Associates in Physical Medicine & Rehabilitation offers Prolotherapy as a safe, natural treatment for ligament and tendon injuries. Below are answers to commonly asked questions about this non-surgical option for pain relief. For more information about whether Prolotherapy is right for you, contact APM&R today at (734) 712-0050.

What is Prolotherapy?

Prolotherapy is a natural, non-surgical method of assisting the body in healing ligaments and tendons. It involves the injection of dextrose, or other similar solutions (non-harmful irritants), into sites of pain in ligaments and tendons. When ligaments become relaxed and weak, they cause pain. By stimulating the body’s own natural healing mechanism, Prolotherapy helps strengthen loose or injured ligaments and tendons, and repairs them into stronger, more supportive, and less painful tissue.

Why should I consider Prolotherapy instead of other treatments?

Unlike medications and cortisone injections, Prolotherapy contains safe ingredients. Repeated cortisone injections can damage and weaken tendons and ligaments. Long-term use of pain relievers and anti-inflammatory drugs like aspirin, ibuprofen and naproxen can mask symptoms without healing tissue. In addition, the success rate of surgery for chronic ligament and tendon injuries is unpredictable.

What benefits can I expect from Prolotherapy?

Some patients get benefits immediately, and some require several injections to see improvement. The procedure may boost function and eliminate the need for medication.

What can I expect during the procedure?

Prolotherapy involves the injection of small amounts of dextrose, or other non-harmful solutions, into ligament and tendon structures. Although many patients tolerate this well, some injections can be uncomfortable, so lidocaine is added to the solution to minimize pain. Few to several injections may be required; injections are done every 4 weeks. If there is no improvement after 3­–4 sessions, further treatment may be stopped.

Are there any complications or risks?

Prolotherapy is quite safe. All injections are done directly onto a bone or into a joint, thus avoiding nerves and blood vessels. The most common complication is increased pain for 1–3 days. Other risks, depending on the treated body part, include nerve damage, permanent numbness, infection, abscess, weakness, spinal headache, pneumothorax, bleeding and allergic reactions. However, these occur rarely, if at all, with an experienced prolotherapist.

How should I prepare for treatment? What should I expect afterward?

Stop taking all NSAIDs (such as ibuprofen, naproxen and aspirin) for at least 2–3 days before the procedure. There is no other preparation. After the procedure, avoid NSAIDs for at least one week. Heat or ice may be used, and mild stretching of painful areas may help. There is no requirement for rest, but you should avoid vigorous activity for 2–3 days; otherwise you may engage in any activity as tolerated.

Will my insurance cover Prolotherapy?

Most insurance companies do not cover Prolotherapy, although there are a few that may pay for it. In the event that the insurance company does not cover the treatment, the patient is responsible for the cost. Most patients find that the expense is worth the improvement of a condition that has been chronic and painful.

What conditions can Prolotherapy treat?

Commonly treated conditions include arthritis, tendonitis and chronic sprains. The list below shows areas of treatment.

Sacroiliac joint, iliolumbar ligaments, facet joints, interspinous ligaments

Bursitis, sacroiliac joint dysfunction, joint arthritis, symphysis pubis pain

Patellar tendonitis, degenerative arthritis, chondromalacia, ligament strain

Rotator cuff partial tear, biceps tendonitis, chronic ligament strains, A-C joint pain

Epicondylitis–tennis & golfer’s elbow, ligament injuries

Chronic thumb strain, joint arthritis

Chronic ligament strains, chronic Achilles tendinosis, plantar fasciitis

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