Prolotherapy (aka Subcutaneous Prolotherapy or Neural Prolotherapy)
Prolotherapy (also called Neural or subcutaneous Prolotherapy)
involves the injection of dextrose into the subcutaneous tissues to
induce healing. This is contrasted to traditional Dextrose or
PRP Prolotherapy whereby Prolotherapy solutions are injected into
ligament and tendon attachments onto bone (fibro-osseous junction
injections). Research into the healing effects of this type of
Prolotherapy have primarily been done by a family physician from New
Zealand named John Lyftogt, MD. 1,2,3 Dr.
Lyftogt is the main proponent and teacher of this type of Prolotherapy.
Herdener received extensive lecture and hands-on training
directly from Dr John Lyftogt, MD in 2013 , the creator and
developer of this valuable pain healing modality, Neurofascial
types of conditions does Neurofascial Prolotherapy help?
regard to published studies it is clear that Neurofascial Prolotherapy
(NFP) helps decrease the pain of Achilles tendinopathy, chronic low
back pain, shoulder or rotator cuff injuries, knee pain and elbow
pain. For doctors, such as Dr. Larry Herdener, Neurofascial Prolotherapy
can be used alongside any condition that can be helped with Hackett-Hemwall
Prolotherapy (HHP). Because NFP and HHP work by different
mechanisms they can diminish the pain of similar conditions, so they
can be given together or separately.
treated with Neurofascial Prolotherapy:
- Degenerative joint disease
- Ligament Sprain
- Neurogenic pain
- Chronic musculoskeletal pain
Prolotherapy vs Traditional Hackett-Hemwall Prolotherapy?
a physical examination, most people with chronic pain have tenderness
over areas of ligament weakness. This is because most chronic pain is
caused by joint instability from ligament laxity. In these
situations tender points are areas where ligaments attach to bone.
Sometimes tender points or areas of pain are located in muscle bellies
or areas where small subcutaneous nerves are located. In these
latter situations, Neurofascial Prolotherapy on these tender points
could be indicated. An example of this is when a person has
trauma to the medial side of the knee. In such a situation, a sprain
of the medial collateral ligament could have occurred and would be
tender upon palpation. In this situation, HHP would be used to
stimulate repair of the medial
collateral ligament (and
also the medial meniscus if indicated). But just as likely would
be a stretching, shearing or tearing of the saphenous nerve, also
located on the medial side of the knee. In this latter
situation, the person would be tender over the saphenous nerve and
would need NFP to the saphenous nerve to decrease neurogenic
inflammation. Once the saphenous nerve regains its own health, it
would be able to function properly to stimulate health maintenance and
health renewal to then relieve the pain.
a series of medical lectures in the 1860’s, John Hilton noted in his
study of anatomy that often the nerve that innervates a joint also
tends to innervate the muscles that move the joint and the skin that
covers the distal attachments of those muscles. For example, the
musculocutaneous nerve supplies the elbow joint of humans with pain
and position sensation. It also supplies the biceps brachii and
brachialis muscles as well as the forearm skin close to the insertion
of each of those muscles. What Dr. Lyftogt found is that patients with
chronic elbow pain often need subcutaneous Prolotherapy (NFP) to this
nerve and other nerves around the elbow to resolve chronic elbow pain.
The nerve supply to the elbow when inflamed not only causes elbow
pain, but can also contribute or be the sole cause of degeneration of
the elbow and the structures that support (ligaments) and move the
elbow (muscles and tendons). Thus to assist regeneration of
these degenerated structures, NFP is given to decrease the neurogenic
inflammation, so once again the musculocutaneous nerve (and other
elbow nerves) can supply “normal” health maintenance and health
renewal to the elbow joint and structures around the joint.
- Lyftogt J. Subcutaneous prolotherapy for Achilles
Musculoskeletal Medicine Journal. 2007; 12:107-109.
- Lyftogt J. Prolotherapy for recalcitrant lumbago. Australia’s
Musculoskeletal Medicine Journal. 2008; 13:18-20.
- Lyftogt J. Subcutaneous prolotherapy treatment of
refractory knee, shoulder and lateral elbow pain. Australia’s
Musculoskeletal Medicine Journal. 2007;12:110-112.