic inflammation can be defined as the mechanism. As a result of these, joint instability and ligament laxity reduce and pain decrease. PRP is the cellular component of the plasma. Although PRP is used for the same reasons as PrT, it can be used in acute cases unlike PrT. This chapter is intended to understand the use of regenerative injection therapies (PrT and PRP) better in the treatment of pain.
Efficacy of Biologics for Ligamentous and Tendon Healing
Operative Techniques in Sports Medicine, 2020
The use of "biologics" has become increasingly popular over the past several decades due to their potential to treat various pathologies by providing supraphysiological doses of anabolic growth factors. Within orthopaedic sports medicine, biologic treatments such as platelet-rich plasma and stem cells/progenitor cells are now widely used to treat soft tissue pathologies despite the lack of evidence for many of these therapies. The effects of orthobiologics on tendon and ligament healing has been investigated in various animal models and clinical trials, yet there is still no clear consensus on which biologic treatments, if any, are efficacious. Among the randomized controlled trials for these different biologics, small sample sizes, heterogenous methodology, and highly variable comparator treatments make comparisons between studies difficult and hinder the understanding of each biologic. The purpose of this review is to provide a concise summary of the best evidence for and against various "biologics" that are being used for orthopaedic tendon and ligament pathologies.
Evidence-Based Regenerative Injection Therapy (Prolotherapy) in Sports Medicine
The Sports Medicine Resource Manual, 2008
The treatment of sports injuries to the point of restoration of full sports performance is an obvious goal in sports medicine. However, healing is the preferred goal because returning connective tissue to normal strength allows for a durable return to full sports performance.. Regenerative injection therapy (prolotherapy) is the injection of growth factors or growth factor production stimulants to promote the regeneration of normal cells and tissue. Inflammation is not required, and scarring is not the result.. Open-label clinical trials have been uniformly positive in outcome, but double-blind clinical trials have been hampered by a needling control that does not appear to be a placebo. Recent studies are making use of a noninjection control.. Making use of consecutive patient data from athletes with career-threatening injuries (i.e., chronic groin strain in soccer or rugby players) that are not responsive to other treatments is a recommended study approach to assess regenerative injection therapy's ability to reverse otherwise permanent conditions. This is an avenue for the critical assessment of regenerative injection therapy's potential.. Serial high-resolution ultrasound images are limited somewhat by uniformity of technique, but they offer a way to follow healing from regenerative injections.