Prolotherapy is the procedure where tissue proliferant are injected into the damaged tissue (ligament, tendon or cartilage) to induce tissue growth. Prolotherapy = Proliferation therapy. As the damaged tissue is healed the pain is reduced. Different types of tissue proliferants had been used with success. When ozone and oxygen mixture is injected as proliferant it is called Prolozone therapy.

History: In 1937, Dr. Louis W. Schultz, published a paper in The Journal of the American Medical Association on the treatment of pain & subluxation of the TMJ. In this paper he described how common TMJ syndrome was, and that the traditional treatments of rest, appliances in the mouth, physical therapy, and surgery were only partially successful. He described a simple method of strengthening the TMJ capsule by injection of Sylnasol, a five percent solution of fatty acid. This was the first true Prolotherapy treatment. The term �Prolotherapy� was coined by George S. Hackett, an industrial surgeon practicing in Canton, Ohio in the 40�s to 60�s. He is considered as the pioneer or founder of modern day Prolotherapy because he brought this technique to mainstream medicine. Dr. Hemwall. Between 1955 until his retirement in 1996, was the main instructor and proponent of Prolotherapy in the United States.

Ingredients of Prolotherapy (tissue proliferant):
1. Osmotic agents like 10%-25% dextrose, glycerin.
2. Agents that attach to the cell wall and stimulates growth like diluted phenol, sarapin, guaiacol, quinine, urea, ozone or tannic acid.
3. Chemotactic agents like sodium morrhuate, a fatty acid derived from cod liver oil.
4. Co-factors like Manganese, Zinc, Vit.C, Growth Hormone, Glucosamine sulfate and Chondroitin sulfate.

How it acts: For many years, the positive effects of Prolotherapy were thought to be mainly based on the concept of inflammation induced by the injection of irritating solutions, with subsequent healing of the injured areas. In recent years, it has become clear that benefit comes from the stimulation of the release of Growth Factors in the treated region. Factors shown to be involved in growth and repair are Human Growth Hormone, Insulin-like Growth Factors I-IV, Transforming Growth Factor Beta, Epidermal Growth Factor, Basic Fibroblast Growth Factor, Platelet Derived Growth Factor, and many others.

Indications: It is indicated in the treatment of different types of musculoskeletal pain, including arthritis, osteoarthritis of knee, osteoarthritis of hip etc. back pain, neck pain, fibromyalgia, sports injuries, unresolved whiplash injuries, carpal tunnel syndrome, chronic tendonitis, partially torn tendons, ligaments and cartilage, degenerated or herniated discs, TMJ and sciatica.

Complications and side effects: These are extremely rare. Main side effects are painful muscle spasm following injection, infection etc.