Prolotherapy is a treatment method that promotes the renewal and strengthening of weakened, worn, damaged, loosened, and weakened tendons, ligaments, and joints by injecting proliferative (cell and tissue regenerating) and irritant solutions (dextrose or mannitol; both derived from natural sugar, lidocaine-local anesthetic) into these tissues, causing proliferation (renewal, growth) and restoring their original strength. The proliferative solutions injected into the joint, at the sites where tendons attach to muscles, and where tendons and ligaments attach to bones, cause inflammation (inflammation), leading to the renewal and strengthening of these tissues. This inflammatory process activates the body's healing mechanisms. Renewal occurs in tendons, ligaments, and cartilage. Subsequently, joint, tendon, ligament, and muscle pains are treated.

HISTORY

Prolotherapy was discovered by American doctor Dr. George S. Hackett in the 1940s, and was later developed and advanced by Dr. Hackett and Dr. Hemwall. It has been successfully and widely used in many developed countries, primarily in the United States, for about 50-60 years. Its history in our country is about 7-8 years.

CONDITIONS THAT CAN BE TREATED WITH PROLOTHERAPY:

Joint looseness and strength loss (laxity)

Tendinitis (chronic pain in tendons and ligaments that do not heal)

Bursitis (inflammation in organs that produce fluid to lubricate joints and tendons)

Arthrosis (joint calcification, wear and tear)

Disorders where muscles and tendons cannot function due to recurrent swelling and pain

Headaches

Back pain (hernia, calcification, post-operative)

Neck pain (hernia, calcification, post-operative)

Back pain (hernia, calcification, post-operative)

Persistent muscle and ligament pain in the spine, rib cage, and ribs

Heel spur and plantar fasciitis

Persistent pain after ankle and wrist sprains

Coccydynia (tailbone pain)

Scoliosis (contrary to popular belief, ligament imbalance is a significant cause in scoliosis)

Osteitis pubis

Knee pain (chondromalacia, calcification, meniscus, ligament injury)

Tennis and golfer's elbow (epicondylitis)

Morton's neuroma

Spondylolisthesis (spinal slip)

Carpal Tunnel Syndrome

Avascular necrosis (necrosis due to insufficient blood supply to bone tissue)

Frozen shoulder

Impingement syndrome (shoulder impingement)

HOW MANY SESSIONS OF PROLOTHERAPY ARE REQUIRED?

The number of sessions required is determined by the patient's and the disease's condition and depends on many factors. Additional problems such as the patient's age, weight, duration of the disease, extent and degree of damage, diabetes, hypothyroidism, metabolic syndrome, obesity, smoking, and alcohol use prolong the healing process. For most patients, 4-6 sessions are sufficient, while some patients show significant improvement in 1-2 sessions, and some may require 8-10 sessions to see results.

WHAT IS THE INTERVAL BETWEEN PROLOTHERAPY SESSIONS AND HOW LONG DOES EACH SESSION LAST?

Injections are administered every 3-4 weeks. However, your doctor may shorten this period to 2 weeks or extend it to 6-8 weeks based on the progress of the treatment. The session duration increases proportionally with the size of the injection area. Each session can last 30-40 minutes. Part of this time is spent on injections, while the remaining time is used to mark the injection sites with a surgical pen and perform manual therapy to enhance the effectiveness of prolotherapy.

ARE PROLOTHERAPY INJECTIONS PAINFUL?

The pain felt during injections is entirely related to the patient's pain threshold. It is very rare for a patient to discontinue treatment due to the pain of the injections. It is not appropriate to continue treatment for such patients who fear injections. Almost all of our patients tolerate the treatment well, comply with the treatment protocols, and complete their treatment.

WILL I HAVE PAIN AFTER PROLOTHERAPY? SHOULD I REST AFTER THE INJECTIONS?

If possible, rest for the first 3 days after prolotherapy. If this is not possible, you can continue your daily activities without straining yourself. Applying heat to the treated area with hot water bags for 15-20 minutes every 3-4 hours during the first 3 days after the injections will increase the benefit you get from the treatment. The temperature should be high, but be careful not to burn your skin. (You can do this by wrapping a thermophore from the pharmacy in a towel).

CAN I HAVE PROLOTHERAPY IF I HAVE HAD ONE OR MORE SURGERIES ON THE TROUBLED JOINT BEFORE?

Having had previous surgery or surgeries on the problematic joint (waist, neck, knee, hip, shoulder, etc.) generally does not prevent prolotherapy. Most of these patients benefit from the treatment. Previous surgical interventions may increase the number of sessions required.

WHAT MEDICATIONS OR SOLUTIONS ARE USED IN PROLOTHERAPY INJECTIONS?

No treatment comes with such a guarantee because many factors influence healing. For example, even after hip, knee prosthesis, or herniated disc surgery, there is no guarantee that you will recover completely and that your pain will disappear entirely. Prolotherapy is not a direct pain treatment but a method that treats the problem causing the pain, ensuring that the pain naturally, permanently, and effectively decreases or disappears.

CAN PROLOTHERAPY BE DONE FOR PAIN RELATED TO INFLAMMATORY RHEUMATISM?

Prolotherapy is not a method that treats inflammatory rheumatic diseases. Inflammatory rheumatic diseases (e.g., Ankylosing Spondylitis, Rheumatoid Arthritis) can be treated during remission periods to address the weakness caused by rheumatism in the joints, tendons, and ligaments, to strengthen the joint, and to reduce mechanical pain.

CAN PROLOTHERAPY BE COMBINED WITH OTHER TREATMENTS?

Prolotherapy can be combined with some other treatment methods. Any method that increases blood circulation enhances the effectiveness of prolotherapy. In our clinic, we combine prolotherapy with Dry Needle Therapy, Neuroprolotherapy, and manual therapy for patients we deem necessary.

WHAT ARE THE SIDE EFFECTS OF PROLOTHERAPY?

Common side effects in prolotherapy include increased pain at the injection site (which is actually expected and desired), bruising, temporary swelling, temporary increase in pain, temporary tingling or numbness in the hands and feet (usually related to manual therapy), muscle spasm, allergic reaction to local anesthetic, syncope, increased heart rate and blood pressure, dizziness, nausea, or vomiting. These side effects are usually very mild and resolve quickly.

IS PROLOTHERAPY A TREATMENT METHOD THAT INSURANCE COMPANIES COVER?

Prolotherapy is not covered by SGK and private insurance companies in our country. Although the cost of treatment is the patient's responsibility, it is an extremely cost-effective treatment.