• Hip Pain Boston
    A fully-functional hipbone enables you to move about and perform your daily activities. Mild or chronic hip pain can interfere with routine tasks like getting out of the car and walking down the stairs. Keep reading to discover the causes of hip pain.

    Anatomy of the Hip Joint

    The hip joint consists of two bones: the pelvis and thighbone or femur. It is a ball and socket joint, as the head of the femur sits in a socket area (acetabulum) inside the pelvis.

    The hip articular cartilage reduces friction between the bones, while the synovial membrane provides fluid for lubrication. There are ligaments surrounding the hip joint that link the femur to the pelvis. Other parts of the joint include muscles, tendons, bursae, arteries, and veins.

    Since the hip joint bears a lot of weight, it is vulnerable to wear and tear. With age, the muscles, tendons, and cartilage can become damaged, or bones can break from injury.

    Causes of Hip Pain

    Some conditions that cause hip pain include:


    Osteoarthritis describes age-related cartilage breakdown that is common in weight-bearing joints. The pain may be dull or intense. It often improves with rest and worsens with movement. In addition to pain, osteoarthritis leads to stiffness and reduced range of motion. You may struggle to complete simple tasks like tying your shoe.


    Bursae are liquid-filled sacs that reduce friction when bones, tendons, and muscles rub together. Inflammation of the bursae causes pain that occurs even as you rest. Repetitive activities that irritate the hip joint are the major cause of bursitis. This is more common in women.

    Hip Fracture

    Osteoporosis, cancer, and other conditions make the hip bone brittle and weak. People with brittle bones are more likely to break a hip after a fall or direct blow. Stress fracture is another risk factor, especially among female athletes with bone weakening, menstrual irregularities, and eating disorders. Hip fractures cause severe hip pain and may result in complications like a blood clot in the leg.


    When the tendons attaching bones to muscles become irritated or inflamed, pain and swelling occur. Tendons lose elasticity with age, but tendinitis also results from overuse, lack of stretching, or injury.

    Hip Labral Tear

    The hip labrum is a ring of flexible cartilage that follows the outside rim of the hip socket. It maintains alignment between the ball and socket and promotes the hip’s range of motion. Hip labral tears are common among athletes who perform twisting movements.


    Hip pain may come suddenly, or you may feel a day-to-day dull ache. Often, hip pain is accompanied by a reduced range of motion or limping. The pain may get worse with activity, or it may persist as you rest. You may also feel discomfort in your groin, buttocks, or thigh.


    Your health practitioner will ask about the movements that worsen the pain and observe you in motion. Describe how the hip pain started and how it interferes with daily activities. Imaging tests like MRI scans, X-rays, and CT scans will show the problems with the soft tissues in the hip.

    How Prolotherapy Can Help

    Consider prolotherapy if your hip does not get better with rest, ice and heat therapy, and medications. Prolotherapy describes the injection of an irritant solution that causes an inflammatory response to stimulate healing. The treatment strengthens worn ligaments and tendons, reduces pain, and promotes joint stability.

    Hip pain is mainly caused by degenerative conditions like labral tears, arthritis, and bursitis. Prolotherapy is effective in treating hip pain because it addresses ligament laxity and hip instability.

    Hip Surgery in Boston
    Hip Issues in Boston

  • Hip Surgery Boston

    A painful hip can interfere with everyday tasks and keep you uncomfortable. Hip problems impact everyone, regardless of age, and result from a range of causes, including arthritis, fractures, injury, and compressed nerves. If your hip pain does not respond well to non-surgical options, your doctor may suggest hip surgery.

    Signs You May Require Hip Surgery

    Persistent pain around the hip or groin that gets worse over time may indicate the need for surgery. The pain may radiate down to the knee and worsen with activity. Some patients also have difficulty sleeping due to debilitating hip pain. Other symptoms include:

    • Difficulty moving
    • Reduced ability to do routine tasks
    • Tests reveal advanced joint damage
    • Stiffness
    • Mental distress
    • Inflammation or swelling

    If conservative treatments don’t relieve your hip pain, surgery may be an option. Other patients become frustrated with medication or cortisone injections that only relieve hip pain for a few months. If you are worried about the side effects of pain medications and other treatments, consider alternative treatments like prolotherapy.

    Surgical Options

    The various types of hip surgeries include the following.

    Hip Arthroscopy

    Hip arthroscopy diagnoses a range of hip problems via an arthroscope, a flexible tube with a camera. An orthopedic surgeon inserts this device into your hip joint via small incisions at the side of the hip. Thus, the surgeon avoids making a large cut through the soft tissues to examine the hip joint.

    The camera on the arthroscope transmits pictures to the surgeon’s monitor, which allows the doctor to diagnose and even treat some conditions. For example, the surgeon can remove loose fragments of cartilage or repair a labral tear. Hip arthroscopy causes little trauma and has a short recovery time.

    Hip Replacement

    Hip replacement surgery replaces a diseased or impaired hip joint with an artificial joint. The artificial implant is typically made of ceramic, metal, or plastic. You can either get a partial or full hip replacement, depending on the extent of the joint damage.

    The two approaches to hip replacement are the posterior approach and the anterior approach. In the anterior approach, the surgeon makes the incision on the upper thigh’s front part. The incision is made along the outer bottom during posterior hip surgery.

    Hip replacement may be an option if your hip pain interrupts daily activities or conservative treatments are no longer effective. Advanced arthritis is often the reason to get hip replacement surgery.

    Revision Hip Surgery

    Depending on your daily use, an artificial hip joint undergoes wear and tear, and it may no longer be effective. Revision surgery will be needed to repair or replace the worn-out implant. Artificial hip implants also get dislocated, infected, or inflamed. Revision hip surgery reduces pain, restores mobility, and improves the range of motion.

    Prolotherapy: An Alternative to Hip Surgery

    While hip surgery effectively reduces pain and improves the hip’s stability, it carries many risks. Some possible complications include infection, blood clots, dislocation, and loosening of implants.

    Prolotherapy is an effective non-surgical treatment for hip pain, stiffness, inflammation, and reduced range of motion. During the treatment, an irritant solution is injected into the hip joint to encourage the healing of the tendons and ligaments. Prolotherapy stimulates the body’s natural healing process to treat arthritis, unstable joints, and strains.

    Prolotherapy eliminates the need for hip surgery by treating the root cause of your discomfort. Contact Boston Prolotherapy & Orthopedics today to learn about what prolotherapy can do for you.

    Hip Issues in Boston
    Hip Pain in Boston

  • Knee Surgery in Boston

    The tendons, ligaments, muscles, and bones surrounding the knee are susceptible to injury and structural damage. If conservative treatments fail to treat your knee pain, you can explore various surgical options. Chronic knee pain can make your life more stressful, which is why some patients opt for knee surgery.

    Signs That You Require Knee Surgery

    In most cases, knee injury and damage respond well to conservative treatments like medications, cortisone injections, prolotherapy, and physical therapy. However, look out for the symptoms below that indicate the need for additional medical intervention.

    Intense and Frequent Pain

    It is not normal to feel intense, disabling, and frequent knee pain. See a doctor if the pain lasts for weeks or keeps you awake at night. If you need pain medication to go through your day, it may be time for knee surgery. Sometimes, your knee pain may get worse in cold or humid weather.

    Limited Mobility

    You may be a candidate for knee surgery if you have trouble walking the stairs, walking, or standing up from a chair. Chronic pain makes it challenging to complete the activities you could previously perform with ease, such as climbing out of the bathtub or picking up your kids.

    Worsening Arthritis

    Many people with chronic knee pain have osteoarthritis or rheumatoid arthritis, which causes loss of motion, pain, and loss of cartilage. You may need knee surgery to replace the damaged structures.

    Ineffectiveness of Non-Surgical Options

    Home remedies like an ice pack and hot baths may relieve mild knee pain. If the pain persists, your physician may recommend medication, weight loss, cortisone injections, and other interventions that provide relief. However, if your mobility continues to decline, it may be time for knee surgery.

    Types of Knee Surgery

    Arthroscopic surgery is the most common knee surgery, where a surgeon uses tiny instruments to repair cartilage and remove loose fragments. This minimally invasive surgery remedies many kinds of knee problems.

    If the joint cartilage has severely degenerated, your surgeon may recommend a knee replacement operation. During the procedure, the surgeon replaces the degenerated areas of the knee joint with metal, plastic, and ceramic parts.

    Prolotherapy: An Alternative to Knee Surgery

    Prolotherapy is an effective treatment for knee pain caused by worn-out cartilage. The treatment involves injecting irritants into tendons, ligaments, and joints to stimulate a natural healing process that repairs damaged tissues. The result is reduced pain and stiffness and increased flexibility.

    Prolotherapy also enhances the mobility and function of the knee joint. By stimulating the body’s natural healing process, you can hopefully avoid invasive knee surgery. Contact Boston Prolotherapy & Orthopedics to learn more about how prolotherapy can treat your knee pain.

    Knee Pain in Boston
    Knee Issues in Boston

  • Knee Issues in Boston

    The knee joint is vulnerable as it absorbs stress from everyday activities like walking, lifting, and running. You are more susceptible to knee problems if you make many repetitive motions or engage in high-impact activities like aerobics. Many knee issues also arise from the aging process and gradual degeneration from medical conditions like arthritis. Explore some common knee problems below.

    Knee Sprains and Strains

    The knee joint has multiple ligaments that provide stability and alignment. Sudden movements and direct blows to the knee can stretch and tear these ligaments and cause pain and swelling. Similarly, knee strains occur when injuries stretch the muscles and tendons surrounding the knee. Strained muscles can cause difficulty in walking, stiffness, and bruising.

    Torn Cartilage

    Cartilage tears are common among athletes who perform sudden knee twists. The knee joint has two C-shaped shock absorbers on either side called menisci. Meniscus tears manifest as pain or tenderness, crunching noises when walking, locking of the joint, inability to strengthen the knee, and tightness of the knee joint. You can experience these symptoms after the injury, or the cartilage damage can happen over time. Small cartilage tears resolve on their own, while others respond to home remedies and medication. However, you may need arthroscopic knee surgery for severe meniscus tears.

    Arthritis of the Knee

    Different kinds of arthritis can affect the knee joint and cause pain. The most common types of knee arthritis are osteoarthritis and rheumatoid arthritis.

    Osteoarthritis wears out the joint cartilage, exposes the bone, and causes swelling. Then, everyday activities become painful due to the knee joints rubbing together.

    Rheumatoid arthritis triggers inflammation in the joint and leaves the knee feeling stiff, warm, and swollen. Gout, psoriatic arthritis, and post-traumatic arthritis also cause knee pain and reduced mobility.

    Patellar Tendonitis

    Patellar tendonitis results from the inflammation of the tendon patella, which links the kneecap to the shinbone. It is also called jumper’s knee and is common among athletes whose activities include a lot of jumping. However, any repetitive motions can stress and tear the tendon patella and cause pain, swelling, and tenderness.

    Treatment Options for Knee Issues

    Your treatment options depend on the injury’s specifics and the medical conditions causing the knee problems. For example, elevation, ice packs, and rest can facilitate the healing of simple strains. If you have knee arthritis, your physician may recommend medication to manage the inflammation and pain. Other interventions include prolotherapy, cortisone injections and physical therapy.

    If your knee pain results from worn-out cartilage, you will benefit from prolotherapy. The treatment involves injecting an irritant to the knee joint to boost blood flow and encourage healing in the damaged tissues. Contact Boston Prolotherapy & Orthopedics today for natural relief from knee pain without surgery.

    Knee Pain in Boston

    Knee Surgery in Boston

  • Shoulder Pain in Boston

    Your shoulders are among the body’s most flexible joints. They allow you to brush your hair, reach for things, pull your kid’s wagon, and drive to work. Acute shoulder pain can make these simple tasks seem momentous.

    Causes of Shoulder Pain

    The shoulder has a complex anatomical structure that includes tendons, muscles, ligaments, bones, and nerves. Any of these parts may be responsible for your pain.

    For example, rotator cuff tendons become inflamed when they get trapped in the bony area of your shoulder blade. Your rotator cuff consists of tendons and muscles that connect the upper arm bone to the shoulder blade.

    Tiny tears in the rotator cuff can be caused by injury, repetitive motion, aging, and more. Some indicators that you might have such an issue include weakness and popping sounds when you move your arm and pain that interferes with your ability sleep.

    Osteoarthritis is another common cause of shoulder pain. This occurs when the cartilage that covers the shoulder joint wears out over time. The cartilage is the smooth, flexible tissue that enhances the movement of the shoulder joint. Osteoarthritis can result from injuries, inflammation of the joint lining,
    and chronic wear and tear.

    Other causes of shoulder pain include:

    • Frozen shoulder
    • Calcific tendonitis
    • Bursitis
    • Dislocation
    • Broken bones
    • Tendon rupture
    • Impingement
    • Sprains
    • Bone spurs

    Diagnosis of Shoulder Pain

    As demonstrated above, there are numerous causes of shoulder pain. Your physician will first perform physical elimination to identify the possible causes of your discomfort. This may include pressing on different parts of your shoulder to check for tenderness and abnormality and test your range of motion.You might also require imaging tests like ultrasounds, X-Rays, and MRIs. Imaging tests display any damage in the shoulder’s cartilage, ligaments, bones, and tendons.


    The cause and severity of the shoulder pain will inform your treatment options. For some people, the pain responds to at-home interventions like rest, ice, heat, and over-the-counter or prescription nonsteroidal anti-inflammatory medications (NSAIDs).

    Your physician may also recommend prolotherapy, physical therapy, or cortisone injections. If none of these suffice, surgery may be the only remaining option.

    Prolotherapy for Shoulder Pain

    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 addresses the root cause of shoulder pain caused by rotator cuff tears, AC separation, arthritis, and shoulder instability. In addition to reduced pain, you can look forward to an increased range of motion and enhanced strength.

    Shoulder Issues in Boston

    Shoulder Surgery in Boston

  • Shoulder Surgery in Boston

    The shoulder and upper arms are some of the most used parts of the body, and injuries can interfere with everyday tasks such as driving, carrying groceries, and picking up your children and grandchildren. If you suffer from shoulder arthritis, you are likely trying to find quick relief, especially if the pain is progressing in intensity.

    There are multiple remedies and treatments for shoulder injuries, including rest, physical therapy, cortisone injections, as well as surgery. Prolotherapy has emerged as a very effective treatment for injured joints and ligaments – as well as arthritis. This treatment has fewer complications than surgery, resulting in reduced shoulder pain and improved range of motion. Another major benefit is that of not having to miss work. Prolotherapy also strengthens partially torn ligaments and tendons. And it improves the overall function of the joint.

    What is Prolotherapy

    Prolotherapy, also called regenerative injection therapy, uses injectable solutions to trigger the body’s natural healing mechanism. The solution contains irritants – typically dextrose, although other additives might be used by some practitioners.

    How It Works

    To understand how prolotherapy works we first need to understand the structure of the shoulder. What most people think of the shoulder is actually a complex series of muscles, ligaments, and tendons that provide an impressive range of motion. The tendons and muscles maintain the arm in a “ball and socket” joint, enabling you to perform a wide range of tasks – from throwing a ball to swimming.

    Most shoulder issues involve the soft tissues of the muscles, tendons, and ligaments. Repeated trauma and injuries, such as rotator cuff tears, damage the connective tissue, thereby reducing the shoulder’s strength and mobility leading to an increase in pain.

    The treatment options for most shoulder injuries include physical therapy, cortisone injections, rest, and anti-inflammatories. While these interventions will reduce pain, they will not address the root cause of the problem. Once normal activities are resumed, the tearing of the tendon will continue and result in more pain.

    Prolotherapy acts as a regenerative treatment that triggers the growth of new and stronger fibers in the affected tissue.

    When injected, prolotherapy solutions trigger a healing response and the growth of fibrous tissue. This treatment reinforces the fibers in the ligament or tendon where the tendon attaches to the bone. It also repairs mid-substance tears or injuries as well.

    Prolotherapy is often recommended for patients who would like an alternative to shoulder surgery. The following are some of the risks and complications associated with surgery: failure of the procedure, infection, nerve damage, blood clots, loss of time from work, and the expense of rehabilitation.

    What Shoulder Issues Can Prolotherapy Address?

    Dr. Albert Franchi commonly uses prolotherapy to treat injured ligaments and tendons in the neck, shoulders, back, arms, legs, elbows, wrists, hips, knees, feet, and ankles.

    Prolotherapy is also very effective in treating arthritis of the above mentioned joints. Treatments typically relieve shoulder pain, weakness, instability, and stiffness caused by trauma – as well as bad posture.

    Prolotherapy is also an effective course of treatment for joint instability that can be caused by ehlers thandanls syndrome (EDS).

    Prolotherapy is especially effective for tendon tears caused by overuse of the shoulder. Rotator cuff tendon tears are among the most common triggers of chronic shoulder pain, and prolotherapy is a definite alternative to rotator cuff surgery. Prolotherapy can also relieve other common shoulder conditions, including:

    • Osteoarthritis
    • Instability of the shoulder
    • AC separation
    • Partial tear of the bicep ligament


    The first step to administering Prolotherapy injections is a diagnosis, and Dr. Franchi will begin by reviewing your personal medical history. The next step is a physical exam involving the palpation of the affected shoulder. Dr. Franchi will determine if there are any weakened tissues in the ligament or tendon.

    Imaging studies might also be needed to determine the extent of shoulder problems. Ultimately in consultation with Dr. Franchi, together you will decide if you are a good candidate for prolotherapy. Depending on the nature of your problem, it is possible that Dr. Franchi will recommend other interventions, such as rehabilitative exercises.

    What to Expect

    The injection takes only a few seconds to perform and will involve some moderate amount of pain which is tolerable. You may have some residual pain for the following day.

    The protocol is for one injection per week for a total of five weeks for each affected body part. After the five weeks of treatment there is an eight-week follow-up consultation for all patients by phone.

    Shoulder Pain in Boston

    Shoulder Issues in Boston

  • Am I A Candidate For Prolotherapy?

    I’m 26 years old. I grew up showing horses and I have and injury where I injured my L4 and L5 vertebrae in my lower back. Would I be a good candidate for prolotherapy?

    Possibly. The key to prolotherapy is if you have point tenderness in your lower back. Some people think prolotherapy is helpful for herniated disc. I disagree with that. I think it’s too invasive a procedure. But if you have areas on your back where you can say, “I know exactly where this hurts,” prolotherapy is very appropriate. Because when we give you the injections, we give them at the point of pain, because that’s telling us where the ligament or tendon is damaged.

    For an older relative of mine, he often experiences shoulder pain, possibly arthritis. Could prolotherapy help him?

    Yes. I had a woman come to me who could not raise her shoulder. She had severe arthritis. She also had what’s called adhesive capsulitis.

    She came to me and asked if I’d do prolotherapy. At the time I was a little skeptical. I gave her the injections and also an intensive physical therapy program to get her shoulder moving again.

    She is my favorite patient now. She is so happy. She has 90% motion in her shoulder and her pain has gone away. I didn’t believe it so much, so I took another x-ray, and actually some of the arthritis was decreased. Really.

    I had another woman with a torn rotator cuff who refused to have surgery. I said, OK, I’ll treat you. She had an MRI which showed the rotator cuff. She came back three months later like this [raises his arm]. Is said, “Do you mind if I do another MRI? I’ll pay for it myself.” The MRI report showed no rotator cuff tear – it was completely healed.

  • How Prolotherapy Works?

    I’m 26 years old. I grew up showing horses and I have and injury where I injured my L4 and L5 vertebrae in my lower back. Would I be a good candidate for prolotherapy?

    Possibly. The key to prolotherapy is if you have point tenderness in your lower back. Some people think prolotherapy is helpful for herniated disc. I disagree with that. I think it’s too invasive a procedure. But if you have areas on your back where you can say, “I know exactly where this hurts,” prolotherapy is very appropriate. Because when we give you the injections, we give them at the point of pain, because that’s telling us where the ligament or tendon is damaged.

    For an older relative of mine, he often experiences shoulder pain, possibly arthritis. Could prolotherapy help him?

    Yes. I had a woman come to me who could not raise her shoulder. She had severe arthritis. She also had what’s called adhesive capsulitis.

    She came to me and asked if I’d do prolotherapy. At the time I was a little skeptical. I gave her the injections and also an intensive physical therapy program to get her shoulder moving again.

    She is my favorite patient now. She is so happy. She has 90% motion in her shoulder and her pain has gone away. I didn’t believe it so much, so I took another x-ray, and actually some of the arthritis was decreased. Really.

    I had another woman with a torn rotator cuff who refused to have surgery. I said, OK, I’ll treat you. She had an MRI which showed the rotator cuff. She came back three months later like this [raises his arm]. Is said, “Do you mind if I do another MRI? I’ll pay for it myself.” The MRI report showed no rotator cuff tear – it was completely healed.

  • Prolotherapy For Arthritis

    There are many people in their 30’s, 40’s and 50’s that are starting to develop early arthritis. These patients come in with mild pain. This is due to the fact that their cartilage is starting to deteriorate and has small defects and microfractures of the cartilage. Prolotherapy helps to produce fibroblasts that fill in these areas to smoothen out the cartilage – in the same way you would put asphalt in the road to make your ride smoother. This helps to relieve the pain of arthritis significantly. Even patients with severe arthritis can get relief as well.

  • Knee Pain Boston

    Prolotherapy treatment for knees is the number one condition we treat. It is a very effective treatment for cases of arthritis and knee instability that are the result of tendon and ligament damage. Prolotherapy for these type of knee conditions is effective 85% of the time. However, it is not effective for a torn meniscus, unless it is a peripheral tear.

    Knee pain is a common symptom among people of all ages. There are many causes of knee pain, and your soreness may not be a sign of anything serious. However, consult a doctor if the pain gets worse over time.


    The severity of knee pain varies, from a dull ache to sharp and disabling pain. The pain’s location also varies, and you can feel it in one location, or the whole knee may be swollen. Other signs that accompany knee pain include:

    • Stiffness and swelling
    • Instability or weakness
    • Popping sound
    • Inability to bend or extend the knee
    • Limping because of the discomfort
    • Redness and warmth

    Causes of Knee Pain

    Injuries to the ligaments, tendons, and bones surrounding the knee cause knee pain. For instance, basketball and soccer athletes are prone to ACL injuries due to sudden changes in directions. Fractures occur when a bone that surrounds the knee breaks and interferes with the knee’s functioning. The knee joint can also be dislocated during a car accident, in which case you require urgent medical attention.

    Arthritis also causes knee pain, including osteoarthritis, rheumatoid arthritis, lupus, and gout. Other conditions that trigger knee pain include:

    • Bursitis
    • Osgood-Schlatter disease
    • Patellar tendinitis
    • Patellofemoral pain syndrome
    • Tendonitis
    • Baker cyst

    Diagnosing Knee Pain

    Every possible cause of knee pain needs different diagnostic tests. First, the medical practitioner inspects your knee for tenderness, pain, swelling, or visible bruising. The physician may urge you to move your leg as they push the joint to determine the integrity of the knee’s ligaments, tendons, and muscles. The doctor may also suggest imaging tests such as CT scans and MRI, and lab tests to detect inflammation or infections.

    Knee Pain Treatment

    The cause of knee pain determines the treatment path. Your doctor may recommend pain-relieving drugs or medication to treat the medical conditions causing your pain, such as gout and osteoarthritis. In other cases, you may get relief from injection medications like corticosteroids and lubricants.

    Mild knee pain can respond well to home remedies like rest, ice, elevation, and heat. If you have severe knee injuries, your doctor may recommend surgery.

    Prolotherapy for Knee Pain

    Prolotherapy is an effective treatment for knee pain caused by tendon and ligament damage. The goal of the treatment is to inject an irritant solution into the knee joint and increase inflammation. In turn, the inflammatory response enhances blood flow and healing in the damaged tissues. Prolotherapy reduces pain and stiffness and improves the joint’s mobility and strength.

    Is knee pain interfering with your ability to complete your daily tasks? Contact us at Boston Prolotherapy & Orthopedics for non-invasive treatment.

    Knee Issues in Boston

    Knee Surgery in Boston

  • 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

    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.

  • Typical Prolotherapy Patients

    Dr. Franchi discusses different types of patients he has helped over the years.

  • Hip Issues Boston

    Dr. Franchi has found prolotherapy to be an effective treatment for the following conditions of the hip. Arthritis and certain tears of the labrum, as well as hip flexor tendons and groin strains. When treated over a period of five weeks, 80% of our patients found that we have alleviated their pain.

    Your hip joint supports your body’s weight and facilitates the movement of the upper leg. The hip’s structure provides the range of motion needed to climb the stairs, drive, and perform other daily activities. Thus, damage to the ligaments, tendons, muscles, cartilage, and other parts of the hip joint results in physical limitations.

    Some common hip issues include the following.


    Osteoarthritis and rheumatoid arthritis are the prevalent forms of hip arthritis. Osteoarthritis results from wear and tear in the hip joint.

    Slippery tissue named articular cartilage covers the hip joint and reduces friction between the bones, so you don’t feel pain as you move about. As the cartilage slowly deteriorates, your motion becomes limited, and you feel like your hip is stiff. The discomfort worsens when you stand for a long time or walk long distances. Other symptoms include swelling, grating sensation, and tenderness.

    If you have rheumatoid arthritis or any other form of inflammatory arthritis, your body’s immune system attacks the protective lining around the joint, called the synovium. Then, fluid accumulates in the hip joint, resulting in pain and swelling. Rheumatoid arthritis causes hip problems among younger people.

    Avascular Necrosis

    Avascular necrosis of the hip occurs when blood supply to the joint is interrupted. Without sufficient nourishment, the bone in the femur’s head dies and slowly collapses. Also, the articular cartilage wears down and can even collapse and result in disabling arthritis.

    Injuries like hip fractures and hip dislocations can also damage nearby blood vessels and restrict blood supply to the hip joint. Other risk factors include long-term corticosteroid use, excessive alcohol intake, and medical conditions like sickle cell disease.

    Hip pain is often the first symptom of avascular necrosis. You may feel a dull ache in the buttock or groin area, which worsens as you move around.

    Hip Pointer

    Athletes who engage in contact sports like hockey and football often injure their iliac crest, the curved part of the pelvis commonly called the hipbone. A hip pointer typically results from a hard fall or a direct blow to the hip and may cause severe pain. The discomfort is aggravated by deep breathing, coughing, walking, or running.


    Hip bursitis is the painful swelling of the bursae in your hip joint. These fluid-filled sacs sit between soft tissue and bones and reduce friction during movement. When the bursae become irritated due to injury or strains, you feel pain that worsens with activity.

    Bursitis is prevalent among athletes in sports that require a lot of running, such as soccer and football. You may feel pain when you lie on the affected side or walk up the stairs. Treatment goals for bursitis include reducing inflammation and pain and preserving mobility.

    Prolotherapy for Hip Issues in Boston

    In many cases, medication and home remedies only offer short-term relief for hip pain. This is mainly because conservative treatments do not address the deterioration of cartilage, tendons, and ligaments causing hip pain.

    Prolotherapy is an effective treatment for tendon and ligament tearing. This regenerative treatment involves the injection of an irritant to the hip joint to kickstart the body’s natural healing process. The treatment is an alternative to surgery or long-term medications among people suffering from degenerative conditions like arthritis, bursitis, impingement, and labral tears.

    Is your hip pain intolerable? Contact Boston Prolotherapy & Orthopedics today for more hip pain and prolotherapy information.

    Hip Pain in Boston
    Hip Surgery in Boston

  • Joint Instability

    Dr. Franchi discusseshow Prolotherapy works to stabilize different ligaments and tendons that can cause joint instability.

  • Elbow Issues

    Ted Johnson came to Boston Prolotherapy because he had a painful lateral epicondylitis, more commonly known as tennis elbow. He received five treatments and is now back to lifting weights, as he did before. As you know Ted Johnson is in great shape and it was affecting his weight lifting. He is now pain free. Ted also had a back problem. He had sacroiliac instability and he was having difficulty lifting, doing dead lifts. Dr. Franchi treated him with five injections. Sacroiliac instability is caused by a torn ligament and once you get the injections, and the ligament heals, it stabilizes the joint. He is now pain free and back to doing his regular routine.

  • What Prolotherapy Can’t Treat

    There are some joints in the body that Dr. Franchi can’t treat. Certain joints, for instance, the small toes and parts of the fingers, cannot be treated because the joints are so small that it is impossible to get sufficient solution into these smaller joints. Dr. Franchi iterates that prolotherapy is only effective for torn ligaments, tendons and arthritis. It is not for torn muscles, fibromyalgia or nerve pain. There is also one specific joint in the hand that Dr. Franchi gets quite a few calls for that he can treat. That is the muscle at the base of the thumbs. These days when people are doing computer work, are developing arthritis. Cell phones are starting to cause this as well. Prolotherapy is very effective for this condition.

  • Difference Between Golfers Elbow and Tennis Elbow

    Actually there is little difference between golfer’s elbow and tennis elbow. Prolotherapy can be very effective for both conditions.

  • Prolotherapy For Plantar Fasciitis

    One of the most common problems that people come to me for is plantar fasciitis. Many people in middle age start to develop slight falling of their arches. This is due to deterioration of ligaments in the arch. The plantar fascia is the major ligament. The plantar fascia can develop micro tears, sometimes major tears. Plantar fasciitis can be very painful, especially in the morning when you get out of bed. My technique for treating this is a little more painful than the other problems people usually have. Therefore, when the patient comes in, I usually apply an ice pack to the heel before I give the injection. This lessens the pain of the injection and makes the procedure much easier.

  • Prolotherapy Effectiveness

    Prolotherapy originated on the west coast of United States and is slowly moving here to New England. You’re finding more and more articles in newspapers about prolotherapy and there’s more and more research being done about prolotherapy. For over 25 years, the American Association of Orthopedic Medicine has been giving lectures about prolotherapy and teaching the techniques involved in treating their patients.

    I think what happened originally is that most aches and pains were diagnosed as tendinitis – as an inflammatory process – and most doctors easily treated these tendons and tendinitis by giving cortisone injections and non-steroidal anti-inflammatories which temporarily eased the pain but after a few weeks the pain returned. This left some doctors like myself scratching their heads.

    So when I went to the American Association of Orthopedic Medicine’s annual meeting, there were lectures on prolotherapy and I was taught there that the inflammatory process is actually a reparative process which has been known in modern medicine for a long time. And that for acute injuries and for chronic injuries anti-inflammatories are actually contraindicated.

    Dr. Hackett developed a theory and practice of treating these injuries by actually causing a rejuvenation of the inflammatory process. This restarts the healing process and then gives a permanent solution to these aches and pains. Because once the tissue is repaired, the pain goes away.

    Sports Injuries, Arthritis and General Pain Management

    I was treating these injuries, many times with cortisone, and it was not successful. So I heard lectures on prolotherapy, I put that in the back of my mind but for patients that did not get better I started to use this technique. And to my surprise, I started to get very good results.

    I’ve had better success rates with prolotherapy. Over 80 to 85% of the people that I’ve treated with prolotherapy have improved significantly. Some have become complete pain relief.

    Prolotherapy effectiveness for ankles and feet and any joint of the body that is held together with ligaments where that can be damaged ligaments, for instance plantar fasciitis, prolotherapy is an excellent treatment.

    As long as you’re a healthy human being, non-smoker and have no auto-immune problems, prolotherapy is 85% effective.

    In the case of arthritis, the joint service is starting to deteriorate and prolotherapy can help rebuild that joint service and alleviate pain.

  • Will Prolotherapy Give Instant Relief

    People want to know if they’re going to get instant relief from Prolotherapy and I tell them, usually not. Everybody responds at a different time rate. Usually the treatment is either one injection each week for three weeks or possibly five weeks. During that period of time they may show some improvement. The real improvement comes, usually, six weeks after the last injection. So this is a two-three month process. Most people are willing to undergo this process because they get a long-term result. Recently I saw someone that I eight years ago for tennis elbow, and the treatment has lasted this entire time.

  • How Long Until Results Are Realized?

    How long until someone has pain relief with a prolotherapy treatment?

    Pain relief varies quite a bit, depending on the patient. Some patients get an immediate response. I had a Division I hockey player who hadn’t played hockey for six months due to lower back pain. I gave him one prolotherapy injection. He came back to me a week later for the second injection. I asked him if he had any pain. He said, “Doc, I feel fine.” I said go ahead and skate. He came back a week later, he still felt fine. I only gave him one injection and he got relief. Now, this is not typical for prolotherapy. Usually it takes three to five injections; some people start to feel some relief during the injection process. However, you can’t be sure it works until you wait a full eight weeks after the last injection.

  • Does The Pain Come Back After Treatments?

    Years after prolotherapy treatment, 5-10 years

    I warn my patients that the pain can come back. And I’m not hedging on this. But what we’re doing is repairing the tendon with scar tissue.

    The body likes to reabsorb scar tissue. Like when you get a cut, it gets smaller and smaller over time. I’ve had some people come back, long distance runners, a year-and-a-half or two years later, and say my back is starting to hurt again. I give them some injections, usually two or three, and they’re good for another year or two.

    So who wouldn’t trade getting a couple of injections to get a year or two of freedom from your back pain? So, yes, some people do come back to me, but it’s usually a year or two later. Or it’s for another problem. Their ankle is fine but now their shoulder hurts.

  • Athletes and Weekend Warriors

    Torn Tendons and Ligaments: Athletes and Weekend Warriors

    What are some of the sports of the athletes you’ve treated?

    I’ve used prolotherapy to treat everyone from world-class judo competitors, to professional hockey players, to intercollegiate athletes playing football, basketball, baseball, soccer, hockey, tennis, golf, track and field, weightlifters, strong men. Virtually any sport where you’ve have an injury that’s lagging on and not healing can be treated with prolotherapy. I had a professional golfer come to me recently and I was able to solve his problem with prolotherapy. Acute injuries can also heal faster using prolotherapy as part of the treatment plan, along with a good physical therapy program.

    If an athlete is having difficulty recovering from an injury, and surgery is in the near future, is prolotherapy a better option for them?

    Yes. Prolotherapy is an excellent alternative to surgery. Sometimes surgery is required for very serious injuries. But other times it’s optional. Prolotherapy can be very effective for anterior shoulder dislocations, rotator cuff tears, chronic elbow pain due to tennis elbow, planter fasciitis, in which you try to avoid surgery as much as possible. Prolotherapy can be used to treat these injuries, avoid the surgery and avoid the rehabilitation and lengthy recovery time that’s required after surgery.

    I have issues with my lower back that’s been bothering me for years. Would I be a good candidate for prolotherapy ?

    Yes. Prolotherapy is an excellent treatment for lower back pain. If you have point tenderness in your lower back. If you have difficulty getting out of a chair. If you have difficulty standing for long periods of time. This may be due to sacroiliac instability, which is a very common, and much overlooked, cause of lower back pain. I have treated literally 100’s of people with this condition, and 80-90%of them have had their back pain go away.

    What are the basic causes of joint pain and how can prolotherapy treat them?

    The basic causes of joint pain are due to instability of the joint. If we injure our body when we’re young, and we injure a ligament that has not healed properly, the joint doesn’t work properly. The alignment is out. Also, as we get older, the ligaments that hold the joint together thin out, become weak, and sometimes tear. Again, this causes the joint to not work properly. With prolotherapy, you actually cause the ligaments to be repaired. You tighten the joint. So that it operates properly, and the pain goes away.

  • Second Opinions

    Dr. Franchi – why should people seek a second opinion when they have been advised that they need to have a total joint replacement as a result of Osteoarthritis?

    Often there is more than one cause to pain which is overlooked. For example, the diagnosis of lower back pain is complex and often there is more than one cause for your pain - and sometimes the secondary cause can be overlooked. For instance, often people are told they have lower back pain from a herniated disk, however their symptoms don’t match the findings of the MRI. This is most commonly found with SacroiIliac Instability which can be treated with prolotherapy.

    Another common misdiagnosis – people are told their symptoms are from a meniscus or a labral tear, when the real cause is underlying arthritis. This is most common with shoulders, knees and hips. If this is the issue, it can be treated with prolotherapy.

    In both these examples, surgery will not help and, in fact, can do more damage.

  • Prolotherapy For Groin Strains

    Another common problem is groin strains. I am the team physician for Bentley College and they have a Division I hockey team. Therefore, there are a lot of groin strains that occur in hockey players. Sometimes they can be very debilitating. Also for the soccer players. Prolotherapy is very effective for groin strains. Usually it takes three injections. The injections have to be placed precisely at the insertion of the adductor muscles to the pubic bone area. With the patients we’ve seen, we’ve seen an 80% to 90% success rate. Usually the athlete can return to the sport within a couple of weeks.

  • Pubic Instability

    Dr. Franchi discusses how Prolotherapy works to help women with this post-partum condition.

  • Prolotherapy For Hyper Flexible Joints

    There is a special group of people who are also candidates for prolotherapy – people who have hyper flexible joints. Their joints are so loose that they become unstable. Sometimes they dislocate their shoulders. Sometimes they dislocate their knee caps. Sometimes they dislocated their fingers. And, they often have chronic ankle sprains. If you have a chronic instability of any joint, ankle, knee, elbow, fingers, wrists, shoulders, prolotherapy is extremely effective in helping to stabilize these joints, and, by doing so, will relieve your pain.

  • When Should An Athlete Look To Get Treatment?

    Athletes and Prolotherapy

    Would you recommend an athlete do this in their off-season?

    Oh yes. What you want to do with prolotherapy is give it time to heal. However, I’ve treated people in season. If they are still capable of playing and have just minor or moderate amounts of pain and I don’t think there’s any danger, I tell them to continue participating… which is really very good. Because when you get a cortisone injection, playing is really contraindicated, because you may rupture a tendon.

  • Dr. Franchi Discussing How it Feels to Help His Patients

    I receive tremendous personal satisfaction receiving grateful thank-you notes from patients who, three months prior, were absolutely miserable, and now are out of pain, walking without a cane, even running the Boston Marathon. It’s enough to know that my patients sleep better at night as they are no longer waking up because of their pain.

  • Who Should You Choose For Your Treatment

    One common question I get is, “How do you know where to put the injection?” I have had the advantage of being an orthopedic surgeon. Because of this, I’ve seen the inside of the body and don’t just look at it from the outside of the body. After doing this for over 30 years, I have a very good knowledge of the anatomy. If you’re going to receive these injections, it’s very important that they be done by someone who is familiar with the anatomy and knows the precise area to place the injection.

  • Long Distance Therapy

    Time Between Prolotherapy Treatments

    Where do your patients come from?

    My prolotherapy patients hail from all over in New England, and some from New York and New Jersey. I’ve had patients travel from other states, but mostly my practice is in the New England area.

    If travel is an issue for your patients, and they can’t make it each week, are there alternatives?

    Yes. We can set up a schedule where I set up a more intensive treatment which requires more injections in the one office visit. So we can cut down the amount of travel time that’s needed.

  • A Typical Examination

    Watch what a typical examination looks like in our office.

  • Are There Limitations and Side Effects?

    It’s common to have an ankle rolled or knee injuries in sports. What should we do?

    What we should do is elevate the ankle and start early range of motion exercises. We can give either a mild narcotic or Tylenol, and certainly physical therapy in which controlled motion of the joint is started. This will not only help in aiding the healing process; it will make the tissues heal in the right direction and in the right way.

    You mention prolotherapy limitations and side effects – what, if any, side effects are there with prolotherapy?

    Actually there are virtually no side effects. The only recorded side effect that I’ve ever recorded giving injections was a transient rash which lasted for a few days and then went away.

    Being an athlete, or being athletic, obviously being active is an important part of their daily routine. Is there any limitation to activity when experiencing prolotherapy treatment?

    Actually there’s very little limitation. If you get a prolotherapy injection, you should avoid any traumatic sports or heavy weightlifting. You are encouraged, in fact, to continue moving the joint, exercising the joint in a safe and proper manner. This actually aids in the healing. The less we use our joints, the less we use our muscles… the old statement “If you don’t use it, you lose it!” is true.

  • Why Experience Matters

    Dr. Franchi has been performing Prolotherapy longer than anyone else in all of New England. Moreover, his experience as an orthopedic surgeon makes him uniquely qualify to deliver safe and effective treatment.

  • Prolotherapy Success Rates

    What are the prolotherapy success rates?

    I tell my patients that if they go through prolotherapy, there’s an 80 to 85% chance that they’ll get at least a 50% reduction in pain – and some people get complete pain relief.

    What are some examples of injuries athletes have endured that are treated with prolotherapy?

    I had a professional hockey player who had a groin injury and couldn’t play hockey for six months. Today he is fine and skating for a professional hockey team. We have tennis players with tennis elbow – chronic elbow pain which is successfully treated with prolotherapy. People with partial rotator cuff tears, football players, other athletes, they’re all been successfully treated with prolotherapy. I’ve had a strong man who had plantar fasciitis who was successfully treated with prolotherapy.

    There are many different ligaments in your body that have aches and pains. One of the most common ones is a sacroiliac instability. People think that they have a disc problem, but it’s not. They have pain on the sides of the back, difficulty getting up in the morning. I treat them with prolotherapy. Pain is reduced and sometimes completely resolved.

    When is prolotherapy not the best treatment?

    Some people are not cured with prolotherapy – these usually are people that are smokers, have autoimmune disease or are not in general good health. But if you’re healthy and live a healthy lifestyle, prolotherapy is very successful.

    I have to ask, do the injections hurt and how many are required?

    Yes I’m sorry to say that injections do hurt, but only for short period of time. I use a solution of 50% dextrose with some lidocaine, so approximately 3 to 4 minutes after the injection the pain goes away. A couple of hours later when this wears off, you will have increased pain and it may last for a day or two, but then that will subside.

    Depending on the patient, usually I give one injection each week for 3 to 5 weeks. Then I wait 6 to 8 weeks to see if we’ve caused the tissue to repair – and the pain should go away, if not completely, at least by 80 or 90%.

    Treatment depends on the area that I have to inject. If you have a large area site, say like in the sacroiliac area, I may have to do three or four injections that day to cover the whole area. But usually injections are spread out one each week for 3 to 5 weeks. If you miss a week because you happen to be out of town, it’s not a problem. As long as we keep the inflammatory reaction going, eventually the tissue is going to heal and your pain will go away.

  • Toes, Ankles and Feet

    Dr. Franchi talks about treatment of certain joints in which implants and joint replacements are not successful; specifically, ankles, wrists, elbows and the great toe of your foot. In these cases, the implants do not work very well; therefore, you are left with a choice of the fusion of the joint. The downside of this, is that you will have a stiff joint after. A fusion causes the transference of the stress, that was normally taken up by that joint, to the joints above and below the fusion. As a result, a patient will eventually develop arthritis in those joints. Additionally, a patient will have limited range of motion. Prolotherapy can successfully treat these conditions, successfully, and a patient can avoid this.

  • Cortisone vs. Prolotherapy

    Cortisone Boston

    Cortisone shots are used to treat a range of orthopedic issues, including tendonitis and arthritis. Cortisone mimics the actions of cortisol in your body, which is released by the adrenal glands. Unfortunately the effects of cortisone are short-lived.

    While cortisone shots are powerful anti-inflammatory medications, they have many limitations. At Boston Prolotherapy & Orthopedics, we encourage treatments that provide long-term relief to issues such as back pain, arthritis, and tendonitis. We recommend Prolotherapy for patients who want to lead more active lives.

    Uses of Cortisone

    Cortisone shots typically contain a corticosteroid medication, and the doctor may include a local anesthetic for pain relief. The shot can be painful, especially if the physician removes fluid before the injection. You will feel more pain when receiving the injection to a small joint compared to a larger one. However, the pain will be tolerable if experienced hands give the shot.

    Cortisone injections will relieve inflammation around the targeted area and reduce pain. The shots typically work within several days, with the effects lasting for a few months. Various conditions for Cortisone treatments would include:

    • Bursitis
    • Osteoarthritis
    • Gout
    • Arthritis
    • Back pain

    What to Expect

    1. Before the Treatment

    You may benefit from cortisone if you have pain because of an inflamed joint. Your medical history will affect the medication’s suitability for you. You will also need to disclose all medications you are using, including blood thinners and dietary supplements with blood-thinning effects.One of the side effects is that cortisone may increase blood sugar in brittle diabetics.

    Your physician may recommend X-rays and other tests, depending on your age and diagnosis. You can also ask your physician about other options for treating your condition since cortisone injections only provide short-term relief.

    2. During the Treatment

    Cortisone shots are typically administered in an outpatient setting and take just a few minutes. To start, you will lay down at an angle that gives the health professional access to the inflamed joint. It is advisable to take deep breaths to be as relaxed as possible.

    You will experience a pinching sensation as the cortisone is being injected, although a local anesthetic will be included to make you more comfortable. The physician will then clean and bandage the injection site. You may be required to flex the joint to encourage the spread of the cortisone.

    3. After you are treated with cortisone.

    Most people will walk around immediately and effortlessly after the shot. You can drive yourself home after being observed for a short time. Resting the joint is vital for reducing inflammation, and you should avoid formal exercise for several days.You can use a mild analgesic or ice to relieve soreness around the area.

    It is essential to monitor pain levels after the cortisone injection for your doctor to review during follow-up consultations. You will likely experience reduced pain two to seven days after the shot.

    How Many Cortisone Injections Can You Get?

    Most physicians limit the number of cortisone shots to a joint to avoid damaging the cartilage. Typically, you can only receive cortisone injections three to four times a year, with at least six weeks between successive injections. The risk of side effects of cortisone also increases with the number of injections. If you are looking for a safer and more long-term treatment for joint pain, you should consider Prolotherapy.

    Risks of Cortisone Injections

    Like any other treatment, cortisone injections carry side effects and risks. Potential complications include:

    • Pain and swelling
    • Fat atrophy
    • Increased blood sugar
    • Cartilage damage
    • Menstrual changes
    • Sleep problems
    • Weakened ligaments and tendons
    • Infection (although rare)
    • Allergic reactions

    Due to the potential risks, cortisone shots are not recommended for people with an existing infection or broken bones. You can reduce the risk of some side effects by strictly following your physician’s lifestyle restrictions. In addition, notify your physician immediately should you experience unusual swelling and major joint instability.

    What if a Cortisone Injection Does Not Work?

    If the benefits of a cortisone shot wears off quickly, you might want to explore other treatments that can provide effective results. The side effects of cortisone can also be serious, and it is better to seek safer remedies.

    At Boston Prolotherapy & Orthopedics, we use Prolotherapy to treat the root cause of joint inflammation. While cortisone will temporarily ease the pain, prolotherapy will stimulate the healing of an injured tendon or ligament as well as create a fibrous cushion in the joint of arthritic patients. This should provide long term relief.