Prolotherapy and PRP
Prolotherapy and platelet-rich plasma, or PRP, are both injection treatments used in musculoskeletal medicine, but they differ in their composition and proposed effects.
Traditional prolotherapy generally uses a dextrose solution to stimulate a localized healing response. PRP is prepared from the patient’s blood and contains a concentrated mixture of platelets and associated signalling proteins. Neither treatment is universally preferable. The appropriate choice depends on the tissue involved, the nature and severity of the injury, previous treatments, cost, and the available evidence for the particular condition.
The evidence supporting the use of PRP is significantly greater than that supporting dextrose treatments, but this could simply be an artifact of the greater potential return on investment associated with the research into PRP protocols. The decision to use dextrose or PRP is always based on a conversation between the patient and the practitioner about the particular injury.
Who may not be a suitable candidate?
Prolotherapy may need to be avoided or postponed in the presence of
- An active infection
- An allergy to an ingredient in the injection, although alternatives can typically be substituted
- A significant bleeding disorder
- The use of certain blood-thinning medications, although a stable medication protocol does not prohibit treatment
- Poorly controlled health conditions that may interfere with healing
- Uncertainty about the source of the pain
- Any use of recreational drugs before the visit
- Uncontrolled immune conditions
A complete approach to recovery
As a Naturopathic Doctor, I expect my patients to be engaged in their healing process. Prolotherapy treatments go a long way toward promoting recovery; however, many other factors need to be considered. If a person is substantially unwell, it may be advisable to address this before beginning treatment. When a person is unwell, the body may not have the resources required to heal.
By addressing overall health first, fewer or even no injection treatments may be needed to restore health. Many factors contribute to healing and may also be discussed as part of treatment. These may include specific exercises or stretches, the use of other health modalities to support healing, nutritional considerations and supplementation, and, in some cases, prescription adjunctive treatments.