Prolotherapy: Gentle Regenerative Medicine for Joint Pain and Hypermobility
Prolotherapy is a treatment that involves injecting a sugar solution into an injured or painful joint, ligament, or tendon. The solution is intended to create a mild irritation or inflammation in the affected area, which can stimulate the body's natural healing response.
The inflammation caused by the injection triggers the body's immune system to send blood, nutrients, and growth factors to the area, which can help repair damaged tissue and promote healing. Over time, this process can lead to strengthening and tightening of the ligament or tendon, which can reduce pain and improve mobility, especially in those suffering from hypermobilty.
Prolotherapy is often used to treat chronic musculoskeletal pain, such as back pain, knee pain, or tennis elbow. It is considered a relatively safe and non-invasive treatment option, although it may require multiple sessions to achieve optimal results.
In conditions of hypermobile joints (whether from injury or Ehlers-Danlos Syndrome), Prolotherapy provides a reliable way to relieve the pain associated with ligament laxity. In someone who is hypermobile, the muscles around the problem area become overactive compensating for the lack of stability. As a series of prolotherapy treatments begins to heal and tighten the dysfunctional ligaments, the muscles reduce their overactivation and symptoms improve.
Prolotherapy often gets overlooked nowadays because of the advances in PRP and Stem Cells but it remains very effective in many cases while being the most gentle of the treatments we do.
Gentle means that it tends to have the least discomfort during the procedure and the least post-treatment soreness. This is great for mild conditions where you can stay active though a treatment course.
Prolotherapy remains an effective therapy with very simple ingredients: dextrose, lidocaine, and water. Activating your self-healing response doesn't have to be expensive to be effective.
Cost is a factor in medical decisions and having an affordable and effective option is very important to us. We also offer discounted prolotherapy to in-need patients with a referral from their PCP.
What does the scientific literature show?
Each Bullet Point Summary Links To A PubMed Study
How Many Treatments Will I Need?
The vast majority of patients need more than one treatment. This is because the healing process takes time and we want a continuous period of healing stimulus to achieve symptom relief. It can vary widely for different people and different conditions, but most people need a minimum of 3 treatments spaced out over 3-4 months. Injuries most likely resolve and don't require continuous treatment. Degenerative conditions, like osteoarthritis, generally get optimal results with routine treatments every 4-6 months, depending on severity.
Are The Treatments Painful?
There is often temporary discomfort/pressure associated with the treatment as fluid is placed into small spaces. We offer a full array of options to ensure and prioritize patient comfort:
Local and Regional anesthetic
Nerve Blocks when indicated
Nitrous Oxide Sedation
Pain Medication (Opioids and/or natural supplements)
Anxiolytics (Rx or natural supplements)
The majority of patients experience minimal pain with these measures. All patients will be provided instructions for post-treatment care that outlines additional comfort measures.
Is There A Recovery Period After A Treatment?
For prolotherapy, the recovery period is usually 1-3 days. During this period the treated area may feel increased achiness and/or stiffness that can be treated with heat applications and Tylenol (not anti-inflammatories). You do not need to be immobilized or non-weight bearing but you should avoid all strenuous activity during this period. After the post-treatment soreness has resolved you may begin slowly increasing your physical activity as tolerated.
Are There Medications Restrictions During Treatment?
Most medications do not need to be stopped and do not interfere with the treatments. The exception are anti-inflammatories. This includes NSAIDs (Advil, Aleve, ibuprofen, etc) and steroids (prednisone orally or steroid injections). These inhibit the process that the treatments are trying to stimulate so they should be discontinued prior to any treatment. There are some exceptions and Dr. Oltman will address your specific needs as a part of your treatment plan.
What Is The Cost Of A Treatment?
We require payment at the time of service. We provide you with a Superbill that you can submit to your insurance company for reimbursement. HSA accounts can also be used to pay for our services.
See our Pricing page for the full details on treatment cost and insurance coverage.
Are The Treatments Image-Guided?
Yes. Every treatment and every injection a patient receives is ultrasound-guided for the highest possible precision. The target is visualized and Dr. Oltman guides the needle directly into the area where the medicine needs to go for maximum results. There is no guess work. Dr. Oltman's RMSK credential is "Registered in Musculoskeletal Ultrasound" and distinguishes him as an expert in the technique that only a few doctors in the entire state of Oregon have. Read more about Ultrasound Expertise here.