Physiatry Menu Physiatry Perineural Injections Platelet Rich Plasma Prolotherapy Prolotherapy The Basics Prolotherapy is a treatment style that works to stabilize the joints through injections into the surrounding ligaments and tendons. Patients struggling with chronic pain or reduced mobility and range of motion can benefit from this unique regenerative medicine treatment that utilizes the body’s own healing process, helping to decrease pain and restore function. Dr. Michael Bertram, a board-certified Physician of Physical Medicine and Rehabilitation (also called Physiatry) at St. Elizabeth Physicians, is specially trained and certified in regenerative medicine treatment approaches, including prolotherapy, Platelet Rich Plasma (PRP) and perineural injections. Who does it benefit? As we age, our tendons and ligaments can stretch and loosen, making the joints wiggly. This can occur from natural causes – simple overuse of the tendons or ligaments – or a progressive disease like osteoarthritis. The result of wiggly joints and stretched out tendons or ligaments is pain and decreased mobility. Prolotherapy can benefit patients with a variety of ligament, joint and tendon issues, including: Degenerative arthritis in the joints – including the spine Tendon degeneration or tears – Achilles tendon, rotator cuff, tennis elbow or patella tendon injuries Ligament damage – anterior cruciate ligament (ACL) or medial collateral ligament (MCL) injuries Chronic ankle or knee sprains How does it work? Prolotherapy targets specific spots in the body with ultrasound-guided injections. These injections contain a concentrated sugar solution that causes location irritation and microdamage at the injection site, signaling to the body to get to work in that specific location. These injections start a three-phase healing process: Inflammatory process – this initial phase starts increasing blood flow to the affected area. This phase lasts a few weeks and helps flush unhealthy tissue out of the area. Fibroblastic (restorative) process – this secondary phase forms new blood vessels and collagen in the affected area once the inflammatory process is complete. Maturation (remodeling) process – the new tissue in the affected area becomes stronger and healthier, making the ligaments and tendons surrounding the joint tighter and more stable. Prolotherapy patients can often see benefits after just one or two treatments, although Dr. Bertram typically recommends five to six treatments to fully maximize prolotherapy benefits. John's Story Prolotherapy treatments with Dr. Bertram changed Northern Kentucky resident John Vogel’s life. After working with Dr. Bertram, John has gone from spending all day in his armchair to walking around Disney World pain-free. Learn more about John’s story and how prolotherapy greatly improved his quality of life. Make an Appointment For more information and to schedule an appointment with Dr. Michael Bertram, a specialist in Interventional and Regenerative Musculoskeletal and Spine Physiatry at St. Elizabeth Physicians, please call (859) 957-0052 or click here. FIND A LOCATION A Unique, Comprehensive Approach Prolotherapy is a great non-surgical option for patients who are struggling with chronic pain or limited mobility. Dr. Bertram utilizes a multispecialty-based evaluation during your initial appointment, looking at the entire body instead of just focusing on the painful problem area. By collaborating with physical therapists, chiropractors and other physicians when necessary, Dr. Bertram creates a comprehensive, personalized treatment plan for each patient, helping to improve function, reduce or eliminate pain and improve the patient’s overall health.