A reader asked me if I’d ever had prolotherapy yesterday, and since I’ve been meaning to write about it for a while, now seems like the right time to put this out there!
What is prolotherapy?
Prolotherapy is a relatively new form of treatment, meant to speed the healing of sprained ligaments.
It involves an injection of special substances into the specific area you want to treat. These substances (there are a few different options, but usually it’s a solution of sugar water) cause the body to devote more resources than it normally would in order to try to repair those ligaments. The goal is to reduce inflammation and cause ligaments that have been stretched out to tighten back up, in order to do the job they were meant to do.
Prolotherapy treatments are not yet widely available, and, to an extent, are still in the research stages.
To be honest with you, for a while I thought of prolotherapy as something that was too “out there” for me. I’ve come to feel that I’ve wasted a lot of time and money on “alternative” treatments which almost never amounted to anything, so now I basically try to stay on the beaten bath. (I have had to go somewhat outside of the box to find answers for the SI joint, but I do make sure everything that I do is based on some kind of legitimate research).
My opinion of prolotherapy changed once my regular doctor told me that there was a well-respected doctor at an established hospital in the Boston area who was involved in prolotherapy research, and offered treatments at her office.
I normally don’t give out the information of places I go on my blog, but in this case, I feel comfortable telling you that doctor is Dr. Joanne Borg-Stein, who practices at Newton-Wellesley Hospital and Spaulding Rehabilitation Hospital in Wellesley.
I found Dr. Borg-Stein to be really smart, kind, and very informative. She told me that although prolotherapy doesn’t help everyone, it has made all the difference for some of her patients. (If you want to know more about Dr. Borg-Stein’s research, here is an interesting interview with her at the Journal of Prolotherapy).
We talked for a while. I told Dr. Borg-Stein about my problems; how they started, and how I’d been going to the chiropractor for almost five years, and none of my adjustments ever seemed to permanently stick.
At first she seemed to think prolotherapy could be the missing piece for me.
However, there was one key detail that I (luckily) thought to mention that made her completely change her mind.
I asked her how important it was for the SI joints to be in place during the procedure, and for them to stay in place afterwards. She said it was very important– the injections were going to cause the ligaments to tighten up, and it was important that they tighten up holding things in the right place. In fact, she explained that many of her patients came straight from the chiropractor, if they were going to be receiving injections in the SI joint.
This is when our plans came to a dead halt. I told her there was no guarantee my SI joints would still be in place by the time I got there from the chiropractor, or that they wouldn’t bounce out of place on the way home.
I have to be honest with you– the look on her face at that moment made me realize that I might be an extreme special case, in terms of how hypermobile my SI joints are. I got the impression that no patient had ever told her something like that before.
I had known for a long time that many of the joints in my body are hypermobile– the orthopedist who performed my surgery for compartment syndrome had told me this.
Since there isn’t really a clear or easy way for a physician to assess the SI joints for hypermobility, I hadn’t really thought about it too much before, in terms of these joints in particular.
I asked Dr. Borg-Stein about it, and she agreed with me. Through luck of the draw, I must have just been born with bone shapes that didn’t fit together in a particularly stable way. It had never been a problem before my injury, because I had enough ligament and muscle strength to compensate. But now that both of those had been diminished, my unstable joint shape was now much more of a factor.
We agreed together that, in my case, prolotherapy could possibly backfire, and that it was not worth pursuing.
However, I really appreciate her time and honest opinion. If you think prolotherapy might help you, I would definitely recommend looking into it! And, of course, if you are in the Boston area, I definitely recommend consulting Dr. Borg-Stein.
In case you’ve just stumbled upon my blog, I want to reassure you that I did end up getting better without prolotherapy (or surgery!). For more on how this happened, I’d recommend starting in these two places:
If you want more information on prolotherapy:
I really recommend this SI joint Facebook group, where a lot of people discuss their experiences with it.
You can check out this brief article by Dr. Borg-Stein
The New York Times: Injections to Kick Start Healing
The Boston Globe: Targeting sports related injuries with new treatments
Additionally, here is a great blog I just found: Recover Your Stride, written by Jim Hansen, a patient who received successful SI joint prolotherapy injections from Dr. Borg-Stein. He offers a lot of great information, and a different perspective (as someone who was actually able to receive the injections!). I found the video above thanks to him as well.
That’s all for now! If you have any questions, let me know!
4 thoughts on “What is Prolotherapy? (and why I didn’t end up having it).”
My si Joint is unstable after exercising for almost two years and loosing 46 lbs. My muscle strength is excellent. Yet I am in pain every day all day. A physiatrist gave me exercises different from my PT which has greatly reduced my joint from going out. I am about to try Prolotherapy hoping it will work. What I have a hard time with is if your Joint is mobile as you state prolo would help tighten your ligaments. Even if it is out of place during or after the procedure it can always be put back in place. Once in place and the prolo worked over time it should stay there. Same concept as strengthening your muscles by swimming.
Hi Dave, thanks for your comment! Actually, I think you are probably right about prolotherapy working whether the joint is in place or not. Since I wrote this post I had another reader reach out to me about her own prolotherapy consultation, and her doctor said the same thing. I wrote an updated post about it, which I meant to link to here: https://sijointsaga.com/2017/12/21/prolotherapy-sacroiliac/ I wanted to leave this post up because this was my own experience, and because the doctor I saw is very well-respected. Hopefully I’m not steering people away from prolotherapy by doing so. I think I will edit this post and make things more clear.
Anyway, thanks so much for sharing your thoughts! I’m glad your physiatrist was able to give you some helpful exercises. Wishing you the best of luck moving forward!
Dr. Joanne Borg-Stein isn’t the end all be all. There are other prolo doctors out there. With my experience: Dr. Borg Stein is indeed very kind and informative, however – is very selective on her patients and selective on the areas that she treats, and does not practice comprehensive prolotherapy like you may have seen Dr. Hauser do online. All the surrounding ligaments around your SI should be treated as well and a lot of solution needs to be used. Not just a couple ligaments in your SI, or a couple ligaments in your lower back. You must receive full comprehensive treatment to all ligaments and tendons that could be pain generators. Expect at least 10-15+ injections at least – or the doctor isnt practicing the comprehensive method.
I would get a 3rd opinion and look into some postural work/strengthening in conjunction with prolo.
Hi Jon, thanks for the info! It’s very interesting (and, unfortunately, confusing for patients) how many different treatment models there are out there! I appreciate you sharing this perspective.