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Why do prolotherapists need to use MSK ultrasound?

  • Confirm palpation findings
  • Use a targeted approach
  • Get better outcomes for patients

I have had the opportunity to work with almost a dozen musculoskeletal practitioners who use prolotherapy in their practices. These practitioners are usually Naturopathic Doctors or Osteopaths. Without exception, the prolotherapists who began incorporating both diagnostic ultrasound and guided prolotherapy treatment sessions reported an improved response in their patients.

Prolotherapy, also known as proliferation therapy, is an injection-based treatment used in chronic musculoskeletal conditions. The prolotherapy treatment involves injection of an irritant solution into a joint space, weakened ligament, or tendon insertion to relieve pain. Most commonly, the solution is a blend of dextrose, glycerin, and lidocaine. Treatments are generally given every 2 to 6 weeks for several months in the series ranging from 3 to 6 or more treatments.

In my experience, most prolotherapists have been trained to do a significantly high number of injections (20 to 30 is common) in the area of the patient’s complaint. This is especially true with back pain patients. It appears this technique is employed to “cover all the bases”.

From its foundation, prolotherapy has considered itself to be regenerative medicine. As with all other applications of regenerative medicine, accurate diagnosis and targeted placement is necessary.