Prolotherapy: A Treatment for Knee Osteoarthritis

Osteoarthritis is a condition caused by the inflammation of our joints, often due to degeneration and damage of our joints over time. This form of arthritis can occur in our hips, shoulders, hands, and spine; however, it most commonly occurs in our knee joints. Osteoarthritis of the knee is a very painful, chronic disease that impacts your mobility. However, in recent years studies show that prolotherapy has been proven to decrease pain, improve activity, and remove stiffness more than other forms of treatment for osteoarthritis.

What is Prolotherapy?

There is no cure for osteoarthritis of the knee; however, there are treatments that can manage your symptoms and reduce your pain. Prolotherapy, short for proliferation therapy, is a non-invasive treatment that involves the injection of a solution into a weak or damaged area of the body in order to regenerate and repair tissue. More specifically, for osteoarthritis of the knee, a small amount of solution, often dextrose (sugar), lidocaine (a commonly used local anesthetic), and sterile water mixture, is injected near the painful or damaged joints to induce an inflammatory response. Once injected into the affected area, these seemingly benign substances promote healing, which is initiated by the body.

“I have found prolotherapy to be very helpful in a variety of patients from knee osteoarthritis, sacroiliitis, shoulder issues, and even TMJ (Temporomandibular Joint Disorders),” said Dr. Saunora Prom of TPMG Tidewater Sports and Osteopathic Medicine.

How does prolotherapy work?

Initiating the inflammatory process is thought to cause the production of fibroblasts (the body’s repair cells), which deposit new tissue fibers to repair an injury, ultimately stabilizing the area, restoring function, and diminishing pain. The resulting reduction in pain and improvement of function has the potential to be permanent. Each prolotherapy session is done in-office and takes around 30 minutes from prep to finish.

What can I expect at a prolotherapy treatment visit?

Before the procedure can begin, an initial discussion of the risks and benefits of prolotherapy will take place between the patient and provider. Once the patient has a thorough understanding of the procedure and associated risks, consent for the procedure will need to be obtained before proceeding with the treatment.

For the actual procedure, the patient is positioned on an exam table, and the treatment area is prepped and sterilized. In most instances, the area will be numbed with lidocaine by a very fine needle, followed by the prolotherapy injection(s). The solution is then injected into the treatment area and covered to protect against infection.

How frequently are injections needed?

Depending on the injury or condition, a series of two to three injections are performed every four weeks. Fewer treatments may be needed depending on the resolution of symptoms. The healing time is different for everyone, but most people can expect to see results as soon as three to four days after their visit. However, this is a regenerative healing process that may take a few weeks to see full results.

“In general, I find that patients’ knee pain after prolotherapy decreases by approximately 50 percent. Pain improvement can last for one year,” said Dr. Prom. This treatment can decrease your osteoarthritis pain while also improving your function, so you can return to work and play.

What can I expect after I receive an injection?

The injection site will likely feel sore and achy for the next few days, often resolving 24 to 72 hours post-injection. It is highly recommended that the injection site be iced. Refrain from using any steroids or Non-Steroidal Anti-inflammatories (NSAIDs) such as ibuprofen (Motrin) or naproxen (Aleve) for seven days after your procedure; doing so will only block the intended regenerative response. To prevent infections, avoid swimming or soaking the injection site in a bath or hot tub for 24 hours post-procedure.

“After prolotherapy, it is important to remember to try to optimize knee health by working on the other factors of arthritis including obesity, activity modification, smoking, and other medical issues,” said Dr. Prom.

How does prolotherapy differ from steroid injections?

Steroid injections are a commonly used treatment to block inflammation and pain for acute and chronic musculoskeletal conditions but are usually only a temporary solution. However, steroid injections have been associated with side effects, including high blood pressure, and weight gain. Steroid injections prevent the body’s normal healing process while masking the pain and, in the long-term, weaken the joints and ligaments. The deteriorating the joint is also sped up.

What are the side effects of prolotherapy treatment? Is it painful?

Other than mild discomfort during and after the injection, prolotherapy solutions have minimal side effects like any other injection such as swelling. Prolotherapy injections are mildly painful, much like a flu shot, and can be numbed with a topical cream as needed. Speak with your doctor about what medications you are able to take for any soreness that may occur afterward.

Untreated osteoarthritis of the knee can lead to decreased mobility of the knee and increased pain that may worsen over time. Those with knee osteoarthritis can still enjoy the activities they love. Prolotherapy injections can help you play with your grandkids, walk your dog, ride your bike, and so much more. Talk to Dr. Prom today about whether or not prolotherapy injections are right for

Saunora Prom, DO, CAQSM

About Saunora Prom, DO, FAOASM

Saunora Prom, DO, FAOASM started Tidewater Sports & Osteopathic Medicine, Greenbrier in 2011 to provide the Hampton Roads area with a variety of interventions for orthopedic issues and with a vision to bring non-surgical options to the forefront of orthopedic medicine. As many musculoskeletal issues do not require surgery, Dr. Prom first strives to find a true root cause of pain and the right personal treatment for his patients. As a sports medicine specialist, he is an ideal physician for the “weekend warrior” and “industrial athlete”, as well as the non-athlete; including those who wish to become active or begin an exercise program. He also provides the latest in concussion treatment, including ImPact testing and OMT.

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