Prolotherapy (Proliferative Therapy), is a nonsurgical, non-operative regenerative procedure used to treat damaged ligaments and tendons that cause painful musculoskeletal conditions that can affect all the joints of the body and the spine.
Prolotherapy has been practiced in the United States since the 1930’s, is supported by a growing body of scientific evidence and is currently practice around the world.
What do we treat?
This regenerative medicine therapy is effective in the treatment of chronic pain for musculoskeletal injuries, arthritis, tendinitis, bursitis, and joint instability. Some examples will be:
Low back pain, even including those resulting from pregnancy
Neck pain, including whiplash injuries
Cervicogenic headache (Most tension headache and migraine)
Plantar fasciitis and other foot and ankle problems
Hip or knee problems including osteoarthritis
Shoulder problems including rotator cuff problems
Elbow problems like tennis and golfer’s elbow, wrists and fingers issues,
Jaw pain like TMJ syndrome
Its purpose is to stimulate the body to repair and strengthen ligaments and tendons, thereby restoring stability, improving function, and reducing pain. It has proven to be remarkably effective and remarkably safe over the years.
How does it work?
Affected areas are injected with a dextrose (sugar derivate) solution that initiates growth of healthy tissue to reduce pain, improve mobility, and restore function.
The process is started by the injection which creates a series of tiny injuries where ligaments and tendons attach on the covering of the bone and by the solution used for the procedure. This way the body’s healing processes to strengthen and repair injured and painful joints and connective tissue is stimulated. The body builds new blood vessels which grow into the ligaments and tendons and allow the repair cells to reach the overstretched areas and start depositing new collagen to strengthen this structures. Once the ligaments are strong, that joint stays in place and trucks properly, muscle contract normally, the nerves inside ligaments and tendons are no longer overstretched and are no longer sending pain signals to the brain.
Treatment intervals vary depending on the specific problem and severity of the area being treated, typically between every 3 to 6 weeks, for a total of 4 to 6 treatments. Usually, no relief is noted before the second treatment. Patients that are hypermobile will require an increased number of sessions.
The anticipated rate of success depends on a number of variables, including the patient’s history and ability to heal. Studies have shown that 80% to 85% of patients experience improvement with prolotherapy. In practice, prolotherapy must sometimes be combined with other types of treatment like physiotherapy, manipulations or nerve blocks.
Before the procedure:
Eat a light meal, plan for a driver to bring you back home, take your medication as usual. Is best to wear dark colour clothing, as some bleeding from the needle insertion might occur.
Please fill in the consent form, brief pain inventory and PHQ-9 forms and bring them to the appointment. If you wish to filled them in the office please do arrive 15 minutes earlier so you allow time for this forms to be filled in.
What to expect during the procedure:
A series of injections will be done to the painful areas. Your pain might increase temporarily and you might feel fullness in the injected areas. If, at any time, you experience severe pain or you feel dizzy, you must let us know so we can make sure that the procedure is as comfortable and as safe as possible for you.
After the injection:
You will stay lying down on the examination table for few minutes. If, when you get up, you feel weak or dizzy, you will have to lie down again to recover. After you will be able to dress we will ask you to wait 15 minutes in the waiting room before leaving. If you feel dizzy, you must tell us so they can help you lie down again.
If a bandage is applied, you can take it off. You can take a shower, however it is best to avoid having a bath or jacuzzi 1 day after the procedure. You will be able to resume your normal activities 3 to 4 hours after the treatment, when the tendon, ligament or joint is no longer under anesthesia and the solution is reabsorbed by your body. Please avoid vigorous exercise that involves treated area for at least 2 weeks post procedure
Complications of the procedure:
nclude bruising, temporary increase in pain, involving the injection, with mild swelling and stiffness, for up to 2 days. The discomfort can be reduced with pain relievers such as Tylenol or other prescribed medication. Very rare complications are: nerve injury with persistent weakness or numbness, joint infection and, if thoracic area are injected, pneumothorax (a collapsed lung). If you note one of these serious complications, please contact the office or go to the nearest emergency room.
Anti-inflammatory drugs, such as aspirin and ibuprofen (Advil, Motrin, Naproxen), and icing are not recommended for pain relief because their action suppresses the desired inflammatory healing process produced by the prolotherapy injections.
Please let us know before each procedure if you are allergic to local anesthetic (lidocaie, xylocaine) and/or corn.
Prolotherapy is not covered by MSP. Some extended benefit plans will cover a portion of your cost for the materials.
we prefer that new patients be referred by their treating physician (family physician or specialist) because your treating physician will send us all the relevant medical information, including copies of X-rays, scans or MRI that were performed and, for good continuity of care, a report including the diagnosis and the suggested treatment will be sent to your treating physician.
Direct consultation, if you do not have a treating physician or if your treating physician does not want to make a referral is possible and you can still be seen in consultation, but we will ask you to provide copies of X-rays, scans or MRI that were performed in the past.