Questions after Prolotherapy Treatments
In our office we utilize a comprehensive Prolotherapy approach of treating the whole joint with many injections at a single visit. Other offices may not follow this protocol instead relying 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 soon approaching 25 years of service and experience helping people with issues of chronic pain.
Caring Medical Prolotherapy specialists, Ross Hauser, MD, Danielle Steilen-Matias, PA-C, David Woznica, MD, and Katie Worsnick, PA-C also 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 help 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.
How often should I get treated with Prolotherapy? Follow-up is generally recommended at 4-6 weeks after each treatment to ensure an accurate assessment of results, avoiding an evaluation of a patient during the “window period,” which is typically at the 2-3 week mark. 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:
- When depression and anxiety prevent healing of back pain
- Painkillers and anti-depressants can increase chronic pain
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.