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"SWEET RELIEF . . . Injecting tendons with a dextrose
(sugar) solution to trigger
an inflammatory reaction is
just one way in which
which practitioners are using prolotherapy to target
sprains and strainsprains and strains."

K. Dean Reeves, MD
BioMechanics Magazine
Sept. 2004

Better Business Bureau MemberSM

Prolotherapy: Frequently Asked Questions


You may be new to the world of Prolotherapy for chronic pain relief and have many questions. Here are general answers to some questions we are frequently asked:

1. What is Prolotherapy?

Prolotherapy is a little known but highly effective method of treating osteoarthritic joint pain, and chronic ligament and tendon weakness. The term "Prolotherapy" is short for "proliferation therapy" with proliferation meaning "rapid production". In Prolotherapy, the weakened areas are injected with a "proliferant solution" that directly stimulates the growth of healthy, strong tissue.

2. How is Prolotherapy done?

Prolotherapy treatments consist of injecting a proliferant solution into the painful area or joint. This creates a short duration of inflammation and stimulates the immune system's own healing mechanism to produce collagen and cartilage. The new collagen and cartilage strengthens and restores joints and supporting soft tissue, reducing or eliminating many different types of pain.

3. What is in the injected solution?

The injection consists of: 1% Procaine, Dextrose (pharmaceutical grade sugar water), Methylcobalamin (which is the active form of Vitamin B12) and Hyaluronic acid. On occasion individualized homeopathic remedies are added to the solution.

4. Are the injections painful?

Patients report varying degrees of discomfort from mild to moderate. You can be assured that any discomfort you may experience will be brief and manageable. Occasionally a nerve may be touched with the needle, this leads to an electric jolt going down the leg or arm, the jolt goes away as soon as the needle is moved off of the nerve.

5. If this the same as cortisone injections?

No, Dr. Mason-Wood does not use cortisone in any of his treatments. Long-term medical research studies show that cortisone injections weaken tissue and interfere with the healing process. Prolotherapy solutions are called proliferants and cause the ligaments and tendons to be strengthened or lead to cartilage regeneration by stimulating the body's natural healing response.

6. How long do Prolotherapy treatments last?

It usually takes Dr. Mason-Wood less than 20 minutes to administer the Prolotherapy. There is no recuperation period, and you may leave the office immediately. Often you will be in the office for 1.5 hours on the first visit to review your medical history, conduct a complaint oriented physical, go over your medical lab reports and have time to ask questions and have the answers fully explained.

7. How will I feel after a Prolotherapy treatment?

Immediately after the treatment many patients describe a feeling of fullness in the joint. Quite often for the first hour the joint feels better because the Procaine has numbed the joint. Once the Procaine wears off you may feel sore at the injection site for a day or two. For the first two weeks you may feel the same, better or worse as the healing process proceeds. The fourth week after the injection is the time when you can best assess the results of treatment. Any noticeable increase in strength, decrease in pain, improvement in sleep or change in other symptoms is evidence that the healing process has been triggered.

8. What about exercise?

Tissue heals better when it is being stressed - to a point. Do not do any exercise that causes significant pain. Pain is your body telling you that you are overstressing healing tissue. You may do any exercise that does not increase your pain level. For athletic injuries, do 60% of your maximum weight or intensity, but more reps. Movement is good, pain is bad. If you do not exercise regularly, start NOW!

9. How many Prolotherapy treatments will I need?

The number of treatments varies with each patient. Many of our patients have reported partial or complete relief of pain after a few sessions. Patients with a healthy immune system generally require fewer treatments. The average person requires 4 to 8 treatment sessions given at 2 to 6 week intervals.

Remember, Prolotherapy relies on a patient's own body "healing" itself and this can be a slow process. The connective tissue strengthens 4 to 6 weeks after each treatment session, which is why it is important to continue treatment. It is normal to experience waxing and waning of functionality and pain relief during the course of treatment.

Almost invariably patients will have some return of pain after a couple of treatments. Assuming a patient's immune system is healthy,repeated treatments should provide longer and increased pain relief until a sustained improvement in pain is realized.

10. Is Prolotherapy safe?

Every medical procedure has risks, however Prolotherapy is an extremely safe procedure. The risks are far less than taking aspirin or ibuprofen over a lifetime to relieve chronic pain. In Prolotherapy, the risks and side effects will vary depending on the area being treated, and Dr. Mason-Wood will discuss these possibilities fully with you during the initial consultation.

11. Will my insurance plan cover for Prolotherapy?

There are many different extended healthcare insurance companies and it is best to check with your employers plan to see if the treatment is covered. Many have coverage for the naturopathic visit portion, but not the injection. Please check with your insurance plan.

12. Why isn't Prolotherapy covered by medical insurance?

Modern medical research demands that therapies be proven by double-blind placebo controlled trials. For medications, the pills can easily be made to look alike and a sugar pill used as a placebo that is presumed to have no therapeutic value. For procedures like Prolotherapy and most surgeries, there is no adequate placebo. Cortisone cannot be used as a placebo because cortisone can only be injected 3 times a year; typically, Prolotherapy requires 4-6 treatments.

Health Canada wants more data to show the effectiveness of Prolotherapy. Drug companies pay for research when it is profitable. They are unlikely to pay for research on Prolotherapy because this would not be a profitable venture. In fact, drug companies and surgeons would profit less if Prolotherapy would be more widely used, since fewer people would need pain medication and they could avoid expensive surgeries or complications from surgeries.

13. Are there any things I can do to prolong or stop the healing process
      with Prolotherapy?

There are several things that can inhibit healing, and they are: i) patients who over-exercise the healing joint or body part, ii) taking anti-inflammatory medications and/or supplements, iii) giving up and stopping Prolotherapy treatments prior to complete healing, and iv) eating a diet that causes inflammation.

14. How long does Prolotherapy healing last?

Since we can continue to "wear out" or be re-injured, it is impossible to predict how long your healing will last. Sometimes patients come back a year or more later for a "booster" procedure in the same area, others have to come back sooner. Some patients don’t require any boosters. It really depends how well you take care of yourself and how your body will respond to the treatments.

15. What is the cost of Prolotherapy?

Prolotherapy costs vary depending on the part or parts of the body that need treatment. The first treatment usually costs about $300 with follow-up treatments costing $200, supplement costs that will contribute to the healing process will vary. Prolotherapy is less expensive than surgery because there is no "recovery period" or downtime from work. Patients are encouraged to continue with normal daily activities, work and exercise.

16. Why don't more doctors practice Prolotherapy?

  • While Prolotherapy has been available in Europe for over 60 years, Prolotherapy is new to Canada and most health care professionals are not aware of it. Also, since it is not taught in medical school many practitioners don’t know that they could recommend Prolotherapy. Prolotherapy also requires special training, which most practitioners have not taken and it is performed by only a handful of physicians in Canada and the U.S.

  • The procedure takes ½ - 1½ hours and most busy doctors offices cannot afford to take this amount of time for one patient.

  • The technique of Prolotherapy requires an in-depth knowledge of anatomy and the skills to place the injections accurately. It takes a great deal of study and training for a physician to become adept at the technique.

  • Many doctors and patients are looking for a "quick fix", and with Prolotherapy results do not occur overnight. Therefore the Prolotherapy patient must be committed to the treatment because multiple sessions are often required.

  • Because there are very few doctors who perform Prolotherapy, patients just accept the pain or have surgery. While surgery has its place, many patients and doctors are not aware that Prolotherapy may relieve their pain and delay or prevent the surgery they thought they needed.

17. What are the contraindications for Prolotherapy?

  • ABSOLUTE: Cancer, Pregnancy and same day Airline travel

    • Allergy to one of the ingredients: such as Dextrose (derived from corn) or Procaine (a short acting anesthetic).

  • RELATIVE: Some patients may require more sessions if they have a health condition that compromises immune system function – please discuss these in detail with Dr Mason-Wood.

    • Smokers
    • Patients with type 1 or 2 diabetes
    • Patients taking daily NSAID’s (non-steroidal anti-inflammatory drugs).
    • Patients taking immune suppressant drugs (prednisone, imuran, methotrexate, etc.)
    • Patients with hormone deficiencies.

18. What are the best things to do following Prolotherapy?

  • Drink at least 2 liters of water following all injection therapies. Dehydration is the number one reason for post-injection discomfort.

  • Have soft tissue therapy (ART, physical therapy, chiropractic, etc.) as soon as possible following the injection treatment. The gains made from soft tissue treatment immediately after injections seem to be very accelerated.

19. What do I bring to my first visit?

PLEASE BRING THE FOLLOWING:

  • Gowns are provided however some patients prefer their own loose clothing or shorts as we will be examining the lower back &/or lower extremities

  • Any reports of MRI’s, CT scans, x-rays, & ultrasounds, etc.

  • Copy of all recent blood work (less than 6 months old)

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