Nonsurgical Ligament / Tendon Reconstruction

Prolotherapy, also known as nonsurgical ligament reconstruction, “prolo,” and Regenerative Injection Therapy, is a proven and effective injection technique for the treatment of chronic pain. Prolotherapy can be useful in treating a number of musculoskeletal conditions, including:

• Back Pain
• Knee Pain
• Hip Pain
• Fibromyalgia
• Carpal Tunnel Syndrome
• Rotator Cuff Partial Tears
• ACL / PCL Sprains
• TMJ Syndrome
• Sciatica
• Post-Concussion Headaches
• Tension Headaches
• Neck Pain
• Shoulder Pain
• Ankle Pain
• Sports injuries
• Golfer’s Elbow
• Frozen Shoulder
• Ligament Tears
• Yoga Overstretch Injuries
• Headaches
• Migraines

• Wrist Pain
• Elbow Pain
• Rib Pain
• Arthritis
• Sprains / Strains
• Tennis Elbow
• Adhesive Capsulitis
• Facet Syndrome
• Herniated Discs
• Scoliosis

  • Whiplash

In fact, prolotherapy can be used to treat any painful joint condition that involves damage or stretch to the ligaments and or tendons.

What is Prolotherapy?

The term “prolotherapy” or “prolo” is derived from “proliferation” because the treatment causes the proliferation (growth, formation) of new ligament or tendon tissue in areas where these structures have become weakened. Ligaments are like tight rubber bands that hold bone to bone, whereas tendons are strong rubber bands that hold muscle to bone. Both tissues, ligaments and tendons, can become weakened with overuse or be injured when exposed to excess stress. Ligaments and tendons only have so much ability to stretch before they tear, and are then slow to heal because of a low blood supply. Resultant pain from the damage to these structures is common because of the high number of nerves that innervate them. Thus, old injuries to ligaments and tendons can still, after many years, be a common source of chronic pain.

Prolotherapy, at the simplest level, uses a solution of dextrose (sugar) and local anaesthetic (procaine, lidocaine), which is injected into the ligament and/or tendon where it attaches to the bone. The sugar in the solution triggers a localized inflammatory response that stimulates blood flow into the area. As new blood flow enters the old injury, nutrients and cells stimulate repair of the tissue. The dextrose is the stimulant but your body has the innate ability to do the healing itself.

What solutions are used in Prolotherapy? Why are there different solutions?

Prolotherapy uses a range of solutions, but the simplest, and often all that is needed, is dextrose with a local anesthetic. All solutions, no matter what they contain, are designed to create an inflammatory healing response and to ease pain. Each patient has an individual response and some will require stronger solutions than others. Additives that can increase the physiological inflammatory response include sodium morhuate, cod liver oil, sarapin, phenol, and pumice. In some instances, where a stronger healing response is needed, the patient will require Platelet Rich Plasma Therapy (PRP). Other patients will respond better to increased local anesthetic to ease pain more quickly. Some patients may require other techniques than Prolotherapy, like Neural Therapy, IMS, Trigger Point Therapy, or Neural Prolotherapy. One of the advantages of seeing Dr. Berghamer is the diversity of techniques he employs to help manage pain.

What technique of Prolotherapy is most effective?

While using the appropriate solution at the optimal strength is important to the success of prolotherapy treatments, technique and skill are crucial to ensure complete resolution. Dr. Berghamer has been trained in Hackett-Hemwall Prolotherapy and uses Applied Kinesiolgy Techniques to further the accuracy of needle placement. Although the technique of prolotherapy is of utmost importance in healing damaged ligaments and tendons, Dr. Berghamer has spent years studying the interrelationship of bones, ligaments, tendons, muscles and fascia. As such, he has developed skills to be able to address not just the damage to ligament and tendons but to all the associated structures and their interactions. Techniques employed include Prolotherapy, Applied Kinesiology, Joint Manipulation, Spinal Manipulation, Neural Therapy, Trigger Point Therapy, Neural Prolotherapy, Platelet Rich Plasma Therapy, Kinesio Taping and Theraband Exercise Therapy.

How long is a course of Prolotherapy treatments?

Most patients typically require three to six treatments, administered from two to four weeks apart, depending on the severity of the condition and a patient’s overall healing ability. Occasionally, a patient may require more than six treatments as well as other therapies as indicated above. Dr. Berghamer has found a combination of therapies to be most effective in treating chronic pain.  Dr. Berghamer believes in comprehensive treatments that ensure all areas of concern are addressed and any obstacles to healing are removed.

Who is a candidate for Prolotherapy?

All joints in the body can be treated with prolotherapy. Anyone with a history of injury and unresolved pain should consider a consultation. If you have pain that arises after standing too long, and then goes away briefly while sitting only to force you to get up again, or if you wake with pain that gets better with movement, or if you have pain that gets worse when you put stress on a joint, you should consider a consultation. Of course, only a physician trained in prolotherapy can determine whether your condition would benefit from it or another method of treatment.

Experience, knowledge and technique lead to results. Contact Dr. Berghamer to assess your pain today.

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Dr. Jonathon Friz Berghamer