Prolotherapy for Dogs

Prolotherapy for back and joint pain in dogs
What is prolotherapy?
Prolotherapy is used to decrease joint pain. Prolo means proliferation, and prolotherapy causes collagen proliferation in ligaments and tendons to make joints more stable. When joints aren’t stable they stretch and distort the nerves and tissues around them, causing pain.

How prolotherapy works
Prolotherapy causes inflammation because inflammation leads to increased collagen deposition.

To cause collagen to proliferate, irritating material is injected into sore tissues. This material creates inflammation, and the inflammation stimulates the body’s natural healing cascade. The first 3 days following injection, white blood cells (granulocytes) come to the area, causing increased heat, swelling, and pain. Then, over the next few days, a different group of white blood cells (macrophage and mast cells) comes to clear the debris. The white blood cell activity stimulates fibroblast cells to release the strong, fibrous connective tissue called collagen. (Fibro = fibrous tissue and blast = cells that build.)

Collagen fibers from many fibroblasts weave together. creating structure that forms ligaments and tendons. If the weave is even, and cross linking is neat, the collagen is strong. If the weave is uneven and cross linking is jumbled, the fibers form collagen scar tissue.

What’s injected with prolotherapy?
Substances injected that cause inflammation include, dextrose, glycerine, cod liver oil, and phenol. In pets, these materials are injected into ligaments and tendons around the spine, elbows, wrists (carpi), and knees (stifles).

Why prolotherapy causes pain
The initial reaction to prolotherapy is inflammation, and the area is expected to be more painful. Inflammation is necessary to stimulate the fibroblastic cells that produce collagen. As collagen is deposited in the area, the joint becomes more stable. The more stable the joint is, the less stretching of surrounding nerves and tissues is caused by movement.

Drugs to avoid if receiving prolotherapy
When pets undergo prolotherapy, they should not use NSAIDs, such as aspirin or Rimadyl, to block inflammation because inflammation is the goal of therapy.

If pets are too uncomfortable to eat, sleep, or exercise normally after prolotherapy, they can be given homeopathic medications or lidocaine injections. Neither homeopathic medications nor lidocaine block the deposition of collagen because they don’t block inflammation.

Who benefits from prolotherapy?
Dogs most likely to benefit from prolotherapy are those with:
· athletic injuries that stretch joint structures,
· genetic tendency to loose joints, or
· genetic tendency to disc disease.

Why prolotherapy is not used to treat arthritis but is used to treat loose joints
Prolotherapy is used to treat lose joints. Often loose joints become arthritic over time, and it’s easy to have the impression that prolotherapy is used for arthritis. It is not. Prolotherapy is to increase tension and solidity of tissues surrounding joints and the spine.

In joints with normal laxity, arthritis occurs because of
· wear and tear,
· bacteria such as the Lyme disease spirochete damaged the joint, or
· the immune system attacks the joint.
When joint pain is due to these problems, prolotherapy is not called for.

On the other hand, when arthritis or disc disease is caused because ligaments and tendons are loose, prolotherapy is used.

Genetic tendency to develop loose joints
For many dogs, loose joints are caused by activities that overstretch joint tissues, but in some dogs loose joints appear to be genetic. These joints do not respond to any the normal therapies, including splinting and acupuncture, but they may respond to prolotherapy or to immune-modulating drugs.

Why prolotherapy is used for disc disease
Many dogs develop disc disease in the “waist” area of back where they have the most flexibility. In areas of increased flexibility, the soft disc material between the vertebral bones is under the greatest pressure. In aging dogs, and dogs with genetic tendency to disc disease, the disc may not be able to hold up to the pressure. For these dogs, prolotherapy may be of benefit.

Summary
Prolotherapy is rarely done in veterinary medicine, but for dogs with lax joints who have not been helped by other therapies, it is worth considering. Prolotherapy will benefit these dogs by increasing joint stability. The more stable the joint, the less stretching of nerves and surrounding tissues, so the less pain these pets will have.