Simply defined, prolotherapy—short for proliferation therapy—is a treatment that stimulates the repair of painful areas. It has been around since the 1930’s and in a nutshell it’s an injection treatment that stimulates repair of musculoskeletal injuries and pain. It can take different forms like platelet-rich plasma, and stem cell prolotherapy, which uses autologous sources of stem cells as a source. The body is a stimulus response machine that is programmed to heal, but with chronic musculoskeletal pain there’s no continuing stimulus to provoke healing. What prolotherapy does is it tricks your body to go to those areas that haven’t healed and get them healing. It stimulates the repair of painful areas that haven’t healed. It does this by irritating the affected area in a directed and specific manner that creates an over-response that stimulates healing.
Prolotherapy can definitely be done in primary care offices. In fact, it’s taught in the family medicine program of some programs. For instance, the University of Wisconsin School of Medicine offers it in their family medicine program and they give a course every year to family doctors. But some doctors, of course, aren’t really that interested in learning it or don’t have time to learn it and in those cases at least if they know about it they can refer. In terms of contraindications, I would just say the person has to be healthy. They have to have no reason that would prevent them from healing. For instance, they can’t have an underlying condition that would prevent them from healing, such as uncontrolled diabetes. But as long as those conditions are under control, and the patient is healthy, has a desire for improvement, and understands the process that they’re going through, they are good candidates. I would just say there are certain things that prolotherapy can’t do, but in a general sense there’s a lot it can do.