Prolotherapy: Under-Recognized Treatment for Osteoarthritis Pain

Woldin B, Ross Hauser, MD. Prolotherapy: under-recognized treatment for osteoarthritis pain. The Pain Practitioner. 2014;24(3):16-22.

A new research article appears in the Pain Pracitioner co-authored by Ross Hauser MD.

Pain is a highly charged and emotional experience that is hard to describe and even more difficult to quantify, and the pain experienced in osteoarthritis is no exception. Osteoarthritic pain is a complex issue for patients and their health care providers, the latter of whom have relatively few effective treatment options to offer in terms of pain resolution and return of function. Prolotherapy is an injection technique that aids in healing arthritic joints and relieving pain and is emerging as a promising treatment option in osteoarthritis...

In Hackett-Hemwall prolotherapy, a small amount of a proliferant solution such as hypertonic dextrose, sodium morrhuate, or polidocanol is injected into the painful entheses of ligaments or tendons, as well as at trigger points and adjacent joint spaces. This produces an inflammatory response involving fibroblastic and capillary proliferation, along with growth factor stimulation, that induces healing and strengthening of the damaged or diseased structure (40-42). When OA is advanced, cellular prolotherapy, which utilizes cellular and extracellular matrix components of the blood, fat, or bone marrow, is recommended. This cell-based technique consists of intra-articular injections of the PRP portion of the blood or progenitor cells from a lipoaspirate or bone marrow aspiration. The goal of this type of prolotherapy treatment is not only pain relief but also regeneration of joint structures including articular cartilage.

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