Treatment for joint pain without anti-inflammatory drugs, steroid or surgery.



Post Prolotherapy Instructions / Guidelines

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Post injection soreness:

Typically, post-injection stiffness and soreness can be expected and is necessary for the healing process to begin. Some patients will describe a feeling of fullness, heaviness or numbness in the area treated and adjacent structures. Occasionally, the patient will feel a complete resolution of pain after the treatment because of the numbing effect of the anesthetic used in the prolotherapy solution. This numbing generally wears off within a couple of hours. 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.

How to reduce the pain and soreness following treatment:

To help the muscle soreness resolve itself sooner, massage therapy and moist heat applied to the area is recommended. Heat usually soothes the soreness, but ice will slow the healing prolotherapy stimulates. Nutritional supplements may be prescribed afterwards to help promote a healthy inflammatory response and to help with the pain. Other acceptable modalities that improve circulation and stimulate the healing process after prolotherapy include; acupuncture, massage therapy, ultrasound and infrared heat.

AVOID the following after treatment:

No anti-inflammatory (NSAIDs) medications may not be used once treatment begins because they interfere with the healing process that the prolotherapy injections started. They include all of the following:

*Advil, Ibuprofen, Motrin, Voltaren, Vioxx, Celebrex, Prednisone, Aspirin, Cortisone etc

An exception to this is for those who take a baby aspirin each day for their heart. Regular use of narcotic drugs should be avoided because they will inhibit the immune system and slow the healing. Tylenol may be used for a short period of time. If you are not sure whether a medication you are taking interferes with your prolotherapy treatment, bring it to our attention and we will help you out. Remember, it is important to treat the source of the pain through strengthening the damaged areas rather then just cover it up with chronic pain medications. Frequent high-velocity chiropractic adjustments should be avoided because they do not allow the joints treatment with prolotherapy to stabilize.

Should I exercise following prolotherapy? What should I avoid doing?

Controlled exercise and mobilization of the treated area promotes tissue healing and results in faster recovery after the treatment. It does so by increasing blood flow and nutrients. For this reason, movement and exercise are recommended as soon as patient feels ready. 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. The amount will depend on your level of fitness before and on how many areas were treated.

When should I return to work?

In most cases, depending on your job, you may return to work or school the same day as your treatment. If, however, your job places a great deal of stress on the treated area or if you have significant post-injection discomfort, you should not return to work the same day. A few days is recommended before returning to strenuous athletic activity.

When do I return for my follow-up visit?

Even 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. Gradually as treatment progresses, improvement in pain as well as functional changes will occur.

What about Nutrition?

It is also important to remember the diet and lifestyle choices on overall recovery process. Nutrition deficiencies are epidemic in our modern society and this affects overall health and healing of ligaments and tendons. Ligaments require proper vitamins, minerals, amino acids, and collagen formation for repair, and proper diet and nutrition is thus imperative for healing to occur. Similarly, lack of proper hydration will hinder healing and cause ligaments to shrink. It is recommended that you drink at least 6-8 glasses of water per day.

Importance of Sleep

Lack of sleep is a significant component of chronic pain and chronic pain is a strong factor in sleep disruption. Chronic pain affects cortisol levels (a response to stress the body perceives-affecting the adrenal glands). Where cortisol goes up the feeling of restlessness and insomnia occur. The secretion of cortisol stops when the pain cycle is stopped. Other benefits of deep restful sleep is that it produces growth hormone which is released from the pituitary gland and is anabolic (which means growth as repair).

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