chapter  9
19 Pages

Practical prolotherapy

WithRoger Oldham

Prolotherapy was introduced by Hackett in 1958 and derives from the Latin proles meaning ‘generation’ or ‘growth’. Prolotherapy describes the injection of non-pharmacological irritants and hyperosmolar solutions into dysfunctional joints, capsules, tendons, ligaments and entheses. Prolotherapy is drug-free and allows the body to heal efficiently with minimal scarring. Ligament laxity is an important risk factor in the development of osteoarthritis and this can be relatively easily corrected with prolotherapy. Prolotherapy can only be performed competently with the knowledge of clinical orthopaedic tests of ligamentous and joint instability, referred pain of ligamentous origin, surface anatomy, and an ability to visualise deep structures in three dimensions. It can be usefully practised alongside physiotherapy, manipulation, trigger point therapy, attention to posture, pain management, and general health measures. Prolotherapy will help in resistant cases and should be injected into all tender areas sometimes, therefore including the radiohumeral joint and annular ligament as well as the enthesis.