Dear Doctor,

I’ve heard that Regenerative Injection Therapy could help with arthritis.  What can you tell me about this?

Regenerative Injection Therapy (RIT), also known as Prolotherapy is a treatment for joint pain that has been studied and practiced by physicians since the 1950’s.   RIT is performed by orthopedic, osteopathic and naturopathic medical doctors specially trained in these types of injections.  Many studies have been done on RIT with more than 500,000 patients studied.  With time, knowledge of RIT has increased and it is currently being practiced at Yale University Hospital, The Mayo Clinic in Rochester, and Scripps Institute in California. The American Academy of Pain Management endorses RIT for chronic unresolved musculoskeletal pain.

Chronic musculoskeletal pain is the number one cause of chronic disability in America and the leading reason for patient visits to physicians.  Treating musculoskeletal pain can be difficult.  Conventional treatment options are at times insufficient to restore function and reduce pain.  Physical therapy, manipulation, drug treatment, corticosteroid injections and surgery can be beneficial in certain circumstances.  When they are not successful, however, patients are often left without options.

RIT gives ligaments and cartilage a second chance at healing and is often described as “anti-aging medicine” for the joints.  When a joint is injured ligaments and tendon insertions are “strained”.  This causes an inflammatory response, a critical phase of healing.  Inflammation at a site of injury clears dead cells, promotes capillary growth and restores damaged tissue.  However, there is the misconception that with time sprains and strains will heal completely.  In fact, post-injury healing of ligaments and tendons is only 50-70% of pre-injury strength.  When ligaments are lax, joints become unstable and degenerative changes occur which cause osteoarthritis.  For example, if one of the ligaments in the knee were strained, the knee joint is predisposed to early onset of arthritis.  Because RIT gives the ligament and cartilage a second chance and healing, the ligament is strengthened, the joint is stabilized and the course of arthritis is reversed.

To determine if a person is a candidate for RIT a complete history and physical exam are done along with lab tests and X-rays as needed.  The joint is evaluated and the site of degeneration is determined.  If there are no contraindications, a solution of dextrose, procaine, B12 and Glucosamine sulfate is introduced to the ligament or joint.  This launches the healing cascade leading to deposition of new, better organized collagen and restoration of joint health and function. 

An average patient requires 3 treatments spaced one month apart.  People with certain conditions may be contraindicated for RIT.  Additionally, smokers, those over 85 years old and patients with Fibromyalgia or disease associated with poor tissue healing may have less than optimal responses.  These people may benefit from a course of nutritional supplementation prior to treatment with RIT.

Clinical success rates for RIT are 85% for resolution of chronic pain and dysfunction.  This makes RIT is a treatment with great potential benefit for many.