Prolotherapy is the use of a solution that helps grow stronger ligaments and tendons. Arthritis is considered a joint problem but the pain from arthritis is often caused by the surrounding soft tissue, which consists of ligaments and tendons. Because of this, prolotherapy is a great treatment for a wide range of arthritic conditions. As you will find out from reading on, if you have arthritis, you have the opportunity to greatly benefit from prolotherapy.
Ligaments hold together bones. Around a joint they blend together to form a joint capsule. Tendons are said to connect muscles to bones, but it is more accurate to say that tendons are the continuation of the muscles that help connect the muscles to bones. This connection helps the muscles move the bones. The problem for both ligaments and tendons is that they do not get much blood flow. The difference in blood flow between the muscles and tendons and ligaments is highlighted by the color differences. Muscles are red with good blood flow, while ligaments and tendons are yellow-white, suggesting poor blood flow.So when they are injured, ligaments and tendons do not heal well. This contrasts with muscle, which has good blood flow so when injured, tends to heal very well in four to six weeks.
Joint arthritis is thought of as the wearing out of bones that are connected. A common example is the knee joint. An X-ray of knee arthritis shows that the bones are closer together, called joint space narrowing (or on the spine, this is called disc space narrowing). Also seen on X-rays are bone spurs that grow off the bone. What is not well visualized on X-rays are ligaments and tendons.
It is important to understand that loosening of ligaments plays a key role in the development of arthritis. Also, much of the arthritic pain is from the ligaments and tendons around the joint. By strengthening the ligaments and tendons with the prolotherapy solution, the arthritic pain can dramatically improve. Even when knee arthritis is severe, as in bone-on-bone, you can improve with prolotherapy. That is because much of the pain is coming from the ligaments and tendons and even with severe arthritis, the tendons and ligaments respond well to prolotherapy.
As a general rule, bone spurs result from loose ligaments. When a ligament is loose, the joint has intrinsic instability. Sometimes the stability is severe enough that the joint slips out of place. More often, there is mild laxity (looseness) such that the bones mildly rub against one another. In reaction to this physical stress, bone spurs develop as a way for the bone to protect itself. While the bone spur can cause some stiffness with movement, it usually does not cause pain. However, unhealthy ligaments can cause significant pain. By improving the strength of the ligament, the joint pain will subside. Also, when joint movement is affected by arthritis, the tendons also bear stress with the abnormal movement. These weakened tendons also produce pain. With strengthening the tendons, the pain is significantly improved.
The shoulder is the most mobile joint in the body, so is susceptible to arthritis. While they are considered different conditions, rotator cuff tendonitis and shoulder arthritis result from a similar cause. The rotator cuff is a group of four muscles that wrap around the shoulder like a cuff. By its name you can guess that the rotator cuff helps rotate the shoulder. Just as important, the cuff helps stabilize the shoulder, helps keep the shoulder joint in place when the arm is moving. When the ligaments weaken, this puts stress on the shoulder joint so bone spurs form and arthritis develops. At the same time, when the ligaments weaken, the rotator cuff muscles have to work harder. The cuff muscles then become strained, eventually progressing to a tear. Thus, rotator cuff injuries and arthritis form as part of the same process. The good news is that because both problems involve ligament laxity and weak tendons, both conditions respond very well to prolotherapy.
Hips and knees are the key weight-bearing joints, so are also vulnerable to arthritis. By strengthening the ligaments and tendons around knees and hips, the pain improves. Hands include our most-used joints, so are also very susceptible to arthritis. Because they get so much use, the finger joints become stiff, painful and even deformed. While prolotherapy will not necessarily reverse the deformity, arthritic hand pain responds beautifully to prolotherapy. This is because the hand pain is caused by very small, tender ligaments which are strengthened by prolotherapy.
While arthritis in the spine has different names including stenosis, spondylosis, facet syndrome and degenerative disc disease, they all have a similar underlying cause: lax ligaments. Even disc herniations are related to lax ligaments. Discs are sandwiched by the vertebra (spine bones) and are made of fibrous tissue with a center gel-like substance. When the ligaments weaken, the vertebrae lose their support. This increases disc pressure, so the disc fibers weaken, eventually herniating or falling out. When the disc compresses the nerve, severe leg pain results, otherwise known as sciatica. As the discs wear out the space between the vertebrae narrows, with bone spurs forming. This leads to the typical arthritic spine pain, known by the various names described above. This process is similar in the cervical spine (neck) and lumbar spine (low back). The key to understand is that lax ligaments are a strong contributor to all these conditions. This is why prolotherapy is so effective for neck and back pain conditions.
Another key aspect of prolotherapy that complements its effectiveness is that it is very safe. As opposed to a steroid injection, which suppresses body functions and has to be limited due its toxicity, prolotherapy stimulates the body’s healing reactions so it can be repeated if necessary and can be used for multiple areas of pain. As opposed to arthroscopy, which treats arthritic pain by cutting away loose tissue fragments and bone spurs, prolotherapy treats arthritic pain by building and strengthening tissue for long-term healing. Arthritic joints respond beautifully to prolotherapy because weakened ligaments are a strong factor in the pain caused by these joints. Prolotherapy treats those ligaments, thus reducing the arthritic pain.
In summary, prolotherapy is a great treatment for arthritis affecting multiple joints including the most commonly affected joints including the shoulders, hips, knees and fingers, and even less commonly affected joints such as the elbows, wrists, ankles and toes, and anywhere along the spine including the neck and low back. The reason it is so effective for arthritis is because the pain caused by arthritis is often caused by lax ligaments, and these ligaments are strengthened by prolotherapy. Please check my website, where I describe the logistics of prolotherapy (Prolotherapy Info) and go into more detail about how prolotherapy works (How Prolotherapy Works).
Dr. Slaten is a pain wellness physician in Ridgewood, New Jersey. For more than 20 years, he has been practicing with great skill and an open mind. Learn more about prolotherapy and his other treatments at his website, www.njprolo.com.
