What is in prolotherapy injection?
Most of this information is derived from the writings of Allen R. Banks, Ph.D. Proliferants used in
Prolotherapy are basically substances that lead to new
collagen formation. Collagen is the naturally occurring protein in the body that makes up ligaments and tendons.
Prolotherapy solutions help strengthen these structures by initiating the first step in the wound-healing cascade, which is local inflammation. Once the
inflammation has begun, fibroblasts are stimulated. These are the cells that make the collagen. New collagen is produced, making the
ligaments and tendons stronger and tighter. The solutions vary in the mechanism by which they cause localized inflammation but, in general, they all act by causing localized tissue damage or irritation, which initiates the influx of inflammatory cells. The exception to this rule is
sodium morrhuate, which probably acts more as a chemotactic (attraction) factor.
Osmotic Proliferants (Solutions)
Osmotic proliferant solutions are the most commonly used proliferants and include
dextrose and
glycerin. These are injected and cause a higher osmotic (concentrated) gradient outside of the cells than inside of the cells. This causes cells to lose water and break. These broken cell particles stimulate an influx of
inflammatory cells and initiate the wound-healing cascade to the specific area. Osmotic proliferants are water-soluble and thus, very safe. Being water-soluble means that whatever the body does not need is excreted out in the urine and is not stored in the fatty tissue of the body. Other proliferants in this class include the
minerals zinc,
calcium, and manganese. The minerals are also cofactors for various enzymes. For instance, manganese is needed for the enzyme superoxide dismutase, which helps the antioxidant status of the body. Since some people believe arthritis is from oxidative damage, some Prolotherapists, including those at Caring Medical and Rehabilitation Services, use manganese in the solution for
arthritic patients.
Irritants
These are substances that are known to directly alter the
proteins on the surfaces of the cells. They act by attaching themselves or their byproducts to the surfaces of the cells at the injection sites and they either damage the cells directly or render them reactive to the
immune system. In either case, the immune cells are attracted to the area and start the immune response. The irritants that are used most commonly in Prolotherapy include dextrose, phenol, guaiacol, tannic acid, and plasma QU (quinine, urea). The
Prolotherapy solution used in the two double-blinded studies was P2G, which included phenol, glycerin, and glucose. We use an
alkaline extract of the pitcher plant called
Sarapin. The exact mechanism of how Sarapin relieves pain is unknown but is felt to
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