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RATE OF HEALING
WITH PROLOTHERAPY
Ross
Hauser, M.D.
Unfortunately for most, one treatment of
Prolotherapy is not sufficient to cause enough
growth of ligament and
tendon tissue to permanently eliminate the chronic pain or sports injury.
The typical young athlete requires about two or three treatments, adult athletes typically
require anywhere from four to eight treatments.
The inflammatory response typically occurs over a four to six week
period, therefore most
Prolotherapy physicians see patients for re-evaluation every four to six weeks. Athletes often
do not have six weeks to wait for their next treatment. The athlete will tell the doctor
something along these lines, "Doctor, the PGA tour starts in six weeks. I need to be healed by
that time." In such an instance, the athlete may be treated weekly or every other week.
The anesthetic in the solution used during
Prolotherapy sessions often provides immediate pain relief. The pain relief may continue, after the effect of the anesthetic subsides, due to the
stabilizing of the treated joints because of the
inflammation caused by the
Prolotherapy injections. This pain relief normally continues for a few weeks after each treatment.
Between the second and fourth weeks, the initial stabilization induced by the Prolotherapy
subsides, and because the initial growth of ligament tissue is not complete, some of the
original pain may return during this "window period" of healing. The patient is typically
seen for follow-up four to six weeks after the treatment so progress can be accurately assessed,
avoiding evaluation during the "window period." Prolotherapy is performed every four to six
weeks because most ligaments and tendons heal over this time frame.
As the healing progresses, the number of injections required per treatment usually decreases. The pain generally continues to diminish with each treatment until it is completely eliminated,
often after four to eight sessions. In some cases, athletes or other chronic pain patients will
not experience pain relief after their first or second
Prolotherapy
treatment. This does not
necessarily mean that the therapy is not working, but rather it is an indication that the
ligaments and tendons are not yet strong enough to stabilize the joints.
The amount of
collagen
growth required for stabilization of the joint is different for each person.
A patient who
experiences pain relief at rest, but not during activity requires further treatment to
strengthen the area. If Prolotherapy treatments are continued, there is an excellent chance of
achieving total pain relief with the resumption of all previous activities, including athletics.
For the rare person who feels no relief with the third treatment, we do a nutritional assessment to see if there is something impairing the healing process. Some people want to do all of this on the first visit, which is often ideal because all aspects of healing can be initially addressed. Remember that Prolotherapy starts the healing process, the body grows the stronger tissue. The healthier the person, the more the tissue will be stimulated to grow with each treatment. If a person has a depressed immune system because of hormonal problems, nutritional deficiencies, or other medical problems (e.g., diabetes, etc.), these will decrease the body’s ability to heal. Smoking and excessive drinking of alcohol have the same effect. This is where techniques like metabolic typing, nutritional counseling, and overall natural medicine care are encouraged.
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