Pain management by Prolotherapy and Perineural injection therapy: Non-Surgical Interventional Regenerative Orthopedic Medicine

PROLOTHERAPY is derived from “PROLES” a latin word meaning “proliferation”. It is an injection treatment designed to stimulate the repair of injured connective tissue fibers because chronic musculoskeletal pain results from ligament and tendon weakness or relaxation (laxity). Lax connective tissue undergoes stretching even under normal tension which stimulates the sensory nerve fibers that normally do not stretch. Injecting small amounts of solution within the relaxed ligament and tendon stimulates the production of new fibrous tissue and bone cells to strengthen the fibro-osseous junction. Prolotherapy works as spot welding to stabilize the articulation and permanently eliminate the disability. The most important molecule in initiating and maintaining the pain is the trans-membrane mechano-sensitive non-specific ion channel known as Transient Receptor Potential Vanilloid type 1 TRPV1. These ion channels allow the influx of Na+ and Ca2+ resulting in neuropathic pain and neurogenic inflammation. They are found mainly in small sensory un-myelinated C fibers and some myelinated A? fibers. Lyftogt PIT treats the neuropathic pain and the neurogenic inflammation by blocking TRPV1.