Questions after Prolotherapy Treatments

In our office, we utilize the Comprehensive H3 Prolotherapy technique to treat the whole joint with many injections at a single visit. Other offices may rely on one or two shots over 20 or more visits. In our clinical experience we believe our method has provided our patients with the highest level of pain relief. This is based on our decades of service and experience helping people with issues of chronic pain.

Caring Medical’s Prolotherapy providers, Ross Hauser, MD and Danielle Steilen-Matias, PA-C, take an individualized approach to get the ideal results. Prolotherapy treatments are “customizable,” treatments can be adjusted in many ways to help the patients realize their goals of healing their chronic pain.

After Prolotherapy Treatment

A patient is generally sore for a couple of days after Prolotherapy. This is because the 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.

Nutritional supplementation to encourage soft tissue healing such as bromelain, MSM, or other soft tissue support formulas are recommended.

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 within a few 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.

How many treatments do I need?

The average patient requires three to six Prolotherapy treatments at 4-6 week intervals. Some patients require only 1-2 treatments to reach complete healing, which are typically younger patients or those who have sought Prolotherapy right away after an injury. Other patients require six or more treatments, for more severe cases. A patient’s overall health status plays a role in their healing – eating a healthy diet, getting enough sleep, living an active lifestyle, reducing stress, and eliminating cigarette smoking will help accelerate the healing process. While even doing all of these things to aid in healing, most of our patients also take high-grade nutritional supplements specifically designed to assist in tissue repair.

Will I feel immediate pain relief after the Prolotherapy? The anesthetic in the solution used during Prolotherapy sessions often provides immediate pain relief. The pain relief may continue after the effect of the anesthetic subsides due to the stabilizing of the treated joints because of the inflammation caused by the Prolotherapy injections. The Prolotherapy treatment itself is considered “diagnostic” in that the patient often feels significant relief immediately after the treatment because the area causing the pain was injected.

How long will the pain relief last? The pain relief normally continues for a few weeks after the first treatment. Between the second and fourth weeks, the initial stabilization induced by the Prolotherapy may feel like it has lessened because the initial growth of ligament tissue may not be fully complete, therefore some of the original pain may return during this “window period” of healing.

Why the 2nd treatment may feel different? Sometimes a person may feel like they are 50% better after their first treatment, and then after the 2nd treatment feel “it didn’t do anything.” That’s not really true. If there is a big jump after the first treatment compared to the second, there may be many reasons for this. A common reason for this feeling with a regenerative treatment like Prolotherapy is that after the initial progress, a person is more likely trying to do more activity, especially if their favorite hobbies or work was hindered prior to the early stages of pain relief. The stresses put on the joint(s) may still be a little much for the area. The most important thing to remember is that healing works in stages-all types of healing- physical, emotional, behavioral, spiritual, etc. Most people need around 4-6 treatments in the series. Most of our lives are not exactly the same from month to month between treatments. During the course of a treatment series, people will experience times of higher/lower emotional stress, more/less travel, more/fewer physical demands, better/worse sleep or eating patterns. All of these things of living a normal life have an effect on how we heal injuries, and sometimes may feel like 2 steps forward, 1 step back. That may very well be ok and normal during the overall course of your Prolotherapy treatment series. Some people experience a good deal of relief after the first treatment then have smaller jumps until the end of the treatment series. Others may not feel much early on, then have a big jump after receiving a few treatments. While this may be understandably frustrating, we encourage people to hang in there and continue to be open and honest with the provider so we can adjust the treatment as needed or discuss what other areas of your life may be having a negative impact on your ability to heal an injury. Remember, Prolotherapy is 50% us and 50% you. We want to see you succeed and overcome chronic, disabling pain!

How often should I get treated with Prolotherapy? Follow-up is generally recommended at 4-6 weeks. Some patients are seen more frequently, especially when treating an acute injury or sports injury where the athlete needs to return to his/her sport very quickly. As healing progresses, the number of injections required per treatment usually decreases. The pain generally continues to diminish with each treatment to the point where the patient is at 100% function.

If, after a few Prolotherapy sessions a person has not had significant improvement, we start a search for additional causes of a person’s pain, such as dietary/allergy issues, underlying infection, or unresolved emotional or stress-induced situations.

The issues of depression and anxiety are covered at length in our articles:

Another reason a person gets inadequate Prolotherapy is that there was inadequate inflammation with the Prolotherapy treatment. Prolotherapy needs to spark a new healing cascade through inflammation, In some people, stronger Prolotherapy solutions are needed to get an adequate inflammatory reaction after the treatment.

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