Understanding Prolotherapy
The first question we usually receive from someone interested in receiving Prolotherapy treatments is: What is Prolotherapy?

Prolotherapy treatments are injections that work with the body’s inflammation process to strengthen ligaments and tendons for long term relief.

Prolotherapy stimulates the body to repair painful areas by inducing a mild inflammatory reaction in the weakened ligaments and tendons by producing collagen. New collagen shrinks as it matures. The shrinking collagen tightens the ligament that was injected and makes it stronger. The inflammation causes the blood flow to dramatically increase in the ligament and/or tendon, alerting the body that healing needs to take place.

Prolotherapy has the potential of being 100 percent effective at eliminating chronic pain, but that depends upon the technique of the individual Prolotherapy doctor and the overall health of the individual receiving it.

One important aspect of administering Prolotherapy effectively is injecting enough of the solution into the injured and weakened area(s), as well as using a strong enough solution. If this is done, the likelihood of success is excellent.

At Caring Medical, we use the Hackett-Hemwall Prolotherapy method. Dr. Hackett, M.D., was one of the original inventors of the technique, and Dr. Hemwall M.D., one of his first “Prolotherapy students”. He, in turn, became a master of the technique and personally trained many of the Prolotherapy doctors practicing today. Dr. Ross Hauser, M.D., the medical director at Caring Medical in Oak Park, Illinois, was Dr. Hemwall’s apprentice resumed his practice upon his retirement.

How is
Hackett-Hemwall Prolotherapy different from other Prolotherapy techniques?

Hackett-Hemwall Prolotherapy is much more comprehensive than other techniques. Hence, the reason we call it comprehensive Prolotherapy! In this instance, comprehensive means that we do not only treat the area that is painful, but also the areas that are causing the pain.

For example, if a patient comes in with pain under the knee cap, and we discover that his cartilage has degenerated, we do not simply repair the cartilage. We also perform Prolotherapy on the surrounding tendons and ligaments in order that they are strong enough to prevent the knee cap from moving incorrectly and wearing away the cartilage again.

We also tell the patient how to exercise correctly to strengthen the muscles that are weak and contributing to the problem. We sometimes even give nutritional advice. This is how Caring Medical’s method of Hackett-Hemwall Prolotherapy is described as “comprehensive”.

We also inject many times as we always address joint instability which typically leads to the condition in the first place.

Our basic solution is dextrose-based and includes many injections rather than one or two injections. Most of the time, we recommend that treatments are given every four to six weeks to allow time for growth of the new connective tissues. The average person requires three to six visits total. The treatments are done in the office and do not require imaging or X-ray guidance or conscious sedation. Many body parts can be treated at the same visit.

Dextrose Prolotherapy
The Hackett-Hemwall technique involves using a safe and simple base solution of dextrose as the primary proliferant, along with an anesthetic (procaine or lidocaine), that is given into and around the entire painful/injured area (many injections vs one injection.) When injected, there is a greater concentration of dextrose outside of the cell than in the cell. This causes the cells to lose water and break. The broken cells stimulate an inflammatory reaction, causing a wound-healing cascade to that specific area.

Comprehensive Prolotherapy also means many Prolotherapy solution options
To make the basic dextrose solution stronger, the comprehensive Prolotherapy method involves having a wide array of solutions available so that each Prolotherapy treatment can be individualized to a patient’s particular needs.

Sodium morrhuate, an extract of cod liver oil, for example, may be added to speed the repair of the injured tendon(s) and/or ligament(s) and is typically used in more severe cases or in athletes who need to return to their sports more quickly.

We also uses added nutrients and/or hormones to facilitate tissue growth. Platelet-Rich Plasma Prolotherapy or Bone Marrow Prolotherapy utilize the patients’ own growth factors to further growth of tissue even more.

Platelet- Rich Plasma (PRP) Prolotherapy
PRP is a form of Prolotherapy involving a blood draw to use your own growth factors in the solution. It is NOT a stand alone treatment because when an injury is severe enough to require PRP in addition to the concerns in the joint, there is also ligament/tendon trouble around the joint. Dr. Hauser uses PRP Prolotherapy at Caring Medical typically for more severe injuries such as a torn labrum or meniscus. Patients are generally seen every four to six weeks like any other Prolotherapy patient.

The PRP process involves drawing blood from the patient’s vein, processing and centrifuging it, and then extracting the platelet rich portion of the plasma and using it for injection into the injured joint. In other words, PRP treatment is done just like any other Prolotherapy treatment, except the solution is plasma enriched with the patient’s own growth factors.

It is very important to have PRP done by a Prolotherapy doctor. Why? Well would you go to a Prolotherapy doctor to have surgery? Or go to a surgeon to get Prolotherapy? Standard dextrose Prolotherapy must also be done in order to treat the surrounding areas around the joint.

Bone Marrow Prolotherapy
Another aspect of comprehensive Prolotherapy uses your own stem cells. When we administer this kind of Prolotherapy, we are typically trying to resolve cartilage concerns or severe osteoarthritis and degeneration. Like PRP, it is administered into the joint along with Hackett-Hemwall comprehensive Prolotherapy to address all concerns.

Bone marrow is extracted either from the iliac crest (hip bone) or the tibia (shin bone) and directly injected into the patient in the area of concern. The benefits of bone marrow Prolotherapy are that it is taken from the patient and immediately injected back into the patient. No additions, no growing, no processing in a petri dish, just your cells back into your body in order to increase cartilage repair and cell growth. We also administers standard Hackett-Hemwall Prolotherapy to strengthen the joint further and treat the surrounding ligaments and tendons.