Injections + Other Treatment Modalities

Regenerative Joint Injections (PRF)

Prolotherapy in its original form works by irritation. You inject a mild irritant into a ligament or tendon, the body mounts an inflammatory response, and that response is what starts the repair. It is a real technique and it has been used for a long time.

I do not use it that way any more. I use platelet-rich fibrin instead, prepared from your own blood on the day, with no irritant involved.

The reasoning is about the joint itself. The temporomandibular joint has a poor blood supply, which in my experience is a large part of why it can be slow to heal. In a chronic case the tissue is being irritated every day already, so adding more irritation is not the missing ingredient. What is missing is the material the body would normally bring in through the blood, and that is what PRF is: a concentrate of your own platelets and the growth factors they carry.

PRF's slower spinning process produces a fibrin scaffold that PRP does not, which is why I reach for it when a longer acting matrix is the goal.

It is also not the first thing I do. The joint gets decompressed and stabilised with an orthotic first, over several weeks, because an injection into a joint that is still being loaded wrongly is treating a moving target. PRF usually comes at the third visit, once that decompression has had time to work.