Questions & Answers About Prolotherapy

What is Prolotherapy?
What do you mean “stimulates normal healing?”
What do you inject during Prolotherapy?
Do the injections hurt?
Are all Prolotherapists the same?
Who is the ideal candidate for Prolotherapy?
What are some of the conditions that respond to Prolotherapy?
How many treatments are needed?
How often do I need to get treated?
What do you mean by chronic pain?
I just injured myself. Can I get Prolotherapy?
Will there be soreness after Prolotherapy?
What signs or proof is there that Prolotherapy is working for someone?
What if results are not seen immediately with Prolotherapy?
What are the risks with Prolotherapy?


What is Prolotherapy?

Prolotherapy is a proliferative injection treatment that stimulates the body to repair painful areas. Specifically it involves the injection of natural substances, including a person’s own cells, into painful areas to stimulate the body’s own repair mechanisms to strengthen and heal injured structures. Mostly, Prolotherapy is used to strengthen ligaments and tendons. Ligament injury is presumed to be the preliminary cause of joints that become degenerated. This along with the fact that most degenerated joints have tenderness at ligament attachments around the joint, account for the fact that degenerative arthritis and degenerated structures typically respond beautifully to this regenerative treatment. Prolotherapy is the ideal option for pain arising from ligaments, tendons, and degenerated joints.

What do you mean “stimulates normal healing?”

The body heals by inflammation. When an athlete has a hard work out and hurts after it, this occurs because the workout has inflamed the muscles. The normal inflammatory healing reaction is what will not only repair the damage from the workout, but also cause the muscle physiology to actually change to make the muscle fibers bigger, stronger, and have more blood supply. Prolotherapy is a treatment that stimulates the normal healing reaction. So this proliferative treatment, like exercise, can cause structures like ligaments and tendons to become stronger and thicker. Because it stimulates normal healing, athletes and people who are active typically love the therapy because they can work out through the course of receiving Prolotherapy.

What do you inject during Prolotherapy?

While part of the “art” of Prolotherapy is what is actually injected to stimulate healing, most Prolotherapists use a base solution of hypertonic dextrose. The dextrose is a sugar made from corn. Some utilize additional substances such as Sarapin (pitcher plant extract), hormones, and various minerals and vitamins. Solutions using a person’s own cells, such as Stem Cell Therapy and 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.

Do the injections hurt?

Yes, while the injections hurt, lidocaine or another anesthetic is put into the solution to decrease the pain. Also a lidocaine or anesthetic cream can be rubbed on the skin to make the injections less painful. Some people receiving Prolotherapy will take medication to help take the . Some who get a lot of areas treated will need intramuscular or intravenous Demerol or other forms of conscious sedation to help them get through the procedure. Realize though, most patients get through the Prolotherapy procedure without medications or sedation. In expert hands, Prolotherapy just takes a few minutes per session.

Are all Prolotherapists the same?

The skill level and competency level varies among Prolotherapists, as it does in any field. Depending on the severity and complexity of your condition, it is worth researching the most qualified Prolotherapist to do your treatment. This often requires traveling to see a Prolotherapist, as this is a specialty treatment. Unlike Primary Care Physicians, Urologists, Dermatologists and other more common practices, you will probably have to do a more thorough search for a Prolotherapist that fits your needs.

Who is the ideal candidate for Prolotherapy?

The best candidate for Prolotherapy would be one who has an injured structure causing their pain that responds to Prolotherapy. This typically is an injured or torn ligament or tendon, or a degenerated joint or spine.

If a tendon or ligament is completely torn then surgery is typically warranted. In certain nerve conditions, surgery may be warranted. Even in these two scenarios it is typically recommended that an evaluation be done by a qualified Prolotherapist. Sometimes the patient, or even their doctor, thinks someone has a pinched nerve or complete tear, but when evaluated by a Prolotherapist that is just not the case. The person then receives Prolotherapy and responds well to the treatment. In summary, to determine if you are a good Prolotherapy candidate, it is best to get an evaluation by a Prolotherapist.

What are some of the conditions that respond to Prolotherapy?

• Chondromalacia patella
• Tendon strains
• Incomplete tendon tears
• Incomplete ligament tears
• Ligament sprains
• Degenerative disc disease
• Fibromyalgia pain
• Frozen shoulder
• TMJ syndrome
• Hypermobility syndrome
• Plantar fasciitis
• Tendinosis
• Pelvic floor dysfunction
• Pubic symphysis pain
• Tennis elbow
• Meniscal tear
• Labral tear
• Post surgical pain
• Osteoarthrits pain
• Pyriformis syndrome
• Iliotibial pain
• Joint instability

and many, many more. Please check with your specialist’s office to see if they treat your condition.

How many treatments are needed?

Most conditions require three to six sessions of Prolotherapy. Obviously some conditions respond with one or two 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 a Prolotherapist about your specific condition.

How often are Prolotherapy treatments done?

Most people receive Prolotherapy every four to six 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. It is best to discuss this with your Prolotherapist at the initial consultation.

What is meant by “chronic” pain?

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

I just injured myself. Can I get Prolotherapy?

It is common for someone who has been cured of their chronic pain with Prolotherapy to get Prolotherapy for acute pains. Acute pain is a pain that just started. 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. So yes, even for an injury that just occurred, Prolotherapy can be used.

Will there be soreness after Prolotherapy?

Yes, this is sometimes described as a “good” kind of soreness. Similar to the kind of soreness you have when you had a good workout. The muscles tighten and yes, it is painful, but not awful. Typically the area feels tighter and stronger right away. A patient should not have awful, awful pain after a Prolotherapy treatment. If you do, please call your Prolotherapist’s office and report it. Sometimes pain pills or muscle relaxers are needed for a short time, but there are other natural options as well to soothe the area after treatment. Discuss the best options for you with your practitioner.

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

Wow, this is a good question. Here are some ways a person knows that Prolotherapy is working:

• Pain level is decreasing.
• The amount of pain medication required is decreasing.
• Function or activity level is increasing.
• Clicking or grinding of the joint is decreasing.
• The area moved better (muscle spasms going away).
• Patient is happier.
• 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 Prolotherapy 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, two out of three 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 Prolotherapy sessions are stopped and further digging into why the person is not healing may be suggested, as well as additional imaging or other tests.

What if Prolotherapy doesn’t work? Do you have any other solutions or tests you can do?

If someone is convinced that they are a good Prolotherapy candidate, but the initial Prolotherapy treatments did not work, it may be best to get a second opinion by another Prolotherapist. There are definitely differences among these Regenerative Medicine specialists, including solutions used, amount of solution used, technique differences, and of course, experience. Some practitioners also place a great deal of emphasis on helping the person heal by eating a proper diet, supplements, natural hormone replacement and exercise.

What are the risks with Prolotherapy?

Prolotherapy, like all injection procedures, carries with it a risk of infection. Typically with Prolotherapy 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, spinal headache (spinal leak), and synovitis (joint swelling/pain). Like all medical procedures, Prolotherapy carries risks. These risks should be discussed with the doctor doing your Prolotherapy.