Prolotherapy is another type of injection therapy, but differs from trigger point injections because in the case of prolotherapy the target tissues are the tendons and ligament attachments of the joint (as opposed to the muscle). Substances utilized are typically procaine, dextrose, and methylcobalamine (vitamin B12), and the purpose of the therapy is to strengthen weakened tendons and ligaments, and relieve pain. The intent of the treatment is to create inflammation at the injection site, which causes an increase in stem cells, platelets, and other growth factors. In addition, the inflammatory response is the stimulation of the immune system’s own healing mechanism to produce collagen and cartilage. The new collagen and cartilage strengthens and restores joints and supporting soft tissue, and thereby helps to reduce or eliminate many different types of pain.
We have found that in many cases, tendon or ligament weakness causes associated trigger points in the muscle which can increase fragility. Therefore, we often combine prolotherapy treatments with trigger point injections because in our experience it is not uncommon for the prolotherapy part of a treatment to fail as a result of not identifying the restriction or referred pain pattern of the trigger points.
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