Ligaments help to provide stability in the joints. They prevent the joint from moving more than the normal range. Some people have lax ligaments that allow more than normal movement, often spoken of as being double jointed. In the spine there is a complex arrangement of ligaments which allow flexibility in some directions and produce restraint in others. Sometimes ligaments can be overstretched or even torn (as in a sprained ankle). The ligaments may then not control the joint adequately leading to instability which may put abnormal stress on the joints and discs in the spine.
Prolotherapy works by stimulating the body to make new fibres which are laid down within the substance of ligaments, thickening and strengthening them. The solution phenol 2%, dextrose 30% and glycerol 30% is mixed with local anaesthetic and a small amount injected into the ends of the ligaments close to their attachment to the bone. This initially provokes inflammation that attracts cells that make collagen fibres in the area. Over the ensuing weeks these fibres are incorporated into the existing ligaments. Each ligament has to be stimulated three or four times at intervals of a week in order to produce sound fibrous development. The proliferant solution mixed with local anaesthetic is injected into ligaments or joints causing inflammation that attracts cells that lay down more collagen fibres. Over the ensuing weeks the fibres are incorporated into the existing ligaments making them stronger and tighter. Usually several treatments are needed to get the full benefit.
Prolotherapy may help many patients but is likely to be particularly helpful if the patient is hypermobile (very stretchy) has joints that tend click or where osteopathy, chiropractic or physiotherapy has helped short term but does not seem to produce long lasting benefit.