Regenerative Proliferative Medicine, PRP and Dextrose Prolotherapy

People often ask me the to explain the difference between Proliferative or Regenerative Medicine and Dextrose Prolotherapy and PRP. Proliferative/Regenerative Medicine is the umbrella term for the medical modalities of Dextrose Prolotherapy (sometimes referred to as Prolotherapy) and PRP, both of which are used to treat joint pain.

These are the two ways of treating the spine, and the joints. It can help them heal and can take away pain – sometimes pain that has been there for many years.

This article goes into detailed descriptions of what these terms actually mean and how the processes differ from each other.


Dextrose Prolotherapy (aka Prolotherapy)

Prolotherapy is the original treatment that has been practiced for more than 50 years. It was first introduced by two famous physicians, George Hackett and Gus Hemwall. They discovered that by very precisely inflaming the tissues that hold the joints together, the body (that miraculous healer) will repair the damage and heal the joints.

So, they began teaching this way of removing pain to doctors who would listen. They were invited to Honduras (a country that was very short on health care workers) to do their work and teach other doctors. The first step in undertaking this method is to learn where each ligament and tendon starts and ends as well as how to find it using your hands. The learning took place by examining patients and studying anatomy. At this time, ultrasound and MRI technologies were not available.  When MRIs became available, they would joke that the well trained hands were the MRI (My Regional Investigator).

George Hemwall and Gus Hackett passed on their legacy to Jeff Patterson (my mentor). He and his organization, called the Hackett Hemwall Patterson Foundation, are affiliated with the University of Wisconsin. They bring doctors trained in this technique to Honduras each year and teach physicians who travel from all over the world to learn from them.

Training and Teaching at HHP

I started training through this organization approximately 15 years ago and was made an instructor in 2012. It is a very hands-on and intense learning process. Even though I had already been an anatomy instructor, I had to study very hard to understand the subtlety of the biomechanics of the joints and the common sources of pain.

At the time, the practice taught by HHP (Hackett, Hemwall and Patterson) used only concentrated dextrose (sugar water) as a means of inflaming. It was, and is, very safe. Dextrose Prolotherapy is the process of identifying the pain source and then injecting Dextrose into the joint and/or the surrounding ligaments and tendons. The slang term, Prolotherapy, is just a shortened version of this name.

Enter Platelet Rich Plasma (PRP)!

Platelet Rich Plasma is the part of blood that naturally inflames and repairs joints in normal healthy people. After seeing success with Dextrose, I began to use PRP in this same manner in which HHPF trains for Dextrose. PRP provided another more powerful substance to strengthen the structures that hold our joints together. I found it to be highly effective since I started using it approximately 10 years ago.

How to Maximize Effectiveness of PRP and Dextrose

Most other physicians simply inject a single shot of PRP into middle of the joint and don’t treat the adjoining tendons and ligaments. Amazingly, this sometimes works, but it’s not the most effective use of these medical modalities.

In some cases, the milder effect of dextrose is enough. By and large, the strength of PRP used with the comprehensive technique taught by the Hackett Hemwall Patterson Foundation is the most effective. When using PRP, I treat not only the main joint, but also the surrounding tendons and ligaments. This brings the powerful healing substance of your own plasma to the tendons and ligaments. A hypermobile joint can often cause pain and further deterioration of the joint. As a more powerful healing agent than dextrose, PRP can reduce hypermobility and thereby reduce pain and increase healing.

Ultrasound for Precision

Lastly, because precision is really important in addressing joint pain, I began using ultrasound technology to aid visualization nearly 10 years ago. Ultrasound enables me to increase the accuracy of injections into hard-to-find ligaments and tendons. Thus, it adds a means to verify where the treatment is needed as well as increase effectiveness.