Prolotherapy Treatment Questions

ARE YOU A CANDIDATE FOR PROLOTHERAPY?
Prolotherapy stimulates the body to repair the painful area. For the patient who has localized areas of pain or the person who has had a recent injury from an accident, Prolotherapy is a very effective treatment to strengthen those specific areas and eliminate the pain. Realize, however, that Prolotherapy starts the growth of new healthy, strong tissue. Your body--your own immune system--grows the tissue. For the person who has a host of other chronic nutritional, hormonal, allergic problems, these deficiencies and illnesses should be corrected so the body will be able to respond to Prolotherapy.

The ideal Prolotherapy candidate has the following:
 

1. Pain originating from a ligament or tendon
2. Strong immune system
3. Willingness to improve and receive follow-up visits
4. Healthy diet
5. Positive mental outlook

When Prolotherapy Does Not Work
The most common reasons why a person may not attain improvement with Prolotherapy are the following:

1. Depressed immune system
2. Nutritional deficiencies
3. Hormonal deficiencies
4. Other factors causing the pain that are not being addressed
5. Correct area being treated but repair not yet complete
6. Wrong area being treated

This last fact is often overlooked. A good example of this relates to patients with lower back pain. Typically what is needed for back pain is for the patients to receive Prolotherapy to the lower back at the sacroiliac joints. In a small percentage of the people, the sacroiliac joint remains weakened because the pelvic joint in the front (pubic symphysis) also needs to be treated. The sacroiliac ligaments, in this instance, will only maintain the strength that is attained with Prolotherapy if the pubic symphysis is also treated.

-

WHY PROLOTHERAPY RESULTS MAY NOT BE SEEN IMMEDIATELY 
Prolotherapy in its ability to cure chronic pain is completely dependent on the Prolotherapy doctor treating completely the injured structures. This means that all the injured structures are treated with a strong enough solution to heal the area in a reasonable peroid of time. We find that most people are cured of their pain with three to six Prolotherapy sessions. If by the sixth Prolotherapy session a person has not had significant improvement, we search for another cause of their pain like infection or allergy. People who are receiving 30 or 40 Prolotherapy sessions to cure their chronic pain are paying a lot of money that they wouldn't have to pay if they went to a physician who utilizes stronger Prolotherapy solutions then they are receiving and/or did more shots per visit.

In general with the Hackett/Hemwall/Hauser technique of Prolotherapy, a good rule of thumb in regard to the number of Prolotherapy injections, (Watch where do Prolotherapy injections go and do they hurt?)  per area is 10 to 20 for an extremity (knee, ankle, shoulder) and anywhere from 30 to 60 for the neck, back, or thoracic spine.

Another reason a person gets inadequate Prolotherapy is that there was inadequate inflammation with the Prolotherapy treatment. Remember the body only heals by inflammation. In some people stronger Prolotherapy solutions are needed to get an adequate inflammatory reaction after the treatment. Until a person gets the injured structures completely treated with Prolotherapy with a strong enough solution, the person has not failed Prolotherapy. It is important that after a Prolotherapy session, that a person feels stiff for at least one to two days. If the stiffness after the treatment only lasts a few hours, then the immune reaction to the treatment most likely will not be enough to regenerate the connective tissue needed for healing. In such a situation there are two options. Figure out why the person has a poor immune response by doing metabolic, nutritional, and hormonal testing, or use a stronger Prolotherapy solution. Physicians who have a lot of experience doing Prolotherapy may have ten different solutions they use depending on the individual case. 
-

Why am I Sore After Prolotherapy?
A patient is generally sore for a couple of days after Prolotherapy. This is because the Prolotherapy injections have to go through some muscles to get to the ligaments and tendons. To help the muscle soreness resolve itself sooner, massage therapy and moist heat applied to the area is recommended. Natural products to encourage soft tissue healing are recommended. Gentle manipulation techniques, such as myofascial release, strain-counter-strain, or activator gun treatments, are helpful. Other modalities that improve circulation and assist the healing from Prolotherapy include acupuncture, Rolfing, electrical stimulation, magnets, infrared heat, and ultrasound.
 

For those who are more sensitive to pain, medications such as Tylenol and Ultram, which are not anti-inflammatory medications, are permissible. Occasionally a muscle relaxant is needed. It is very important to avoid anti- inflammatory medications, as these may decrease the effectiveness of Prolotherapy. Narcotic medications, such as Vicodin, Tylenol with Codeine, and Darvocet should also be avoided because they depress the immune system. Of course, this is not helpful because the immune system is critical for healing after Prolotherapy.
 

Exercising is permitted as soon as the patient feels ready. Generally, light exercise can begin two days after Prolotherapy. The general rule is if a certain activity or exercise hurts significantly, switch to a different one. A small amount of pain is expected while recovering from an injury, but not significant pain. If the patient receives one Prolotherapy treatment and feels fine, follow-up is still recommended to allow the physician to assess the area for complete healing. If it is still significantly tender, further treatments are needed because the area is still injured. Once the tenderness is gone, the patient is cured.