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Prolotherapy: What it is and How it Works

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What is prolotherapy?

Prolotherapy is a regenerative injection therapy that stimulates the body to repair inflamed and painful areas.  More specifically it involves the injection of dextrose, a sugar solution into painful areas to stimulate the body’s own repair mechanisms to strengthen and heal injured soft tissues.  In short, prolotherapy is used to strengthen ligaments and tendons.

Ligament injury is presumed to be the primary cause of joint degeneration or osteoarthritis.  Most degenerated joints have tenderness at the ligament attachments around the joint, and this pain resolves beautifully to prolotherapy treatments. Prolotherapy is the ideal option for pain arising from ligaments, tendons, and arthritic joints.

What is injected with prolotherapy?

Most prolotherapists use a base solution of hypertonic dextrose, aka sugar.  Some utilize additional substances such as Sarapin and/or minerals and vitamins.  Solutions using a person’s own cells, such as Platelet Rich Plasma (PRP), are also forms of prolotherapy. The word prolotherapy just indicates that the solution used is aimed at proliferating cells, as opposed to steroid injections which are degenerative in nature.

Does it hurt?

Yes, injections are uncomfortable, however, lidocaine or another anesthetic is put into the solution to decrease the pain. Also, an anesthetic cream can be rubbed on the skin to make the injections less painful. At times it is appropriate for patients to take medication to help make the treatment more comfortable.

How many treatments are needed?

Most conditions require 3-6 sessions of prolotherapy. Obviously, some conditions respond with 1-2 visits, while chronic degenerative joints may need therapy for one to two years. The answer to this question can be best found by talking with Dr. Schulz who is a trained prolotherapist about your specific condition.

How often are prolotherapy treatments done?

Most people receive injections every 4-6 weeks.  In some instances, treatments are given every week to two weeks. The number of treatments and how often a person is treated is dependent on a lot of variables. This should be discussed at your initial consultation.

How do you define chronic pain?

Most painful conditions that do not improve completely by six months typically will not “spontaneously” get better on their own. At this point, the person is said to have a chronic condition.

Can I get prolotherapy for acute injuries?

Yes, acute pain is a pain that is new due to a recent injury. Prolotherapy can typically speed up the healing process. This is especially critical for athletes who do not want to lose a lot of training time.

Will there be soreness after prolotherapy?

Yes, this is sometimes described as a “good” kind of soreness, kind of like the soreness you have when you had a good workout. The muscles may feel tight and that can be painful, but not horribly painful. Often the area feels tighter and stronger right away.  Occasionally pain medications or muscle relaxers are needed for a short time, but there are other natural options as well to soothe the area after treatment.

What signs or proof is there that prolotherapy is working for someone?

• Pain level is decreasing
• Function or activity level is increasing
• Decreased clicking or grinding of the joint
• Reduction in muscle spams
• Exercise level is increasing
• Tenderness in the area of pain is decreasing

Most people get treated until they are pain-free or almost pain-free. Prolotherapy regenerates structures for many months after the last treatment. This is why some people stop getting injections when they are 90% pain-free. If the pain does not totally remit in a couple of months after the last session, then another treatment or two may be needed.

What if results are not seen immediately with prolotherapy?

Typically, 2 of 3 people who receive prolotherapy feel better after the first treatment. Some patients have to get a few treatments before feeling better. If someone has not had any improvement by the fifth or sixth treatment, typically injections are stopped and further investigation into why the person is not healing may be suggested, as well as additional imaging or other tests.

What are the risks?

Like all injection procedures, prolo carries with it a risk of infection though it is uncommon. Typically with injection treatments in general, there is a risk of increased pain, swelling, bleeding, bruising, and redness. Depending on the area involved, there can be a risk of pneumothorax (puncture of the lung), nerve injury, ligament injury, tendon injury, muscle spasms, and spinal headache. Like all medical procedures, prolotherapy carries risks. These risks should be discussed prior to the procedure.

If you have additional questions please call our clinic and set up a complimentary consult with Dr. Schulz.

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