Injection Ingredients
Part two of article segment Injecting Relief Prolotherapy Can Effectively Reduce Chronic Pain

Injection Ingredients
Injection ingredients for Prolotherapy consist of compounds that alleviate chronic pain. To trigger the healing process, clinicians use mild chemical irritants, such as phenol, guaiacol or tannic acid.

After injection, these substances attach to cell walls to stimulate the body's reactive healing process. Some clinicians prefer to use chemotactic agents, such as sodium morrhuate, a fatty acid derived from cod liver oil.

Osmotic shock agents—the most frequently used compounds in prolotherapy—are simple compounds, such as dextrose and glycerine. They work by causing cells to lose water, which leads to cellular dehydration and then inflammation, triggering the healing response. Because these ingredients are water-soluble, they're excreted from the body after producing the desired effect.

Practitioners can add cofactors, such as the anti-oxidant mineral manganese. Or they can use a combination of glucosamine sulfate and condroitin sulfate, which may aid arthritic joint repair. Based on the combinations of compounds, these cofactors may increase efficacy.

Research by Liu observed that efficacy. In a study of prolotherapy's effectiveness, Liu injected a 5 percent sodium morrhuate solution into the medial collateral ligaments of rabbits. After five injections, the ligament mass increased 44 percent, thickness increased 27 percent, and strength of the ligament bone junction increased 28 percent.2

Liu's research confirmed the results of an earlier study; Dr. Hackett and colleagues examined the proliferant Sylnasol when it was injected into rabbit tendons.3 After 48 hours, an early inflammatory reaction surrounding the nerves and blood vessels with lymphocytic (immune system cells that remove damaged tissue) infiltration occurred in the area between two tendons and the tendons and sheath.

Two weeks after injections, fibrous tissue existed. Lymphocytic infiltration had diminished, although small levels were present, which indicated that new white fibrous tissue was still being stimulated. One month after injection, fibrous tissue was present, and lymphocytic and fibroblastic (immune system rebuilding cells) activity had diminished. In other words, the rebuilding cells had finished their job and moved on.

Although prolotherapy compounds work differently and motivate the body to heal through various natural responses, the end result is the same: It cures pain by building new tissue and stabilizing joints.

Before administering prolotherapy, you should examine a patient by carefully and gently pressing on an area suspected of causing pain. You'll know where to apply the prolotherapy injection when your touch elicits an intense pain reaction—a trigger or tender point.

Most of the prolotherapy solutions have a "double-edged" effect and should produce anesthetic and proliferant qualities. For example, the anesthetic agent alleviates the "pain trigger" and lets you know a solution was placed in the proper area. Simultaneously, the proliferant agent begins strengthening ligaments and tendons at the trigger point or tender point site.

Injections at trigger points cause irritation that stimulates the body's natural process for repairing damaged tissue. It does so by causing an influx of fibroblasts and chrondroblasts, the healing cells that create collagen and cartilage. Joints are gradually pulled back into proper alignment as newly produced collagen reinforces muscles, tendons and ligaments. Then, as collagen shrinks, it tightens the joint capsule and prevents excessive, unnatural movement.

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