We use a local anesthetic prior to treatment to ensure the procedure is well tolerated. While the procedure itself is not typically painful, it does have a low grade discomfort, often noted as a temporary sensation of fullness in the area injected. We have done thousands of procedures without anyone unable to complete or repeat the procedure, and overall it is very well tolerated by patients.

First 72 hours after prolotherapy

1. Gently move the joint through its range of motion. This should be done without causing any discomfort or pain.

2. Every hour spend 1 to 2 minutes moving the joint through its range of motion until you go to bed.

3. The evening of the procedure and following day we recommend spending 30 minutes alternating hot and cold applications. This can be as simple as taking a hot and cold pack and putting 5 minutes of heat then follow this with 5 minutes of cold, alternate 3 times.

4. Avoid anti-inflammatory agents. The process of healing requires inflammation and blocking the inflammation cycle will disrupt the healing that prolotherapy promotes.

5. Do not shower, bath, hot tub, or sauna after the procedure until the next morning.

After 72 hours

Once the initial discomfort dissipates, typically within 48-72 hours, you can return to normal activity. It is important when you return to exercise and physical activity that you do not cause pain during activity.

We recommend starting exercises 2-3 days after the procedure and to start back at 50% intensity. After 5-7 days increase the intensity to 70-80%. Let pain be your guide and if any discomfort or pain is present either reduce the intensity or choose exercsies that do not aggravate you.

While each injury has a number of factors that contribute to the answer of this question there are some generalities we can make. Acute injuries will generally heal quicker than chronic injuries. We have treated patients that require 1 treatment to resolve their pain and symptoms while more damaged or injured tissues can take 8 or more treatments to resolve or have significant improvement. Typically, patients can expect to have a reduction in their pain and improvement of their injury within 3 weeks to 3 months of starting treatment.

There is a large body of high quality evidence supporting prolotherapy as a successful treatment in numerous pain and injury conditions. Dozens of clinical trials have shown improved healing and pain management for tendinopathies, arthritis, low back and pelvic pain, TMJ injury, neck pain, plantar fasciitis, and more.

A good open source article that reviews the evidence on prolotherapy can be found here.

We encourage you to do some light movements following the procedure. This includes light walking and simple range of motion exercises for the joint that was treated. After 72 hours you can resume regular physical activity. We advise that the first 5-7 days after treatment you reduce your exercise intensity by 50%.

It is important to that movement and exercise be built in to your injury rehabilitation program. This is because joint injuries heal better with movement and exercise. Remember that further pain with activity often means you need to reduce the intensity or find an alternate exercise that does not further aggravate the injury.

This is up to you but nearly all of our patients are able to return to work the next day without any complications. If you are unsure, then book the following day off to recover, relax, and do light movements. Alternatively, if you work Monday to Friday, book a Friday appointment and have the weekend off.

This will depend on a number of factors but a typical series of prolotherapy is 6-8 treatments. Each treatment is spaced out 3-6 weeks apart.