Back pain affects countless lives, limiting comfort, mobility, and enjoyment in daily life. In today’s Masterclass, join Robert Soliani, a Physician Assistant with over two decades of experience in family practice, urgent care, and holistic health, as he shares transformative insights for lasting comfort.

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Chronic pain and musculoskeletal injuries affect millions of people, limiting mobility and quality of life. Robert Soliani, a physician assistant with over 20 years of experience, led an insightful discussion on prolotherapy—a treatment that offers hope for those seeking alternatives to surgery and pharmaceuticals. This article summarizes the key points from his class, providing an accessible overview of prolotherapy, its history, benefits, and practical applications.

Understanding Prolotherapy

Prolotherapy is a medical treatment designed to stimulate the body’s natural healing process. It involves injecting a proliferative solution, commonly dextrose (a type of sugar water), into ligaments and tendons to promote tissue repair and strengthen weakened areas. The term “prolo” derives from “proliferative,” emphasizing the treatment’s ability to regenerate and reinforce connective tissues.

A Brief History of Prolotherapy

The origins of prolotherapy date back to ancient Greece, where Hippocrates used a rudimentary technique to treat javelin throwers’ injuries by inducing inflammation to encourage healing. In the 20th century, Dr. Earl Gedney, an osteopathic surgeon, refined the practice after using it to restore function to his own injured thumb. Dr. George Hackett further developed prolotherapy, coining the term and advocating for its use to treat chronic pain and ligament instability. Today, prolotherapy continues to gain recognition as an effective, minimally invasive treatment for musculoskeletal conditions.

Why Movement Matters

One of the key takeaways from Soliani’s discussion is the importance of maintaining movement for overall health. As he explains, our bodies are designed for motion, and inactivity can lead to stiffness, weakness, and degeneration—similar to a car that deteriorates when left unused. Engaging in activities such as walking, stretching, and strength training can help counteract natural aging processes, like muscle breakdown (sarcopenia), and support joint health.

How Prolotherapy Works

When ligaments and tendons become overstretched or injured, they can cause chronic pain and instability. Unlike muscles, which have a rich blood supply and heal relatively quickly, ligaments and tendons lack sufficient circulation, making their recovery more difficult. Prolotherapy injections stimulate localized inflammation, which in turn attracts healing cells, promotes collagen production, and strengthens connective tissues. This process restores function, alleviates pain, and enhances joint stability.

Conditions That May Benefit from Prolotherapy

Prolotherapy is particularly useful for treating:

• Chronic back pain
• Knee, shoulder, and ankle injuries
• Ligament and tendon instability
• Joint pain due to overuse or trauma
• Repetitive strain injuries
• Post-surgical pain, including failed back surgery syndrome

Comparing Prolotherapy to Other Treatments

Many conventional treatments for chronic pain, such as NSAIDs (non-steroidal anti-inflammatory drugs), corticosteroid injections, and opioids, only provide temporary relief and may come with significant risks. For instance, corticosteroid injections weaken ligaments over time, while opioids are highly addictive and contribute to widespread public health concerns. Surgery, though sometimes necessary, carries inherent risks and lengthy recovery periods. Prolotherapy, by contrast, addresses the root cause of pain—ligament instability—without the drawbacks of pharmaceuticals or invasive procedures.

What to Expect from Treatment

A typical course of prolotherapy involves 4 to 6 sessions over several weeks, followed by rehabilitation exercises to improve strength and biomechanics. While the procedure itself may cause temporary discomfort, most patients report significant pain reduction and improved mobility. Costs vary, but dextrose prolotherapy is generally affordable compared to surgical interventions and long-term medication use.

A Personal Perspective on Prolotherapy

Soliani shared his own experience with prolotherapy after suffering a severe back injury. Conventional treatments failed to provide lasting relief, but after undergoing several prolotherapy sessions, his pain subsided, and his mobility was restored. Years later, he has not needed additional treatments, demonstrating the long-term effectiveness of this approach.

Who Can Benefit from Prolotherapy?

Prolotherapy is suitable for a wide range of patients, from young athletes to older adults. Even individuals in their 80s and beyond can benefit, provided they do not have contraindications such as bleeding disorders or infections. Elite athletes frequently use prolotherapy to accelerate recovery and maintain peak performance.

Final Thoughts

Prolotherapy offers a promising alternative for those struggling with chronic pain and musculoskeletal issues. By harnessing the body’s natural ability to heal, this treatment provides long-term relief and helps patients regain mobility and function. As awareness grows, more individuals may find prolotherapy to be a viable solution for their pain management needs.