What is prolotherapy?
Prolotherapy is a form of pain management and healing that treats chronic ligament and tendon weakness by injecting a proliferant solution to help directly stimulate growth of healthy and strong tissue, which in turn helps reduce pain by stabilizing the affected area. Prolotherapy fits along a spectrum of more natural medical care, taking its place with more recent advances in regenerative medicine such as platelet-rich plasma (PRP) and stem cells.
How is prolotherapy performed?
A prolotherapy treatment begins when the doctor injects an irritant solution (consisting usually of dextrose mixed with lidocaine for an anesthetic) into and around the painful area or joint. PRP can also be the injected solution. (To learn more about PRP, read our PRP FAQ). This causes an inflammatory response, mimicking that of an acute/new injury, which then stimulates your own body’s healing response and spurs the production of collagen and cartilage. This proliferation allows unstable joints and soft tissue to be restored and strengthened, therefore reducing pain.
How is this different from a steroid injection?
Often, a pain management physician will offer steroid injections to help treat your chronic pain. Steroid treatments usually need to be repeated throughout the year and are sometimes offered to treat multiple different areas of pain in your body (joint, epidural, facet etc.). Although steroids temporarily help with pain, they can actually weaken your tissue and interfere with the body’s healing process. It’s possible that they may even lead to further degradation of the joint and tissues, which in turn may worsen pain over time.
How is this different from a PRP injection?
A PRP injection requires blood to be drawn from your body and placed in a centrifuge to obtain a concentrated amount of platelets (PRP). Prolotherapy uses a mixture of anesthetic along with an irritant, like dextrose solution. Both are promoting an inflammatory response; however, PRP may provide a larger inflammatory response and therefore may not require as many treatments as prolotherapy. Typically, most patients may need 4 to 8 prolotherapy sessions which are spaced about 4 to 6 weeks apart. Once pain reduction is achieved, it is possible to have maintenance treatments a few times a year or less.
Are there medications to avoid before the procedure?
Yes. You should not have an injection if you have used non-steroidal anti-inflammatory medications (NSAIDs) in the 7-10 days leading up to your appointment. Examples include ibuprofen (Advil), diclofenac (Voltaren), and meloxicam (Mobic). Also, we recommend that you refrain from any steroid medication via mouth or injection for at least 4-6 weeks. If you are considering having this injection, please switch to another painkiller such as paracetamol or acetaminophen. When you make your appointment, tell Dr. Moon about all medications you are taking; she can inform you which you should avoid and potentially suggest alternatives.
Does prolotherapy hurt?
Prolotherapy involves injecting a solution into multiple sites along tendons and/or ligaments and may necessitate multiple injections during one visit. They injections may feel like multiple pinches to the skin. If needed, we suggest taking your oral pain med prior to injection (DO NOT TAKE ANY NSAIDS – ibuprofen, meloxicam, etc.). However, most patients tolerate the procedure well and report only mild to moderate degrees of discomfort. A topical numbing medication and even local anesthetic or cold spray may also be used to help any discomfort during the procedure.
When will I see results?
Patients usually see varying degrees of soreness and swelling around injection site for a few days after the injection. This is a result of inflammatory substances flooding the area of the body. The inflammatory process and healing process can result in strengthened tissue and usually continues for a few weeks after the first treatment. Heat can help improve some discomfort. AVOID ICE AND NSAIDS. Follow-up evaluations and treatments are recommended every 4 to 6 weeks, which allows enough time to start noticing improvement. Residual pain is usually reduced after each treatment. If the injury you are treating is acute (recent), healing can occur within a few weeks of injection.
How many treatments will I need?
The number of treatments varies from patient to patient as well as extent of the injury. Patients with a healthy immune system generally require fewer treatments! Generally, patients need 4 to 8 sessions, with sessions being spaced 4 to 6 weeks apart. Many report partial or significant pain relief after one or two treatments. At most, patients usually need ten treatments, and if there is no improvement in pain, prolotherapy is usually not continued. Over time, most patients will start to feel better and may only require maintenance treatments a few times a year if pain starts to recur.
Is prolotherapy safe?
Prolotherapy is very safe when done by a trained physician. Dr. Moon is a Board Certified Interventional Pain Management physician who has performed thousands of pain injections and has undergone training in prolotherapy. Although any medical treatment, including injections, bears a risk of adverse reactions, complications and side effects, with prolotherapy the risk is minimal. Rare side effects and adverse reactions include increased pain, numbness, and infection; allergic reaction to medication; weakness; headache; pneumothorax; dizziness; nausea; and death. The risk and side effects will vary depending on the area being treated.
Who should NOT get prolotherapy treatments?
If you have any of the following conditions, you should not get prolotherapy:
- Low hemoglobin
- Low platelets
- Smokers (results may not be as successful)
- Active infection
- Active cancer
Patients with medical diagnoses such as platelet dysfunction syndromes, thrombocytopenia, hypofibrinogenaemia, hemodynamic instability, sepsis, acute and chronic infections, chronic liver disease, anti-coagulation therapy, chronic skin diseases or cancer, metabolic and systemic disorders are also cautioned against this treatment.
What is the cost?
Regenerative medicine treatments are currently not covered by insurance. However, many patients find that it has great value that outweighs its cost. Furthermore, the procedure costs less than surgery while being much less risky and having no downtime.
Cost for each treatment vary depending on one's specific needs. A consultation is recommended to discuss your treatment course. This can be done via a virtual consultation from the comfort of your own home (if you live in Florida) or an in person consultation.
We accept cash, credit cards, debit cards, and Advance Care. Interested in applying for financing? Visit Advancedcarecard.com
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If you have further questions, please call our office at (904) 580-6777. To schedule online for your in person appointment or virtual consultation, click here.
A credit card is required at the time of scheduling an appointment to reserve your visit with the doctor. A $50 nonrefundable fee will be charged IF your appointment is within 24-48 hours of scheduling to reserve you time with the doctor.
To avoid a nonrefundable cancellation fee of $50, please cancel at least 48 hours prior to your appointment. Thank you for understanding our office policies and the importance of allowing us ample time to accommodate our patients' treatment needs.