This section includes the most common questions we receive from new patients who are just learning about Prolotherapy, as well as from those who are about to start treatment and have questions about what to expect during the treatment series. Within the answers, we have linked to pages with much more detailed explanations and research if you want to dive further into the topic. We want to make your trip to our clinic as smooth as possible, and also help you best understand your condition and how Prolotherapy can potentially provide a cure, so you can optimize your results!
- I’ve been told I’m a slow healer. Will I still be a candidate
- Shouldn’t I do PRP or stem cells instead of Prolotherapy?
- Do I need to change my lifestyle or eating habits to receive Prolotherapy?
- Why do you keep talking about joint instability? That is not what my MRI shows.
- How do the treatments help nerve pain? I thought Prolotherapy was just for joint pain and arthritis?
- How do the treatments help headaches?Can I receive Prolotherapy if I’m taking medications?
- Do I need to have tests performed before I can come in for a consultation and Prolotherapy?
Prolotherapy compared to other treatments you have probably already tried
How is Prolotherapy different from physical therapy?
While these treatments pair very well together, physical therapy (PT) primarily concentrates on strengthening muscles, and Prolotherapy strengthens and repairs ligaments. At the root of chronic pain is joint instability, which is caused by loose ligaments (the structures that hold joints together). It is not a muscle problem, though muscles become involved eventually to help stabilize the joint because the ligaments are too loose to do so. Loose ligaments cause destructive joint forces, resulting in symptoms like pain, bone spurs, swelling, and muscle spasms. Ultimately, the destructive joint forces cause cellular death and joint/cartilage/disc/labrum/meniscus degeneration. Prolotherapy is the only treatment for loose ligaments.
How is Prolotherapy different than cortisone?
In short, cortisone accelerates joint damage whereas Prolotherapy protects and strengthens joint structures. Cortisone covers up pain signals and decreases inflammation. When you block pain, your body cannot tell you it hurts. This creates a vicious cycle of joint damage because you will not alter your activity level and end up doing additional damage to your joints because there isn’t a pain signal trying to warn you about further damage happening in the joint. There are many studies explaining the degenerative effects of cortisone, and most surgeons will even admit that during surgery, they can tell the difference between a joint that has received cortisone injections and one that has not. Prolotherapy aims to correct joint instability, thereby alleviating pain and destructive joint motion. Instability is progressive, meaning if left untreated, the instability gets worse! When the instability gets worse, so does the pain. Therefore, as you keep getting cortisone shots, it does not cure your pain—it simply covers it up while the joint damage accelerates.
Being a candidate for Prolotherapy
I’ve been told I’m a slow healer. Will I still be a candidate?
Absolutely! No two bodies, or immune systems, are exactly alike. Some people do heal faster than others, but that doesn’t mean you can’t be pain free too! You can maximize your healing and minimize the number of treatments needed to become pain free by following any requests or recommendations your provider makes. Your provider will discuss with you things that may help increase your healing ability, such as natural hormone replacement therapy, proper nutrition, stress reduction, and other things that can help your immune system perform at its best so you can reach your goals with Prolotherapy.
Shouldn’t I do PRP or stem cells instead of Prolotherapy?
PRP and stem cells are a type of prolotherapy solution, just like dextrose is. Prolotherapy is the term used for the injecting of proliferating solutions (proliferant therapy = Prolotherapy). Not all patients need PRP or stem cells, many are cured of their instability and pain with dextrose solution. Based on the severity of your instability, functional goals, and other considerations, we will discuss with you the most appropriate solution for your individual case.
Are my stem cells are old or diseased?
Although stem cell numbers decrease as we age, bone marrow and adipose (fat) still have high numbers of stem cells. We have successfully used stem cells and other Prolotherapy solutions to cure patients of all ages.
Do I need to change my lifestyle or eating habits to receive Prolotherapy?
Let’s be honest, we all probably eat things we shouldn’t. A healthy and nutritious diet leads to a healthy body. This doesn’t mean you can never eat cake, it simply means you need to give your body the fuel it needs to heal. Lean proteins and fresh fruits and vegetables are something we all benefit from. The foods we eat give our bodies certain things we need to heal, so a healthy and balanced diet is an important part of healing. If your main food groups are Doritos and Mountain Dew, we need to talk.
Why do you keep talking about joint instability? That is not what my MRI shows.
What your MRI shows is the results of joint instability. That slipped disc or herniated disc is caused by instability! If your ligaments were tight, the disc would not be able to come out of place. Once your ligaments become stretched out, the disc is able to slip out of position. MRI’s are a good tool for certain things, but since you are not moving during an MRI, it does not show the instability in a joint. Digital Motion X-ray and ultrasound are good tools for showing instability because they show the joints while they are moving and you can see the instability.
How do the treatments help nerve pain? I thought Prolotherapy was just for joint pain and arthritis?
Instability causes nerve pain. When the ligaments are stretched and the joint is unstable, the bones can hit the nerves and irritate them, causing nerve pain. Over time, this constant bumping of the bone into the nerve causes the nerve to become swollen and irritated, leading to constant pain. Prolotherapy strengthens the joint and prevents the bone from bumping the nerve.
How do the treatments help headaches?
Often, headaches are caused by instability in the neck. When the ligaments that hold the vertebra in the neck together get stretched out from looking down at a computer or phone, or stretched or damaged from an accident, the muscles tighten up to try to hold the vertebra in place. This muscle tightening causes a lot of stress and strain in the neck and at the base of the skull, and this leads to headaches. The upper vertebra in the neck can also become turned to the side a little bit when the ligaments are unable to hold them together, and this rotation can push up against a nerve causing headaches, face pain, jaw pain, even ringing in the ears. Prolotherapy tightens the ligaments and this allows the muscles to relax and the headaches, and other pains, go away.
Can I receive Prolotherapy if I’m taking medications?
Our clinical team will review your medication list during your New Patient phone consultation and advise if there is anything that should be discontinued, such as NSAIDs or narcotic pain killers. In general, most medications that are unrelated to pain, such as hormone therapy or blood thinners, are fine to continue throughout the Prolotherapy treatment series. Again, for specific medication questions, our clinical team will review your medication list prior to your first appointment and advise.
Do I need to have tests performed before I can come in for a consultation and Prolotherapy?
No. Having the opportunity to talk with you about your case and conduct a physical exam is the first step toward pain relief. Doing additional testing without first having a thorough consultation and physical exam is putting the cart before the horse. If you already have imaging results from other providers, we are happy to review it, but we can provide most of the imaging needed in our office or we will refer you to have a specific test based on your physical exam and history during your initial consultation.
Your first Prolotherapy visit/initial consultation
How would you diagnose me without an MRI?
It is misleading to think that MRI is necessary when you have a chronic pain. A well-trained pain practitioner knows when MRI is warranted, and when it is really just a waste of money. In our office, a thorough physical exam and history are paramount.
Do I need to bring in my X-rays, MRIs, EMGs, and old records?
You can certainly bring any radiologic imaging that you have already had performed. If you do have imaging results, please bring a copy of the disc for us to keep on file, as well as the written report. It is not necessary to have an MRI or other tests prior to your appointment, unless you have been otherwise instructed to do so by your medical provider. Results of recent lab work, done within the last six months, may be brought to your visit if you feel they are pertinent to your current condition.
Should I eat before my appointment?
Yes, you must eat before receiving Prolotherapy. Please eat a good-sized breakfast with protein before coming in for a morning appointment, and eat a good-sized lunch with protein before coming in for an afternoon appointment. The only exception is if you are scheduled to have treatment under conscious sedation. For these instances, you will not eat prior to your appointment. You will be talking with a clinical member prior to your appointment to review any additional instructions.
How long is the visit?
The average new patient visit is approximately 30 minutes. If you are being seen for multiple body areas, have a complicated case it could take longer. For follow up Prolotherapy treatments, the visit duration is approximately 20 minutes.
Will I get Prolotherapy on the first visit?
If the reason you are coming to The Asklepion Centre for Tibb is to receive Prolotherapy (this includes PRP, Stem Cell therapy, Nerve Release, etc..) you will most likely receive it, provided that your body can physically handle it. If your Prolotherapy specialist feels that your general health is too poor, he or she may suggest certain laboratory testing first. This is rare. The majority of patients are able to receive Prolotherapy the first visit.
What forms of payment are accepted?
The Asklepion Centre for Tibb accepts cash, Visa, MasterCard and Bank Transfers. Check out our Prolotherapy prices and payment policies.
After receiving Prolotherapy
When can I work after Prolotherapy?
Most of our patients go back to work the next day. Some even go back the same day, especially if they had an area treated that would not be aggravated by their job. However, it is important to let your provider know what type of work you do and the physical activities your job entails, as they may want to limit certain things based on your particular case, or they may have you wear a certain brace or protect the joint in some other way to maximize your treatments and ability to heal.
Can I drive after treatment?
Many of our patients drive themselves after treatment. There are a few things to keep in mind when deciding if you should ask a friend or family member to either accompany you or pick you up. If you are a neck patient or a right knee/hip/ankle/foot patient, we recommend having a driver for your comfort as the motions required for safe driving may be slowed down for a few hours due to the treatment. Also, patients that request medications for comfort during treatment are required to have a driver.
When can I exercise after Prolotherapy?
Exercises is good! We aim to get you back to your active lifestyle as quickly as we can while optimizing your healing. Your provider may even have a few new exercises they want you to do at home or with your trainer or physical therapist. We recommend you take it easy for the first few days after a treatment. This doesn’t mean be a couch potato! Activities of daily living are great. It simply means no heavy workouts for the first few days. More specific instructions will be provided to you during your visit and written in your treatment plan.
Adjunctive treatments and availability
Can I continue seeing my Osteopath/Chiropractor
This is something your provider will determine. Some of our patients benefit from Osteopathy later in their course of treatment while others do excellent with home exercises prescribed by the provider. Depending on the severity of your instability, your joints may not be ready for osteopathy. For many people who have tried rounds of osteopathy/physical therapy already, this may be the case. Until the ligaments are in a state of repair, physical therapy will continue to be frustrating and lack long-term effectiveness because it is not addressing the root cause of the problem. Osteopathy/Chiropractic may try to address muscle imbalances but those cannot be fixed until the ligaments that actually create the joint are restored. For patients who will benefit from a combined approach, we will work with your therapist on developing a program that will be most effective for you.
Why can’t I get these injections at my other doctor’s office?
Prolotherapy is more than just “shots.” It is a highly specialized procedure. To cure pain, you need a Prolotherapist who understands the importance of a comprehensive approach and knows that just injecting one or two ligaments, or just an intra-articular injection, is not generally enough. Becoming a high-level Prolotherapist takes time and training under another high-level Prolotherapist to learn this technique. Not just attending a weekend course on theory or with cadavers. Patients who have more complicated cases and/or are serious about Prolotherapy need a provider that specializes in Prolotherapy and that has been trained thoroughly in ligament anatomy and does not solely rely on guidance from a machine. Dr. Barrie Oldham ND DO has had extensive training in the United States.
My doctor said Prolotherapy isn’t going to help me.
Many doctors do not fully understand how Prolotherapy works, or even worse, have never heard of it! They may assume that one shot of PRP or amniotic cells is the same as Prolotherapy. If they think Prolotherapy is new, it shows they do not understand the decades of research and patient results supporting its use in chronic pain, sports injuries, and arthritis. Because it is a specialized treatment, providers must take it upon themselves to learn after graduating. It is a huge undertaking to do it the right way, just as is any medical sub-specialty. Thus, it is typically not well understood by doctors who do not specialize in chronic pain care, or who have only tried one-shot PRP.
Prolotherapy treatment goals and results
What is considered a pain cure?
The average cure rate for excellent candidates is 90%; good candidates is 75%; poor candidates is 10%. The reason. Prolotherapy is so successful is that it has a solid foundation which has only been improved as technology advanced over the past 65 years in treating over 40,000 patients. It involves ideal patient selection, treatment method and follow up. Remember, helping soften the symptoms of chronic pain is easy, resolving chronic pain is not. The world’s most scientifically curative regenerative injection method is the Asklepion Centre Prolotherapy Method. Simply it involves treating all of the appropriate joint instabilities and optimizing appropriate forces on the injured structures throughout the healing process. A person is deemed cured of their pain when three criteria are met:
- 90%+ of their symptoms are resolved
- They are back to full activity
- There is objective evidence that the joint instabilities are resolved
Is this just to help postpone surgery?
No! Prolotherapy is the preferred alternative to surgery, eliminating the need for surgery in most cases. Many of our patients have been told they need joint replacements, the dreaded “bone on bone”. We treat patients that have been told they are “bone on bone” on a regular basis with fantastic results! These patients are currently walking, jogging, playing tennis and golfing on a regular basis without surgery!
Don’t get discouraged! Just because you do not notice immediate relief, does not mean nothing is happening. It takes time for your body to heal, and each treatment builds on the one prior. Think of it as building a house; you have to build the foundation first. It may not look like much progress, but without the foundation, you can’t build the house. The first treatment is the foundation, the base for all of your other treatments and the first step toward curing your pain!
Why does the Prolotherapy series take more than one treatment?
Ligaments are white tissues, this means they have a poor blood, and nutrient, supply. Since these tissues have a poor supply of what they need to heal, they are slow to heal. Prolotherapy causes inflammation at the ligaments, which initiates the healing cascade in the area. This inflammation tells the body there is tissue damage, and the body begins to send the additional nutrients and healing cells that are needed to tighten and strengthen the ligaments.
Follow up is crucial with Prolotherapy, and this is when it matters most to work with an office that does Prolotherapy full time. We cannot tell you how often we hear from patients who received Prolotherapy, PRP, stem cells elsewhere and were sent away without any follow up plan. If this is you, please realize that we cannot give you specific recommendations. You need to come to our clinic and we will provide you with more specific details on how to best reach your functional goals and rehab your joint. For instance, whether or not to brace the area, what type of brace, how long to wear it, etc… When it comes to exercise, we make specific recommendations on what type of exercises, when you are allowed to graduate from cycling to jogging to running, etc… We work with you on specific supplements or other healing aids that can help boost or speed your response to Prolotherapy.
The Prolotherapy treatment series is 50% us and 50% you. We will give you the most comprehensive treatment techniques during your visit and recommend a home care plan and/or adjunctive treatment plan for you to work on after treatment. The combination is highly successful, and it is why patients from all walks of life travel to our clinics. Whether your goal is to be able to play with your children or grandchildren, hike Mount Olympus, run your PR marathon, return to work full-time, avoid a career-compromising surgery, enjoy retirement, or stop your pain medication dependency, we want to help you succeed!