Treating musculoskeletal pain
with 'RIT' (prolotherapy) stimulates the body to heal itself.
Regenerative Injection Treatments (RIT) are used for joint, tendon,
ligament, muscle and spinal pain.They have been studied and practiced by physicians
since the 1950s.
More recently RIT done with cell-based therapies using autologous platelet
rich plasma/fat/bone marrow are at the forefront of sports and regenerative
medicine worldwide. The American Academy of Pain Management, American
Association of Interventional Pain Physicians and the American Academy of
Orthopedic Medicine endorses RIT for chronic unresolved musculoskeletal
Chronic musculoskeletal pain is the No. 1 cause of chronic disability in
the United States 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, tendons, and joints 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 to 70
percent of pre-injury strength. When ligaments are lax, joints become
unstable, and degenerative changes can occur, which can lead to
For example, if one of the ligaments in the knee were strained, the knee
joint is predisposed to early onset of arthritis (post-traumatic
arthritis). Because RIT gives the ligament a second chance at healing, the
ligament is strengthened, the joint is stabilized and the predisposition to
arthritis is reversed.
To determine if a person is a candidate for RIT, a complete history and
physical exam are done, sometimes along with lab tests, ultrasound
evaluation, X-rays, CT scans, and MRI's. The joint/tendon/ligaments are
evaluated and the site of damage or degeneration is determined. A detailed
orthopedic physical exam is the most important part of any evaluation.
If there are no contraindications, a solution local anesthetic and some
combination of natural substances (eg. dextrose, vitamin B12, glucosamine
HCL, cell based treatment with the patient's own platelet-rich-plasma,
autologous fat or bone marrow grafts, etc.) are introduced into the damaged
ligaments, tendons and/or joints.
This launches the healing cascade, leading to deposition of new,
better-organized collagen/cartilage and restoration of
ligament/tendon/joint health and function.
An average patient requires 4-6 treatments spaced a 3-6 weeks apart. When
cell-based therapies are used fewer treatment spaced further apart are the
Diabetics, smokers, those over 85, and patients with fibromyalgia or
disease associated with poor tissue healing may have less than optimal
responses. They may benefit from a course of nutritional supplementation
prior to treatment with RIT. It is rare that RIT is contra-indicated due to
a patient's medical condition
Clinical success rates for RIT can be as high as 91 percent, depending on
the location (but not duration!) of the problem. This makes RIT is a
treatment with great potential benefit for many.
E. Fenton, DO. All Rights Reserved. Copyright � 2012 (With Permission)
The AAOM | 555 Waterview Lane | Ridgeway, CO 81432