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Centre for Natural Medicine, Calgary AB
Centre for Natural Medicine, Calgary AB




















































































































































  1. What is Prolotherapy?
  2. How does Prolotherapy work?
  3. What conditions does Prolotherapy treat?
  4. Frequently Asked Questions
  5. Pre and Post Prolotherapy Instructions
  1. What is Prolotherapy?

    Prolotherapy is an injection technique used to treat pain and injury by naturally improving tissue healing and joint stability. Prolotherapy has been used for decades to treat pain from arthritis, injury, or joint overuse – conditions which underlie many causes of shoulder pain, knee pain, elbow pain, hip pain, foot pain and back pain. While other therapies simply mask pain or provide temporary relief, prolotherapy has the capacity to provide actual and complete healing of the injured tissues often eliminating the need for surgery or delaying it significantly.

    While many people associate inflammation with pain and suffering it is actually part of the normal healing process. It is when incomplete healing occurs that chronic inflammation, chronic pain and re-injury become an issue. Prolotherapy uses the natural inflammatory process to remind tissues that repair is still needed.

    Prolotherapy stimulates the body’s innate repair and healing processes to rebuild and regenerate injured tissue. This strengthens and stabilizes joints and decreases the pain associated with arthritis, injury or overuse. Most people find benefit from 3-6 treatments in our Calgary Clinic.


  2. How does prolotherapy work?

    Prolotherapy is a regenerative injection technique that stimulates the body’s natural healing process to regenerate and repair damaged tissue. Prolotherapy comes from the term “proli” as in proliferate or “to grow”. Injecting a solution – the proliferant – into injured tissues initiates a local immune and inflammatory response that is responsible for healing. New blood vessels form, nutrients and oxygen arrive, damaged tissue is removed and over time new tissue is laid down and restructured creating a stronger end product. Strengthening and tightening the injured structures allows the muscles to relax and pain signals to shut-off.

    How do loose ligaments and tendons cause pain?

    Ligaments are connective tissue fibers that attach across a joint to stabilize it. Tendons are made up of similar material and are the bridges or end points of muscles that attach them to the bone. Tendons and muscles move joints and ligaments stabilize them. But what happens when the ligaments get loose – either from a traumatic injury or repetitive use - and can’t perform their job? Nerve fibers in the damaged ligaments send out pain signals to the brain. Subconscious reflex mechanisms cause surrounding muscles to tighten in an attempt to stabilize the joint. This attempted but inadequate compensation leads to structural changes, chronic pain, and further instability.

    Why are ligaments and tendons so hard to heal?

    Think back to any anatomy diagram you’ve seen – with the red muscles and white or grey ligaments and tendons. It’s actually the same way in the body. Muscles are red because they have a rich blood supply while the white structures have very little. It is because of this poor blood supply that ligaments and tendons are notoriously poor healers. They often just don't receive enough oxygen and nutrients that are required for healing. This is why even if you’ve done “all the right things” that some injuries may not have healed completely or properly.


  3. What conditions can be treated with prolotherapy?

    Most injuries that involve damage to tendons, ligaments or joint capsules can be treated with prolotherapy. This includes:

    Shoulder pain, Instability, impingement syndrome, rotator cuff injuries, SLAP injuries/labral tears, arthritis

    Hip/Pelvis: Hip pain, instability, arthritis, pelvis tendinosis and pain, hip stabilizing muscles/tendons, chronic IT band tendonosis, Chronic hamstring strains/tears

    Cervical Spine: Arthritis, instability, whiplash, disc disease

    Thoracic Spine: Arthritis, instability, rib dysfunction

    Lumbar Spine: Low back pain, arthritis, instability, disc disease, herniated disc, spondylosis, pain after surgery

    Elbow: Elbow pain, instability, arthritis, tennis elbow/lateral epicondylosis, golfers elbow/medial epicondylosis, other tendinosis/tears

    Knee: Knee pain, arthritis, ligament instability and tears, peripheral meniscal tears, Runner’s knee (tendinosis), Osgood-Schlatter’s Disease, Pes Anserine tendinosis

    SI joint: Arthritis, instability, sciatica

    Pubis Symphysis:
    Osteitis pubis, instability, sports hernia

    Wrist/Hand: Wrist pain, thumb arthritis and instability, carpal bone instability, carpal tunnel syndrome, TFCC tears, finger arthritis.

    Ankle/Foot: Ankle pain, arthritis, instability and chronic ankle sprains, Sinus tarsi syndrome, Achilles tendonosis/tears, plantar fasciitis

    Note: Other conditions not listed may also benefit from prolotherapy including sports injuries, traumatic injuries, TMJ (jaw) pain, headaches/migraines and more.


  4. Frequently Asked Questions

    How many treatments are required?

    Most patients require three to six prolotherapy treatments on average. Some will respond quite quickly requiring fewer treatments while others may need up to ten or more in order to stimulate healing properly. Treatments are spaced by three to six weeks to allow the healing process time to work.

    What can I expect from the prolotherapy treatment itself?

    Treatments last roughly 30min depending on the area affected and exact nature of the injury. The procedure involves multiple injections of the proliferative solution into the injured tissue. As with any procedure involving a needle there is a certain amount of pain or discomfort. Each patient responds slightly different but in general the procedure is well tolerated. A local anesthetic is used to minimize discomfort. Afterwards, you can expect a slight increase in pain and stiffness as the anesthetic wears off (usually within a few hours). This can last for 1-3 days, with gradual improvement.

    When can I return to work/exercise?

    A return to normal and functional movement is an important part of the healing process. Controlled movement and mobilization promotes faster tissue healing and better recovery following treatment. Depending on the nature of your work or activity you may be able return the same day. For strenuous activity, a few days rest and gradual return to activity is recommended.

    What can I take for the pain?

    Because prolotherapy works by stimulating the healing inflammatory response anything that interrupts this is counterproductive. Do not take NSAIDS (aspirin, ibuprofen, naproxen etc.). Baby aspirin for heart conditions is an exception. Heat may soothe the soreness but ice may slow the healing process in the acute phase. Acetaminophen (Tylenol®) may be taken for the short-term. Discuss your options with your ND.

    How do I know that it’s working?

    Some patients begin to see benefits following the first prolotherapy treatment in as little as two weeks. For others it may not be until four to six weeks after the first treatment. Throughout your treatment we will evaluate your pain and movement to assess progress. Improvements may last for up to three years after the last treatment. If pain or instability returns fewer and less frequent treatments are often required to produce benefits.

    Do I need a referral?

    No referral is necessary. Referrals do often come from other healthcare practitioners for prolotherapy when other treatments have been unsuccessful or surgery is undesired.

    What can I do to help increase healing?

    Activity and movement are necessary in order to restructure and strengthen the new tissue. Being active and physically fit will improve recovery. It is important to strengthen areas of weakness and specific programs may be prescribed. If you smoke, quitting will help maximize healing. If you need help, let us know. Supplements and dietary changes may also be prescribed.

    Is prolotherapy safe? What are the risks?

    The injections and solutions are very safe and there is no evidence that a condition has become permanently worse due to prolotherapy. As with any procedure involving needles there is always the risk of puncturing arteries, nerves, spinal fluid or lung tissue. The complications are rare and are minimized by a skilled and knowledgeable prolotherapist. Infection risk can be minimized by proper care of the injection sites post-treatment. Allergic reaction to the solutions are also rare but have been reported. Be sure to inform your doctor about any allergies you may have. On the whole, complications are uncommon and every attempt to minimize these risks will be taken.

    What are the chances I get better? Or Worse?

    Studies and clinical evidence on prolotherapy show that 85-90% of patients receive at least 50% improvement when treated between 2-10 times. Because prolotherapy produces real healing to injured structures, long-term or even permanent relief can occur.

    Is prolotherapy for me?

    Prolotherapy is not a cure for all types of pain. Nor does it always eliminate 100% of one’s pain. It is, however, very good at addressing pain due to joint and ligament instability. Because all joints are ultimately connected – the knee bones connected to the hipbone – and a problem in one area can actually present itself in another it takes a skilled practitioner to determine the underlying cause. While many injuries or pain may respond to physiotherapy or chiropractic, those due to chronic or traumatic injury where the tendons, ligaments or joint capsules are weakened and stretched require the structural cause to be addressed. Prolotherapy truly does get to the root cause in these cases.

    What can I do to improve the healing process?

    DIET - Eat a healthy, well-balanced diet, including adequate protein intake, to ensure your body has the right building blocks to repair and regenerate new tissue. Supplements may be prescribed to assist in the healing process.

    QUIT SMOKING – Smoking impairs the healing process as it uses up much needed nutrients that could otherwise be used for healing.

    ACTIVITY – In general, more active and physically fit people heal faster. Activity increases blood and nutrient perfusion throughout the body, including damaged areas. Activity and exercise following prolotherapy treatment help to restructure new tissue along lines of stress, and is an important part of the healing process.



    Instructions prior to prolotherapy treatment:

    Inform your doctor about any supplements, herbs or drugs you are taking, especially if they are for pain or joint problems.

    Stop taking all anti-inflammatory medications and natural products, except baby aspirin taken for the heart. If you are unsure whether something is contra-indicated please call the clinic or ask your doctor.

    Inform your doctor about any allergies you may have including those to fish, corn, sugar, anesthetics, latex, or painkillers.

    Eat a light meal 1-2hrs prior to treatment

    Drink plenty of water the day before the prolotherapy procedure as well as the day of.

    If available, bring any x-rays or imaging studies of the area to be treated.

    Instructions following prolotherapy treatment:

    DO NOT take anti-inflammatories (pharmaceutical or natural) after the injections, as these will interfere with the healing process. If you are unsure about anything you are taking please call the office.

    You may take acetaminophen (Tylenol®) or other approved medications for short-term pain relief following treatment. Acetaminophen is taxing to the liver so do not exceed 4000mg per day. If you consume three or more alcoholic drinks per day or have a history of liver issues ask your doctor about other options.

    Remember that it is important to address the underlying cause rather than just cover up symptoms. Pain is a protective mechanism. Further injury may result if pain is dulled and movement or return to activity is too quick.

    Heat may be used to reduce pain but refrain from using ice during the first week.

    To reduce risk of infection avoid swimming pools, hot tubs, and lakes as well as topical oils, creams, lotions etc. at the injection site for three to five days after treatment.

    Some patients experience episodes of pain in the first two weeks after treatment. This is normal and should not be cause for alarm. However, call the clinic if you have questions or are concerned.

    Avoid strenuous activity the day of your treatment as pain perception is reduced (due to the anesthetic) and further injury could occur. In general, a reduction in activity is advised following treatment with a gradual return to your usual routine, as you feel able (usually within two to four days). As a rule movement is important and inactivity will decrease optimal results.

    Pain relief is most commonly noted at 2-6 weeks following treatment with joint strength and stability increasing with each treatment and lasting up to three years from the last treatment. The process is gradual and patience is required but the results are considerable and often permanent.


Please call our centrally located Calgary clinic if you have any questions of concerns. Conveniently located near downtown Calgary.

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