In 1937, Gedney published “The Hypermobile Joint,” the first known article about Prolotherapy (then called “sclerotherapy”) in the medical literature. The 1937 article gave a preliminary protocol and two case reports - one of a patient with knee pain and another with low back pain - with both successfully treated with this method. Gedney followed up this paper with a presentation at the February 1938 meeting of the Osteopathic Clinical Society of Philadelphia which outlined the technique. The solutions used then (and now) are primarily dextrose-based, although other formulas are used and can be effective. Prolotherapy is practiced by physicians in the U.S. and worldwide, has been shown effective in treating many musculoskeletal conditions - such as tendinopathies, ligament sprains, back and neck pain, tennis/golfers elbow, ankle pain, joint laxity and instability, plantar fasciitis, shoulder, knee pain and other joint pain. It has been endorsed by C. Everett Koop, the former US Surgeon General who was helped by it himself as well as practicing it.
Prolotherapy works by causing a temporary, low grade inflammation at the injection site, activating fibroblasts to the area, which, in turn, synthesize precursors to mature collagen and thus reinforce connective tissue. It has been well documented that direct exposure of fibroblasts to growth factors (either endogenous or exogenous) causes new cell growth and collagen deposition. Inflammation creates secondary growth factor elevation. The inflammatory stimulus of Prolotherapy raises the level of growth factors to resume or initiate a new connective tissue repair sequence which had prematurely aborted or never started. Biopsy studies show ligament thickening, enlargement of the tendinosseous junction, and strengthening of the tendon or ligament after Prolotherapy injections.
Prolotherapy is used for musculoskeletal pain or injury which is either unresolved after eight weeks, or (if earlier) where enhanced healing is desired. Prolotherapy works by raising growth factor levels or effectiveness to promote tissue repair or growth. It can be used years after the initial pain or problem began, as long as the person is healthy. Because Prolotherapy works to repair weak and painful joint areas, it is a long-term solution rather than a temporary measure such as drugs or Cortisone.