Prolotherapy
Prolotherapy is an injection of a substance that is thought to trigger the body’s own healing response. The injection can initially cause some increased pain as it results in short term inflammation. Inflammation can be healthy when it's short term and triggers a healing and/or strengthening process like after an injury.
When damaged or weak ligaments are strengthened, support is provided to the joints and other tissues resulting in less pain. The injections must precisely target the specific areas thought to contribute to the weakness and pain. Muscles and tendons can also be targeted with prolotherapy.
Although prolotherapy has been practiced for over 50 + years, it's effectiveness is still questioned by many (or perhaps most) physicians. There are however many studies (including a randomized controlled trial for knee arthritis) over the past 10 years that support it as a safe and effective alternative treatment for joint or other musculoskeletal conditions.
Prolotherapy usually requires multiple sessions of injections to be effective. Each session can consist of anywhere from a few injections to 15 or more injections. These sessions would typically occur over a period of 3 to 6 months.
If a person is taking anti inflammatory medications these should be stopped for at least 3 days before the procedure and for 2-4 weeks after the procedure. This is so that the “healthy” inflammation after the injection is not inhibited.
As with any intervention, a thorough initial assessment is needed to determine if you are a candidate and what areas should be targeted.
Dextrose or “suger solution” is the most commonly used injection solution. Often a small amount of local anesthetic (freezing) like lidocaine will be mixed into the solution as well.
In our experience we get better overall results using PRP (platelet rich plasma) instead of dextrose. The main benefit is that pain relief is seen after fewer injections. For example, the benefit of a single PRP injection is similar to 2-3 dextrose injections. As PRP does trigger more of an inflammatory response, there can be more pain for 7-10 days following the procedure. When you take into account that fewer sessions are typically needed with PRP compared to dextrose, PRP is usually more cost effective.
Alberta Health Care does not cover the cost of prolotherapy or PRP, but does cover the cost of an initial assessment if you are referred by your doctor or other health professional such as a chiropractor or physiotherapist. The cost of prolotherapy can range from $100 to $400 per session. PRP pricing is detailed in the PRP section of our website.