History of Prolotherapy

Prolotherapy Through The Ages

From ancient Greece to the Roman Colosseum, Prolotherapy has a long and storied history in treating joint pain and injuries. It’s a winding story that involves several pioneers and key personal turning points that shaped the modern landscape of regenerative medicine. Each practitioner of this fabled medical approach marveled how a simple irritant injected into a weakened or injured joint could stimulate a regenerative cascade in the human body. The method showed a remarkable ability to reduce chronic pain in patients suffering from joint injuries or degenerative joint disease, commonly known as osteoarthritis.


Ancient Past

Prolotherapy in Antiquity

Many trace the origins of these injection-based procedures for musculoskeletal joint pain as far back as 400 B.C. when the legendary Greek physician, Hippocrates used a hot poker to repair a dislocated shoulder. Historical records show rudimentary forms of prolotherapy may have been used to treat gladiators whose joints, and flesh was ravished by combat in the Colosseum.

Osteopathic Framework

Interdisciplinary Progress

As the centuries passed, injection therapy evolved within the overlapping and emerging disciplines of herniology (treatment of hernias), dermatology, Sclerotherapy (treatment of varicose veins), and osteopathic medicine – ultimately considered the architectural framework for understanding and treating all musculoskeletal disorders in the human body.



Microscopic Healing

Cell Proliferation

The foundational success of prolotherapy has been attributed to its powerful ability to stimulate cell proliferation in damaged ligaments and tissues after an irritant solution has been injected into the joint space.

Perfecting Injection Therapies

The Golden Age of Prolotherapy

Through the ages, various medical practitioners – using a combination of art, intuition, and experimentation – carefully refined the processes until a golden age in prolotherapy began to emerge in the early 1930s. During this early period of the 20th century, medical science and brilliant individuals concentrated their efforts to decipher and perfect injection cellular therapies which aided local healing cells via inflammation induction.


Taking Shape

Prolotherapy in Research

The intense period of research, collaboration, academic papers, and national conferences by various Doctor of Osteopathic Medicine (or those closely associated with it, including Rice, Biskind and Manoil), helped lay the foundations for modern-day prolotherapy injection therapy which was showing value in treating conditions such as chronic knee osteoarthritis and the multiple pain generators in and around this complex joint.

A Doctor of Osteopathic Medicine

Cometh The Hour, Cometh The Man

However, the key physician responsible for extrapolating the advances made in other medical disciplines and distilling the methods into a powerful dextrose-based injection procedure was himself a Doctor of Osteopathic Medicine.


The Hands of Fate

Adversity Triggers Comeback

Dr. Earl Gedney was drawn towards injection therapies after damaging his thumb joint in a freak accident involving electric sliding doors in the operating room. Although X-Rays showed he had no fractures or dislocation, it was evident his ligaments and tendons were severely stretched. He was told by the best surgeons of his day that he should retire from medicine, a profession he deeply loved and respected. Instead, he recalled a lecture he had attended in his younger days as a medical student focusing on the “restricted motion in lumbar segments.” He remembered asking Dr. Charles Muttart, the lecturer, a question that sparks the development of modern-day prolotherapy:

“What about the treatment of the vertebra that is too freely mobile?”

The aging doctor replied: “That, my young man, is the problem for your generation to solve.”

Dogged Determination

Unlocking Prolotherapy’s Secrets

Indeed, that is exactly what Gedney set out to do eventually connecting the disciplines of non-surgical hernia repair to the non-surgical repair of joints, ligaments, and tendons. He began self-injecting his thumb with the irritant solutions which triggered large-scale inflammation and tissue scarring that eventually gave him full use of his joint. In dramatic fashion, he once again became a practicing physician.



Seminal Prolotherapy Paper

The Hypermobile Joint

But now he had a new mission which was advancing the cause of injection-based therapies eventually resulting in a paper published just before the beginning of World War II: “Hypermobile Joint: a preliminary report.”

The Hands of Fate

Adversity Triggers Comeback

Additional papers followed outlining his success in using Prolotherapy techniques to treat knee pain and lower back pain with irritating solutions. During this time he would also launch the Gedney Osteopathic Hospital in Philadelphia which illustrates the remarkable tenacity, research, skill and passion Gedney held for his chosen profession. He would also self-finance additional research to confirm the efficacy of so-called injection-therapies and “Needle Therapy“ focusing on several areas including the sacroiliac joint in the lower back.


Cementing Progress

The 1950s

The formalization of these techniques coalesced in the 1950s when researchers applied the positive findings from ligamentous tissue healing in animals to new trials involving humans. Specifically it was found that the injection of Hypertonic dextrose solution into joint areas of the human body accelerated healing timelines for patients while also reducing pain. This allowed patients to return to normal lifestyle activities, including sport.

Studies showed that Prolotherapy could effectively treat injured intra an extra-articular tissue evidenced by increased inflammatory markers around the affected joint. In laymen’s terms, this essentially meant that collagen, a structural protein of tissue and bone, was being regenerated at the injection site, a clear signal that positive cellular events were taking place in the human body.


Defining Prolotherapy

Emerging Themes

The medical term “Prolotherapy” also emerged during this transformational era. It was used to describe the proliferation of growth factors in tissue and ligaments; joints and tendons. This was pivotal moment in the growth of regenerative and preventive medicine, all underpinned and solidified by other advances being made more broadly in Osteopathic Medicine, the operating system upon which MedicalMasters.org sits.

The 1950s should also be acknowledged for another key milestone: It was the starting point for a disturbing new trend in American health which would see a surge in knee osteoarthritis or degenerative joint disease (DJD). Up and until this point, knee osteoarthritis was considered a rarity, but changes in lifestyle, sporting activities and work environments would fundamentally alter this state of affairs. The increase in knee replacement surgeries and other invasive orthopedic procedures has risen alarmingly to the extent we are set to surpass 1 million procedures shortly.

Consequently, the intersection of injection-therapy with the field of osteopathic medicine was perfectly timed to face up to the specter of osteoarthritis and minimize the need for orthopedic surgeries in the knee, hip and shoulders. Prolotherapy is by nature a minimally invasive orthopedic procedure when performed by a skilled physician and usually takes less than an hour or two. The same day level one procedure is considered a key tool in both regenerative and preventive medicine since it seeks to stimulate the body to heal itself while also reducing chronic pain.

Even as osteoarthritis began taking hold of America in the 150s, pioneers such as Gedney continued to find new insights into how prolotherapy could have positive microscopic effects on ligaments and tendons.

A Labor of Love

Digging Deeper Into Prolotherapy

Dr. Gedney diligently and expertly applied the osteopathic principles of mobilization and ambulation, along with prolotherapy, to treat lower back pain for patients who were generally told by traditional medicine to lay in bed and move as little as possible. His success was well noted, offering minimal risk compared to that of orthopedic surgery and giving Americans new hope that regenerative therapies held the key to long-term health.

Embracing Osteopathic Medicine

The Functional Approach

His approach and arguably the success, was a consequence of choosing to study and treat anatomy under a branch of medicine known as Osteopathic Medicine, conceived and perfected by Andrew Taylor Stills, MD, following the barbaric conditions he encountered during the American Civil War. When he lost three children to spinal meningitis, Stills concluded that traditional medical approaches were flawed and required a much more holistic, functional and scientific approach to treating human disease, including osteoarthritis, without the use of dangerous pharmaceuticals or invasive surgery. He would advertise himself as a magnetic healer and “lightening bonesetter,” but the medical world would officially call him an Osteopath or a specialist in manipulative medicine, that seemed capable of curing hopeless conditions in patients. Overcoming criticism, naysayers and the weight of traditional medicine, the defining moment in this field would be his establishment of American School of Osteopathy in Kirksville in 1892 which would usher in modern concepts of Regenerative and Preventive Medicine.

Since then generations of Osteopaths, including Dr. Gedney and later Dr. Coleman have graduated from this famous college, all imbued with Still’s caring and scientific approach to treating patients with non-surgical orthopedic techniques, including Prolotherapy. Their ability to challenge the status quo using cellular injection therapies is a testament to the problem-solving skills developed at Kirksville which seek broader, contextual answers to treating underlying causes, not just symptoms.

The value of prolotherapy cannot be fully understood unless one understands its application within the field of osteopathic medicine. Since Osteopaths seek to understand any joint issue within the broader context of the patient history, lifestyle and genetic profile, it gives them an unrivalled understanding of when and which cellular therapy including prolotherapy, Plasma-Rich Platelets, and Stem Cells) to apply to the patient condition.


The Philoosphy

The World According To
Dr Still

This approach makes even more sense when one considers the philosophical position of Dr. Still who founded Osteopathic Medicine. He would tell his students:


I want you to carry a picture of all or any part of the body in your mind as a ready painter carries the picture of the face, scenery, beast or anything he wishes to represent by his brush.

We teach you the anatomy of all its branches, that you may be able to have and keep a living picture before you mind all of the time.

So you can see all joints, ligaments, muscles, glands, arteries, veins, lymphatics, fascia superficial and deep, all organs, how they are fed, what they must do, and why they are expected to do a part, and what would follow in case that part was not done well and on time.

I feel free to say to my students, keep your minds full of pictures of the normal body all the time, while treating the afflicted.


A Meeting of Minds

The Science & The Art

This imploration to his students to consider themselves “artists” may seem at odds with the scientific implications of being a medical doctor, but in fact, it highlights the fluid nature of medicine and the required capacity to explore new themes, disciplines, and technology which may help the human condition. Sometimes you need to against the conventional wisdom, using your intuition and research skills to uncover new ways to help patients.

The tension between science and the artist is what made Dr. Still and Dr. Gedney such powerful surgeons, doctors, and healers using more gentle orthopedic techniques such as manipulative medicine and Prolotherapy. It also demonstrates the operator skill required by doctors to correctly and effectively apply cellular injection techniques including Prolotherapy, PRP and Stem Cell Therapy.

It extends into new cellular healing models including the Vampire Facelift, O Shot, and P Shot, which are currently drawing worldwide attention.

Only a skilled, caring physician with a non-negotiable allegiance to functional medicine can reliably and safely get long-term results for patients using Prolotherapy techniques.

In Dr. Still’s words, the “The key was to find and correct anatomical deviations that interfered with the free flow of blood and ‘nerve force’ in the body.”

Thus, it is in the patient’s best interests for the Doctor to deploy an approach which is minimally invasive, reduces pain, and does not ultimately rely on toxic anti-inflammatory drugs or pharmaceuticals, including cortisone injections, to reduce pain and promote mobility.

The Present

I Stand On The Shoulders Of Giants

These milestone events in Prolotherapy’s history are intimately tied into the evolution of Osteopathic Medicine, highlighting the deep respect and devotion I share with Dr. Earl Gedney and Dr. Still for my chosen field of Regenerative Medicine. I do indeed stand on the shoulders of Giants and continue to learn, adapt and perfect my skills in Prolotherapy and Cellular Medicine.

Dr Steve Coleman Signature