Can you heal the SI joints without prolotherapy?

Hi everyone!

I had a really interesting question from a reader recently, and I wanted to pass along my answer to you.

A. wanted to know if I’d ever tried prolotherapy, or any other forms of regenerative medicine.

He wrote, “I have found that if the problem is ligament laxity, then swimming (I have started this month after your suggestion) could maybe relieve some pain, but not heal the SI joints completely, because the ligaments will still be loose.”

He actually makes a great point here, and it’s one that I wanted to address.  So here is my answer:

Hi A.,

I’m so glad to hear my blog was helpful!  I actually haven’t tried regenerative medicine myself.  I was able to achieve what I considered to be an acceptable amount of healing through the more conservative measures I write about on my blog.

What you say about ligaments is true– once they’re sprained, they do not completely heal on their own.  In my case, I was able to strengthen the surrounding muscles enough that they took over for the ligaments, and I didn’t notice a difference in my day to day function.

With that being said, I know my ligaments will always be vulnerable.  It’s like the common saying after someone sprains their ankle, “Once you sprain it for the first time, you’ll always be more likely to sprain it again.”  The same is true for the SI joint.

There are things that, even now, I simply won’t do, because I know they could throw my joint out of place.  For example, I won’t lie with my pelvis or back on a foam roller, no matter how stable I get.

I’ll always be cautious with massage, as well.  It took me a long, long time to find my current massage therapist, who’s really great– and even then, it took us several visits to figure out what did and didn’t work for me.  I found that a lot of massage techniques, even if they’re technically working on the upper back– can affect my SI joints, depending on how the force from the therapist’s hands is travelling through my body.  So that’s another thing I’ll always be cautious with, no matter how stable I seem to be.

The funny thing about the SI joint is that sometimes, the things that affect it aren’t what you think.  So, while I’ll never lie down on a foam roller, I have gone for relatively gentle 2-3 hour hikes and had no trouble at all.  Everything about this joint comes down to how you’re holding your body weight, and how force is travelling through the joint.

So personally, I’m okay with where I am now.  Because I was able to achieve a level of stability that lets me comfortably live a normal life, I didn’t feel it was necessary to pursue any additional procedures.   I know that an important part of maintaining my recovery will be keeping my strength up.  But I am really happy with where I am, because for years, I never dreamed I’d get this far.

This is a personal choice each individual person has to make– whether they feel the cost-benefit ratio of pursuing additional treatments works in their favor.

Prolotherapy can have risks and side effects.   I have seen several people say they did not feel it was worth the temporary period of pain and inflammation it caused– that they felt that set back their healing, more than any benefit the injection actually provided.  So for me, since I felt like my joints were stable, I didn’t feel it was worth risking a potential setback.

However, I do know other people that swear by prolotherapy.  So, if you’re not having luck with conservative treatments like physical therapy and strengthening, I’d definitely recommend checking it out.  This is a great prolotherapy Facebook group where people discuss all of these issues in detail.

And of course, the purpose of this post is not to convince you whether or not to pursue prolotherapy, one way or another.  I’m simply trying to share my thought process with you, and that I believe it is possible for some people to achieve a significant amount of healing through strengthening, stretching, and gentle joint mobilization.

So before you make the decision to undergo something more invasive, whether it’s prolotherapy, radiofrequency ablation, or SI joint surgery, remember to weigh the potential benefits versus the potential costs.

It’s probably a good idea not to pursue any more aggressive forms of treatment until you’ve worked with a good PT, and had the chance to see for yourself if some of the more gentle techniques (strengthening, stretching, taping, joint mobilizations) will be enough to accomplish your goals.

However, if you do decide to try prolotherapy, it definitely has helped a lot of people, so all the power to you!

I hope this post was helpful!  If you have any questions, please feel free to leave a comment below!