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Prolotherapy

National Spine Care | Downtown Calgary Prolotherapy

Prolotherapy is also known as “proliferation therapy,” “regenerative injection therapy,” or “proliferative injection therapy.”

It involves injecting a glucose (dextrose) solution into the body, generally in the region of tendons or ligaments for the purpose of strengthening weakened connective tissue and alleviating musculoskeletal pain.

Repetitive strain is thought to gradually stretch out tendons and ligaments which over time leads to pain and injury. Prolotherapy is thought to stimulate the body’s natural healing response to repair these lax tendons or ligaments. Once strengthened, the weak areas would no longer send pain signals.

dr-frank-administering-proloCan an injection eliminate your pain?

For decades, injections of cortisone were used by medical doctors to help reduce pain.  But what if the pain returns?  How often can a person be injected with a steroid to reduce pain?  These days, a doctor will usually suggest no more than 3 injections of cortisone in a year into the spine.  In knees, shoulders or elbows, the advice is usually no more than 3 in a lifetime.  Research studies are continuing to identify the flaw in conventional wisdom regarding cortisone injections.

So what then?  A surgeon is frequently asked to cut open the body part and cut away damaged tissue, or insert a screw or plate to limit the movement of the painful joint.  But, as with many other treatments, there are no guarantees that surgery will eliminate your pain, and there is always a chance the surgery could make things worse.  Is there a chance the surgery will be done and in retrospect, was actually done on a body part that was only partially responsible for the pain?  These questions can only be answered on a case-by-case basis by a qualified and experienced surgeon.  What if the surgeon states that there is no surgical treatment for the problem you have?  Physicians will be happy to prescribe painkillers, but not too strong and not too many!

At National Spine Care, patients are asking us about non-surgical and non-pharmacological alternatives to help reduce their pain. In response, we are pleased our clinical staff includes a Sports and Exercise Medicine Physician to consult on all available non-surgical treatment options.

A growing number of clinics in Calgary are eager to offer these treatments. We are very excited to be ahead of the curve in offering this safe and effective, physician-delivered treatment right here in our office.  Working in close communication with your practitioner at NSC, Dr. Johnson will offer you advise about which non-surgical treatment options are safe and likely to be .

prolotherapy treatment

Prolotherapy Injection

Neural Prolotherapy

Neural Prolotherapy was developed by Dr. John Lyftogt MRNZCGP in New Zealand. This treatment involves a series of injections with a glucose solution, immediately under the skin with a very fine needle, targeting the source of the pain. It can offer a success rate of greater than 75% for most conditions. The technique differs from Classical Prolotherapy in that the injections are given immediately under the skin while taking great care avoiding contact with the most sensitive ligaments and tendons.

Originally developed by Dr. Lyfogt for the treatment of Achilles Tendinitis, this ‘neural Prolotherapy’ protocol was successfully extended to the treatment of tennis elbow, painful knees, shoulders, neck, hips, ankles, muscle injuries, and low back. Results are consistent and two years follow-up studies have shown success rates between 80-100%. The treatment is also less invasive than Classical Prolotherapy.

How Does It Work?

Because neural Prolotherapy does not target tendons, ligaments or joints the question had to be asked what causes the sometimes dramatic decline in pain levels after even a few treatments. It is thought that glucose assists in the repair of connective tissue in the nerves under the skin in a similar way that Classical Prolotherapy stimulates repair of the connective tissue in ligaments and tendons. These skin nerves are now known to be responsible for painful conditions generally identified as ‘neuralgias’ or ‘peripheral neuropathic pain.’

There is now also compelling scientific evidence that the very small nerves innervating the larger nerve trunk, known as ‘nervi nervorum’ are responsible for inflammation of the connective tissue of the nerve trunk and surrounding tissues. Interestingly and surprisingly this fact has been known for over 125 years.

It is also known that this ‘neurogenic inflammation’ differs from conventional inflammation in that it does not respond to anti-inflammatories or cortisone injections. This is one of the reasons why these commonly used drugs are proving to be ineffective in many painful conditions in addition to a growing awareness that their use is not without serious side effects. It is clear from clinical observations on more than three thousand patients and large case series that neural Prolotherapy effectively reverses ‘neurogenic inflammation’ and resolves neuralgia pain.

Treatment Protocol

Treatment typically involves 6-8 sessions of micro-injections just under the skin with a very small needle. Additional treatment sessions are sometimes needed if a patient has prior surgeries, moderate to severe whiplash injuries with widespread pain, and/or significant underlying medical illnesses (diabetes, autoimmune disorder or history of cancer.) A treatment session can usually be completed within 10-20 minutes. The most common side effect of the treatment is the patient may have some brief tenderness at the injection site or a small bruise. Physical activity is not restricted post-injection, with most patients returning to their usual workouts the same day or next day. More than 98% of patients tolerate the minimal discomfort associated with the injections without a problem. The occasional patient however who is needle phobic or quite pain sensitive may not be a good candidate.

Prolotherapy History

Classical Prolotherapy was developed in the 1940s by an American trauma surgeon Dr. George Hackett, using injections of Sylnasol, a sclerosing agent commonly used at the time for shrinking varicose veins. He targeted ‘lax’ or ‘weak’ ligaments with these injections to make them stronger. Hackett reasoned that if ‘weak’ ligaments were the cause of most joint and ligament pain, strengthening them would resolve the pain.

He documented his early success, anecdotally claiming an 80% success rate for the treatment of low back pain as well as many other painful conditions. He published 16 articles and a textbook on this procedure, which laid the groundwork for further clinical research. A growing number of Prolotherapy studies over the last 40 years have indicated good to excellent results from this type of treatment, with doctors in the USA, Australia and elsewhere continuing to use glucose injections (now using more advanced glucose solutions) with no side effects for painful conditions affecting joints, ligaments, and tendons.

More recently, three researchers, Professor Michael Yelland from Australia and Professors David Rabago and K. Dean Reeves from the USA have published some excellent studies published recently, including a randomized control trial for the treatment of Achilles tendinosis (British Journal of Sports Medicine, 2009). Dr. John Lyftogt has also published six level 4 studies in the Australasian Journal of Musculoskeletal Medicine since 2005.

All medically necessary diagnostic and treatment services that may be provided by
Dr. Frank Johnson are paid for by the government under your provincial health insurance plan.

Note: Prolotherapy Treatments are not insured under Alberta Health Care, however, the office visit to Dr. Johnson is covered.


Call us at (403) 270-7252 to
book your Calgary Prolotherapy consultation appointment today!

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