PROLOTHERAPY
Prolotherapy is an injection technique used to treat chronic, musculoskeletal pain. It works by stimulating the body's own healing process to repair injured or weakened tissues. New fibrous tissue is created resulting in strengthening of the effected area.

What is contained in the injections and how do they work?
Most commonly, the procedure involves the injection of a concentrated sugar solution and an anesthetic such as procaine but each treating physician will tailor the selection of injection substance according to the patient's needs. (No steroids or cortisone is ever used.) This solution causes irritation and slight inflammation of the tissues. Your body naturally responds to this by mounting a repair process at that site encouraging growth of new ligament or tendon fibers, resulting in a strengthening of the weakened structure. Additional treatments repeat this process, allowing a gradual buildup of tissue to restore the original strength to the area.

What determines a patient's response to Prolotherapy?
Each patient must be evaluated thoroughly before treatment can be administered. Success with Prolotherapy depends on factors including the extent of trauma and damage to the effected area, and the patients' overall health and ability to heal.

Which conditions are usually treated with this procedure?
Conditions that are amenable to treatment with proliferant therapy include pain in the neck, back, shoulder, knee, elbow and ankle as well as some forms of chronic headache. It has been used to treat conditions such as joint dislocation, temporal mandibular joint (TMJ) dysfunction, heel spurs, tennis elbow and disc problems.

How many injections are required? 
This varies according to the area that is injured. The injured area may require as little as 4 sessions or as many as 20 depending on the extent of the injury and how well the patient heals. Each time the patient comes in for a "session", multiple injections are given depending on the area of treatment. The back, for example, is injected in multiple locations because there are many ligaments that need to be strengthened. Each session is usually spaced 2 to 6 weeks apart.

How painful are the injections?
Pain perception is a subjective measure but most patients who have suffered with chronic pain problems find that the discomfort of the injections, while not pleasant, is entirely bearable. The mild discomfort passes fairly rapidly and can be reduced with pain relievers such as Tylenol. Anti-inflammatory drugs, such as aspirin and ibuprofen, should not be used for pain relief post-injection because their action suppresses the desired inflammatory process produced by the injection.

Are there are side effects?
Some bruising and a feeling of stiffness or soreness around the injection site are routine. Some patients report numbness over the injection site and occasionally tingling or itching. These symptoms are temporary.

Are there any risks to the procedure?
Any time a needle is placed into the body, particularly when it is around spinal structures, there are risks of infection, bleeding, and injury to nerves. We make every attempt to minimize these risks and have an excellent record of performing these procedures safely in our practice.

When will I see the benefits of Prolotherapy?
About 1/3 of all patients experience benefits right away with a stepwise improvement with each successive visit. Another 1/3 requires several injections before they begin to feel improvement. And the final 1/3 do not get improvement until the sessions are completed and some time has passed. The ability to do things such as sleep, ride in the car, sit, walk (things that were often intolerable prior to treatment without bringing on their pain or worsening their pain.) are all signs that the prolotherapy has been successful.

What are my chances of improvement?
In our practice, greater than 82% of the people that we have treated report a good or excellent result, many of them being permanently cured of their problem.

Do I need someone to drive me to the appointments?
Most people are able to drive themselves home from the appointments since we use no sedation. However, if you are concerned, it may be a good idea to bring a driver with you.

Can I return to work or activities the same day?
There is no requirement to rest or to restrict activity in any way relative to what you usually do. Most people leave our office to return to their job or activities. Of course, this is dependant on the patient's individual preference.
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Will my insurance cover proliferant injections?
Most insurance companies do not cover proliferant therapy. Their contract with you allows them to deny payment for things that they deem "investigational". There are some insurance companies that do pay for prolotherapy. In the event that insurance coverage is not available, most people find that the cost of proliferant therapy is well worth the substantial improvement in what has typically been a chronic painful and lifestyle limiting condition.