Structural Basis of Joint Instability as Cause for Chronic MusculoskeletalPain and Its Successful Treatment with Regenerative Injection Therapy(Prolotherapy)

摘要

Joint dysfunctions and associated musculoskeletal pain are among the most common medical complaintspresented to clinicians. Ligaments are collagenous fibrous structures that are primarily responsible for maintaining smoothjoint motion, restraining excessive joint displacement, and providing stability across the joint. Ligaments also act assensory organs for the joints and have significant input to pain sensation. When ligaments are subjected to forces beyondtheir normal range of motion, injury and failure occur, resulting in joint laxity (looseness or instability), and subsequentdisruptions in the balance between joint mobility and joint stability. These dysfunctions can result in joint pain and thedevelopment of osteoarthritis. Several strategies have been employed over the years in attempts to improve jointinstability from ligament injury; however, some of the standard therapeutic approaches (drugs, corticosteroid injections,and surgery) employed to address these problems have not been very effective because they often do not address theunderlying cause of the problems, and in fact can inhibit ligament healing and restoration. For these reasons, there iscurrent and growing interest among patients and clinicians in prolotherapy, an alternative therapeutic modality that canreduce or eliminate pain by stimulating the natural regenerative processes in and around the joint to facilitate therestoration of degenerated ligaments and tendons to a healthy state, improving joint support, function and reducing pain.This review presents current evidence from clinical studies demonstrating that prolotherapy is a significant and effectivealternative treatment modality for people with ligament-related injuries and resultant joint instability.