David Brouillette, now 54, was only 23 when he fell asleep at the wheel driving back to Baton Rouge late one night from his construction job in Lafayette.

He was only a mile away from his apartment, when he slumped, asleep, over the steering wheel, and his car careened into a concrete culvert.

The steering wheel shoved him to the ceiling of his truck, and the circulation to the top part of his left arm, which had been resting outside his truck, was cut off long enough to destroy muscle tissue.

Brouillette overcame months in a body cast and reconstructive surgery to his face at Charity Hospital in New Orleans — without insurance, he later improvised his own physical therapy to regain working use of his arm — to continue working in construction for 16 years.

In 1992, in constant pain especially in his left shoulder, he went on disability, still running his own trimwork company by using subcontractors, because “my body just couldn’t do it anymore,” Brouillette said.

By then, he was wearing his left arm in a sling.

About 10 years ago, though, he began receiving a pain management treatment called prolotherapy — short for proliferative therapy.

The technique treats injured soft tissue, such as ligaments and tendons, by injecting a liquid — often a concentrated dextrose sugar solution — to trigger the body’s inflammation response that’s always called into play to repair an injury.

Today, after periodic treatments, the mobility has been restored to Brouillette’s left arm, and his pain is way down, he said.

He can go anywhere from several months to a year between treatments.

It’s been a “no-lose” situation, he said.

But until 10 years ago, he had never heard of prolotherapy.

He’s not alone.

Hippocrates practiced a version of it in ancient Greece, and about 20 centuries later, former U.S. Surgeon General C. Everett Koop swears by it.

But the pain management technique remains mostly unknown in everyday life.

Dr. John Clark, a local pain management doctor who uses prolotherapy as a treatment tool, said that’s because of a number of reasons.

Prolotherapy isn’t covered by most insurance, he said, and “nobody is really exposed to it in medical training or residency.”

Physicians can receive training in it, though, in a number of medical centers in the country, many times through the American Association of Orthopaedic Medicine.

Also, prolotherapy isn’t “the usual way of treating an injury,” Clark said.

Traditional treatment focuses on a “damping” of the inflammation response, he said, with the use of such things as ice, rest, and anti-inflammatory medications such as cortisone.

“With prolotherapy, the patient’s own immune system does all of the repair that is done,” said Dr. Paul Kramm, the local pain management doctor who treats David Brouillette.

“My role is to figure out where the repair is needed, and, by injecting at those places, the immune system is called on to begin and complete this repair process,” he said.

“In most cases, prolotherapy is like spot-welding the attachments of tendons and ligaments that have become weakened, to get a stronger attachment to the bone,” Kramm said.

Clark notes that the treatment is “getting increasing use in athletics.”

Indeed, said Jack Marucci, director of athletic training at LSU. Over the past few years, a number of the university’s men and women athletes dealing with acute or chronic injuries have chosen the option of prolotherapy treatment and have done well with it.

“We’ve probably seen about a 70 percent success rate. That’s pretty high,” Marucci said.

The athletes are treated by Kramm.

Dr. Brent Bankston, a local orthopedic surgeon who works with the LSU Tigers football team, said, “The efficacy of prolotherapy is all about picking the right patient, (one with) either an acute or chronic soft tissue injury or tendinopathy,” any pain felt in a tendon.

While “it’s not for everyone and not for every injury,” Bankston said, he notes that “We have had success with it in the LSU sports” program.

Former LSU defensive end Kirston Pittman, now playing arena football with the New Orleans VooDoo, was the first LSU player to try prolotherapy treatment, he said.

“It really actually worked well for me,” said Pittman, who was part of the LSU Tigers’ national championship years in 2003 and 2007.

He went to Kramm for prolotherapy treatment following a rupture of his Achilles’ tendon in 2006.

The injured part of the tendon had healed well after surgery, Kramm said, but “the place where his now somewhat shorter Achilles’ tendon attached to his heel bone became a new problem,” Kramm wrote in a February 2010 article for the Journal of Prolotherapy.

Pittman said the prolotherapy treatment “allowed me to play through my season and knocked my pain down.”

“At first, I was skeptical about the needles,” he said.

It was painful, but worth it, he said.

He had been “walking with pain on a daily basis, practicing in pain, playing in pain” before the treatment, Pittman said.

In 2009, Pittman signed with the St. Louis Rams and, while there, experienced re-injury and surgery, eventually being released with an injury settlement.

None of the people interviewed for this article, who’ve received prolotherapy treatment, sugarcoated the pain of the injections.

They hurt, they say, and the treatments are followed by hours or days of soreness — Brouillette said that soaking in a hot tub after treatment helps.

Not typically covered by insurance, the sessions, which usually include multiple injections, can cost several hundred dollars.

Still, for many, the treatment has been effective.

Lisa Dupree, 31, a casting director who works in Baton Rouge, and Rose Pointer, 38, a local speech pathologist, are other Kramm patients who have benefited from prolotherapy — Dupree for severe back pain resulting from a car accident 12 years ago and Pointer for an injury to a disc in her back that affected the sciatic nerve on her left side.

“It gives you your quality of life back. For someone who suffers from chronic pain, it’s depressing to not be able to do things,” said Dupree, who received a series of treatments in 2007 and a treatment this summer.

“It not only stops the pain, it rebuilds the tissue,” said Pointer, who’s experienced relief from her pain for the first time in four years, following treatment this summer.

David Brouillette, of St. Gabriel, said he’s grateful for the treatment that’s restored more of his abilities to him.

“You take what you got and make the best of what you have,” he said.

His wife, Deborah “Debbie” Brouillette, after seeing her husband’s experience, also benefited from prolotherapy following a neck injury she suffered several years ago when a driver talking on a cellphone plowed into her car, she said.

“Prolotherapy isn’t meant for temporary relief. It’s meant for long-term therapy,” Debbie Brouillette said.

“They hurt … but it passes,” she said of the shots. “It’s a pain worth taking.”

Debbie Brouillette learned that prolotherapy also helped with her longtime irritable bowel syndrome and acid reflux, she said.

Kramm said he’s not yet sure of the reasons for this beneficial effect of prolotherapy and hopes to write an article about it in the future.

He made a presentation about those benefits two years ago to the American College of Gastroenterology, he said.

In an article that appears on the website, http://www.treatingpain.com, former surgeon general Dr. C. Everett Koop writes about how the treatment helped him with what had once been diagnosed as incurable neurological pain.

Koop, a pediatric surgeon, later went on to provide prolotherapy treatments for the parents of some of his patients, he said in a preface he wrote for a book called “Prolo Your Pain Away” by Dr. Ross Hauser.

“The nice thing about prolotherapy, if properly done, is that it cannot do any harm. How could placing a little sugar-water at the junction of a ligament with a bone be harmful to a patient?” he concluded.