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The
Growth Factor Basis of Prolotherapy
Dave
Harris, M.D.
For many years, the positive effects of
Prolotherapy were
thought to be mainly based on the concept of
Inflammation and minor damage
induced by the injection of irritating
solutions, with subsequent healing of the
injured areas. The benefit of solutions containing strong alcohol solutions,
ground-up pumice stone, and other such recipes suggest that this is indeed one
of the mechanisms of the strengthening and healing response seen with Prolotherapy.
In recent years, it has become clear that much of the benefit also comes from
the stimulation of the release of Growth Factors in the region being treated.
Some factors shown to be involved in growth and repair include Human
Growth Hormone, Insulin-like Growth Factors I-IV, Transforming Growth Factor Beta,
Epidermal Growth Factor, Basic Fibroblast Growth Factor, Platelet Derived Growth
Factor, and undoubtedly many others. These have been shown to be released during
prolotherapy treatments and appear to be the main basis for repair.
It has been shown that elevating the concentration of Glucose (sugar) by 0.5% in
the fluid surrounding the
fibroblasts induces the DNA machinery to release
numerous factors such as those mentioned above.
The healing effect is a graded, controlled reaction producing repair of the weak
and damaged
connective tissue. When properly applied, Prolotherapy does not
induce scar formation. The bonds are stronger, healthier, and thicker than
before treatment, and with each treatment continue to strengthen, until the
healing is complete and the pain resolved.
Human Growth Hormone (HGH) has been successfully injected into the joint to
induce growth of
cartilage. In our experience of approximately 30 patients, with
knee, hip, and
shoulder
pain, over 50% of the patients have substantial
improvement in pain. There is
x-rays and
MRI evidence of improved joint spacing
in some patients. We reserve this for our patients who do not respond adequately
to standard
Prolotherapy solutions. We have seen no significant adverse effects
from Prolotherapy in general in our practice experience of over 1000 patients,
and Prolotherapy with HGH appears to have similar safety to date. Since
Prolotherapy routinely greatly benefits more than 80% of our patients, HGH is
not used a great deal, but when these efforts are combined, we see that
approximately 90% of our patients with
Osteoarthritis, ligament strain, and
tendinosis have substantial improvement.
The evidence suggests that we are entering a new realm of Prolotherapy in which
additional factors will be discovered that improve upon the excellent results
and low risk of Prolotherapy.
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