Shin Splints

Shin Splints

Shin splints are micro tears of the muscles that attach to the tibia. They have to be distinguished from stress fractures, which could be caused by running and excessive use. Usually this can be done with an x-ray. And if that doesn’t prove positive, you can use an MRI to definitively diagnose a stress fracture. Usually stress fractures are treated with rest. However, shin splints can become chronic. They are due to the pain of the tearing of the attachment of the muscle to the tibia. Prolotherapy helps to heal these conditions in 90% of the cases. It only requires injections each week for five weeks and staying away from anti-inflammatories. You can still continue to exercise, and 90% of the time, you’ll have a good result.

What is Prolotherapy?

Prolotherapy, also called regenerative injection therapy, is a way of injecting an irritant solution into a tendon or ligament in order to cause a reparative inflammatory reaction to help repair the tendon and relieve pain.

How long has prolotherapy been available in the United States?

Prolotherapy was first used by Dr. George S. Hackett, and it was introduced to the AMA (American Medical Association) in 1955. It has been used mostly on the west coast of United States and now it’s moving very steadily towards the East Coast. It’s been progressing over the last 60 or 70 years.

What are some of the most common uses for Prolotherapy?

Some of the common uses for prolotherapy are tennis elbow, groin strains, sacroiliac instability – which is a common cause of lower back pain – tendonitis of any kind, wrist, ankle, knees.

Can prolotherapy help plantar fasciitis?

Yes. I had a professional weightlifter who couldn’t do the strongman competitions anymore because he couldn’t pull a train or a truck because he had to use his feet. He came to me and got 3-4 prolotherapy injections and now he’s back in competition again.

What is the story about tendonitis?

There are a lot of misconceptions about tendonitis. Everyone thinks that tendonitis is an inflammatory process, but in reality over 90% of the diagnoses of tendonitis are actually a damaged tendon and there’s no inflammatory reaction going on. As a matter of fact, what prolotherapy does is try to create an inflammatory reaction to reignite it so that the healing process starts all over again. Classically, we treated these conditions with cortisone injections, non-steroidal anti-inflammatories and such, usually what happens is you get better for a week or two and then the pain comes back again. That’s because the anti-inflammatories have only masked the injury and what’s really needed is to stop anti-inflammatories, treat it with prolotherapy and incite a new healing process, i.e. the inflammatory reaction, which will start the tendons to heal.

Shoulder Issues in Boston

Our practice treats patients who typically have the following shoulder related issues; arthritis, most rotator cuff tears as well as biceps ligament tears. Prolotherapy is not effective for adhesive capsulitis. When treated over a period of five weeks, 80% of our patients have found we have alleviated their pain.

The shoulder joint has the greatest range of motion of all the joints in your body. It is a complex joint with many layers, including bones, ligaments, tendons, rotator cuff, and muscles. These parts are susceptible to damage by degeneration, injury, and overuse.

Here are some common shoulder issues.


The shoulder is the most commonly dislocated joint in the body, caused by accidents, sports injuries, or falls. Your shoulder is a ball and socket joint, meaning that the top of the upper arm bone (humerus) is rounded like a ball. The ball fits into a cup-shaped socket in the shoulder blade. The shoulder becomes dislocated if the humerus fully or partially moves out of the socket.


Bursitis is the inflammation of the bursa, a tiny, fluid-filled sac that reduces friction between joints. The bursa gets inflamed when there is too much friction. This is common in people who perform repetitive actions, such as gardeners, athletes, and musicians.

Rotator Cuff Tears

The rotator cuff is a group of tendons and muscles in the shoulder that stabilize your arm and let you rotate your shoulder. Tears can occur suddenly due to injury, or develop slowly because of overuse or degeneration. You may have a rotator cuff tear if you have shoulder pain at night and
weakness when moving your arm.

AC Separation

An acromioclavicular joint separation is an injury to the ligaments that link the collarbone to the shoulder blade. The separation can result from a direct blow, such as when you play contact sports like football, hockey and rugby. You may notice a bump at the top of the shoulder, limited shoulder movement, or arm weakness.


Osteoarthritis is the most common arthritis that affects the shoulder. This is a degeneration of the cartilage, which is the outer covering of bone. You may feel pain when you sleep, and limited range of motion that affects your ability to finish daily tasks.

How Prolotherapy Can Help Shoulder Pain

Many shoulder problems affect the soft tissues of the ligaments, muscles, and tendons. In this case, rest, pain medication, and ice and heat packs do little to relieve shoulder discomfort.

Prolotherapy, also called regenerative injection therapy, is a way of injecting an irritant solution into a tendon or ligament in order to cause a reparative inflammatory reaction to help repair the tendon and relieve pain.

Prolotherapy is especially effective for rotator cuff tears as it strengthens partially-torn tendons and ligaments. Additionally, osteoarthritis, AC separation, instability of the shoulder, and other shoulder issues respond well to prolotherapy.

Shoulder pain is a nuisance, particularly if it interferes with your daily life. Contact Boston Prolotherapy & Orthopedics today for relief.

Shoulder Pain in Boston

Shoulder Surgery in Boston

Prolotherapy For Rotator Cuff

Rotator cuff tears can be healed with Prolotherapy about 90% of the time in selective cases. If you have a complete rupture of the rotator cuff, with retraction of the tendon, Prolotherapy will not help you. Also, if you have a large spur digging into the tendon, that needs to be shaved down before Prolotherapy is performed. A number of different people develop rotator cuff tears, but especially for those that work in the trades, people who lift weights, and people who engage in racquet sports, Prolotherapy has been effective. If it is suspected that a spur is digging into the rotator cuff, this can be detected with a simple x-ray. If you have to rule out a complete tear of the rotator cuff with retraction, an MRI is necessary.


Osteoarthritis is caused by a combination of genetics, weight and activity - as well as trauma.

It is unusual for people under the age of 50 to have persistent joint pain unless there is some underlying arthritis. This would be defined as wear tear of the cartilage of the joint surface

It has been shown that Osteoarthritis has been treated successfully by prolotherapy 85% of the time. Almost any joint in your body can be treated with the exception of the spinal column itself. Most commonly hips, knees, shoulders, ankles, elbows, wrists, hands and feet.

Most people get at least 50% - if not complete - relief of their pain for a minimum of a year and sometimes much longer. Prolotherapy is not just a pain reliever. The treatment works by stimulating the growth of fibrous tissue which makes a cushion between the bones and fills in the cracks in the cartilage. For this reason, prolotherapy lasts longer depending on the activity of the individual.

Back Pain

Back Pain Boston

Back pain is very uncomfortable for people of all ages, and can many times lead to depression. As we get older it is one of the primary reasons for people not being able to go to work. As we age many of us commonly complain of back pain because of degenerative disk disease. This affects parts of the lower back, including the vertebrae, ligaments, muscles, and nerves.

In many cases, back pain can be alleviated by a variety of treatments including correct body mechanics. Surgery is rarely used to treat pain in the lower back. If you are interested in easing back pain, you may be a candidate for Prolotherapy. This treatment by Dr. Franchi of Boston Prolotherapy & Orthopedics focuses on a series of injections to start the recovery process and promote healing. Dr. Franchi has helped hundreds of patient return to work.

Causes of Back Pain

The back is a series of discs, bones, tendons, ligaments, and muscles. If you have back pain, your medical provider will use imaging tests to determine the cause and the affected area. Common causes of the back pain include:

1. Structural Issues

The human spine features interlocking bones that are stacked on top of each other called vertebrae. The space between each vertebrae is occupied by protective tissue named discs. If the discs rupture, herniate, or bulge, you will experience back pain. People with degenerative disc disease will quite often develop sacroiliac instability which is a very common cause of lower back pain. Although Prolotherapy does not treat disc problems, it is very effective for sacroiliac instability.

2. Strain

Sleeping at an awkward angle, using the wrong form during workouts, and lifting heavy objects can result in a pulled muscle or ligament in your back. You can also strain back muscles from over-activity, such as prolonged sports sessions without intermittent rest.

3. Poor Posture

Many people spend hours every day hunched over their computers and develop back and neck pain. Maintaining proper posture and taking regular breaks from your computer, even for just a few minutes can help immensely.

Your work could also be placing you at a higher risk of developing back pain. Occupations such as construction, warehousing, landscaping, gardening, and working with patients in a nursing home are among the riskiest activities.

When to See a Physician

Many episodes of back pain can resolve after a few days or weeks. It is best to consult a physician if the pain is severe or ongoing. Back pain can be accompanied by other symptoms that warrant medical care, including:

1. Sudden Weight Loss

If you lose a lot of weight unexpectedly without trying, you should have your back checked by a physician.

2. Fever

Back pain that is accompanied by fever can indicate a severe infection. Sweats, chills, and other flu-like symptoms can also indicate an infection.

3. Trauma and Injury

If your back pain results from a car accident, sports injury, serious fall, or another severe trauma, you should immediately consult a doctor.

4. Numbness or Tingling Sensation

Shooting pain down your legs or arms is an indication of nerve compression in your spine, and you should call your physician as soon as possible.

5. Loss of Bladder Control

Loss of bladder control is an emergency and may indicate cauda equina syndrome. It requires immediate attention and you should go as soon as possible to an emergency room.

Back Pain Treatment

Some common treatments include:

1. Medication

There are many over-the-counter remedies available to relieve back pain. After working with your pharmacist and the pain persists, it could be time for a medical evaluation. Your physician may recommend analgesics, muscle relaxants, and NSAIDs to reduce inflammation. Some practitioners may use cortisone injections to relieve sciatica, but this is only a short term solution and treatment for pain relief.

2. Therapies

Physiotherapy is effective at improving strength and flexibility. A physical therapist will stretch your back muscles and ease your back pain. This type of treatment will be more effective when paired with low-impact exercises such as cycling and swimming. If your back pain is interfering with everyday activities such as tying your own shoes, getting dressed and working at your desk, it’s possible that your physician or massage therapist may recommend supportive devices.

At Boston Prolotherapy & Orthopedics, we have found an 80-90% success rate in using Prolotherapy for back pain arising from sacroiliac, cervical facet, and interspinous ligament instability. Prolotherapy treatment will promote the rejuvenation of the torn ligament and ease your back pain.

Prolotherapy Treatment Process

Walk me through the process.

When you come in, I examine you to make sure that prolotherapy is indicated. I may take an x-ray to make sure there’s not some other source of your pain that I can’t solve. Then, we use sterile technique, and I use a 50% dextrose solution with lidocaine so it doesn’t hurt as much. I give the injections in the appropriate areas.

The first office visit takes 15-30 minutes. But after that, once we know your problem, you could be in and out of the office in five minutes. I start my office hours at 7:00 a.m.

How do you know where to inject?

A lot of that comes with experience. I’ve had the advantage of being a classically trained orthopedic surgeon. So, I’ve seen the anatomy of 1000’s of people from the inside. So I tend to know where things are. I have very good eye-hand coordination and skills, to know where the tendons are supposed to be. So I can coordinate that with my judgment.

You have to apply the needle to the ligament/bone interface – where the ligament inserts into to the bone. You have to know where that is, and you have to know how deep to go with the needle. Obviously, experience counts.

Arthritic Joints

In general, the success rate for the treatment for arthritic joints is 80%. Most arthritic joints will require booster injections a year or two later after the initial successful treatment. We do this at a reduced frequency and cost. The reason for the booster injections is that these injections produce pain relieving fibrous tissue in the joint that will eventually wear out over time.

Ligaments and Tendons

The prolotherapy success rate for patients with torn ligaments and tendons is about 90%, and usually does not require further treatment once the tendon or ligament is healed; unless they are re-injured by a strenuous activity. During a patient’s treatment, we recommend modifying their activities.