Prolotherapy and Prolozone: Regenerative Injection Therapies
What are Prolotherapy and Prolozone?
Prolotherapy is short for proliferation therapy. By this, we mean that we are trying to proliferate (increase) the healing cells of your body. In this case, this is specifically related to the ligaments, which surround and support joints in the body. It can also be used for muscle attachments that have become damaged and pain-sensitive.
Prolozone can use two different types of injection. If a joint or area is chronically inflamed, an anti-inflammatory injection can be used for 1-2 treatments to calm the pain response while injection of a proliferant solution creates localized inflammatory response to trigger the body’s own healing mechanism. The addition of ozone increases oxygen utilization at the site of inflammation, to promote healing and decrease pain.
What do the ligaments do?
Ligaments surround all our joints. They stabilize and protect the joint by allowing normal but not abnormal range of movement. They also have a large number of nerve endings so that if they are stretched, they cause pain. This tells our body to change something to protect the joint from damage.
How are the ligaments stretched or injured?
Our ligaments become slackened (laxity) just with the passage of time and the stress on the ligaments from our posture and from daily activities. They can also be injured by trauma. Sometimes they do not heal fully.
Will I benefit from regenerative joint injections?
First, we have to find out if you are a candidate for treatment by Prolotherapy or Prolozone. Initially, it is important that you have a proper assessment by Dr. Coombs. This may take more than one visit in some cases. The more information I have when you visit me, the better judgment I can make about your treatment.
What are the prolotherapy injections?
The injections most often used consist of a mixture of a local anesthetic, nutrients and Dextrose. The contents of the injection are very safe. The Dextrose solution is a strong enough concentration to irritate the ligaments. This sets off a response in the area, which is needed to start the healing process.
Are there any risks?
The potential risks when puncturing the skin, namely infection and bleeding, are very rare due to the small diameter of the needle and the procedure that I use. Please report any excessive pain, redness, or swelling of the area. Some people have expressed a concern about ligaments becoming too tight after the injections. With Prolotherapy, the body produces new collagen, which is normal ligament tissue. The ligament will become stronger and tighter, but it does not become tighter than a healthy ligament.
The remainder of possible risks depend on the area being injected. For areas outside of the spine, such as the jaw/head region, the shoulder/arm region, or the hip/leg/foot region, there are few other risks. It is possible to touch a nerve with the needle which could give a brief shooting pain. The local anaesthetic can also cause some nerves to go numb temporarily. Prolonged numbness or weakness is rare. For injections in the spine area, it is possible to enter the spinal canal, but I stay away from the midline and always double check to avoid this before injecting. If this were to happen, it may result in a significant headache for 2 – 4 days. Laying flat alleviates the headache. For injections in the rib or chest area, there is a possibility of puncturing a lung (pneumothorax). This is rare. If you feel any change in your breathing, please notify me or my staff immediately.
A very small percentage of the population is allergic to local anesthetics. If you think you are, please let me know. An even smaller percentage of people are allergic to sugar, which is the source of medical Dextrose.
Are these injections painful?
Most people find prolotherapy injections mildly painful. The local anesthetic removes the pain quite quickly. In spite of this, or if you are having many areas or levels injected, you may have difficulty tolerating the pain. If so, we will discuss other ways to minimize the pain. This may mean that you take a painkiller by mouth (e.g. Tylenol 3) or a numbing cream for the skin one hour before your appointment time. You may ask your MD for a mild relaxant, such as Ativan. The addition of ozone to these therapies can help with pain also.
If the spine or rib area is being treated, or if you have taken a pain-reliever or medication which affects your alertness, it is not advisable to drive yourself home. If you are not driving, it is easier to change position. You should have less pain for 1 to 2 hours after the injection, but you may feel a little stiff. When the freezing wears off the injected area will feel funny, perhaps achy and swollen, but not necessarily painful. However, it may help to bring with you a painkiller or painkiller/muscle relaxant combination that you can take on the way home.
Please do not use anti-inflammatory painkillers (Ibuprofen, Advil, ASA, Celebrex etc). Many people find that heat on the area helps afterwards.
How Many Injections Will I Need?
For Prolotherapy and Prolozone in areas outside of the spine, number of treatments needed depends on the amount of ligament laxity or damage and the individual’s response. For the spine region, most men require three to six treatments. Women often require six to nine treatments. Treatments may be done as often as once a week for three weeks then repeated in one months time if needed. For some conditions, treatment will be done every two to four weeks. You can expect to see some reduced pain after one or two treatments, but the healing process actually continues for one to two months after the last injection.
Everyone has pain. Whether it's a sore lower back that won't go away no matter what you do, a sore knee from your more athletic days or a shoulder that you no longer can sleep on, these pains affect the activities that you do (or don't do) in your day to day life.
Dr Coombs has completed training with the American Osteopathic Association of Prolotherapy as well as Maui Regenerative Medicine for the extremities (knee, hip, ankle, shoulder, wrist, hand), the lumbar/ SI area or low back and the upper back/ thoracic and cervical/ neck areas. Dr. Coombs has also completed training with Dr. Shallenberger, the leading physician in ozone therapies and the creator of Prolozone.
Get back to the activities that you enjoy, book an assessment in Kelowna, BC with Dr. Coombs today!
Prolotherapy is short for proliferation therapy. By this, we mean that we are trying to proliferate (increase) the healing cells of your body. In this case, this is specifically related to the ligaments, which surround and support joints in the body. It can also be used for muscle attachments that have become damaged and pain-sensitive.
Prolozone can use two different types of injection. If a joint or area is chronically inflamed, an anti-inflammatory injection can be used for 1-2 treatments to calm the pain response while injection of a proliferant solution creates localized inflammatory response to trigger the body’s own healing mechanism. The addition of ozone increases oxygen utilization at the site of inflammation, to promote healing and decrease pain.
What do the ligaments do?
Ligaments surround all our joints. They stabilize and protect the joint by allowing normal but not abnormal range of movement. They also have a large number of nerve endings so that if they are stretched, they cause pain. This tells our body to change something to protect the joint from damage.
How are the ligaments stretched or injured?
Our ligaments become slackened (laxity) just with the passage of time and the stress on the ligaments from our posture and from daily activities. They can also be injured by trauma. Sometimes they do not heal fully.
Will I benefit from regenerative joint injections?
First, we have to find out if you are a candidate for treatment by Prolotherapy or Prolozone. Initially, it is important that you have a proper assessment by Dr. Coombs. This may take more than one visit in some cases. The more information I have when you visit me, the better judgment I can make about your treatment.
What are the prolotherapy injections?
The injections most often used consist of a mixture of a local anesthetic, nutrients and Dextrose. The contents of the injection are very safe. The Dextrose solution is a strong enough concentration to irritate the ligaments. This sets off a response in the area, which is needed to start the healing process.
Are there any risks?
The potential risks when puncturing the skin, namely infection and bleeding, are very rare due to the small diameter of the needle and the procedure that I use. Please report any excessive pain, redness, or swelling of the area. Some people have expressed a concern about ligaments becoming too tight after the injections. With Prolotherapy, the body produces new collagen, which is normal ligament tissue. The ligament will become stronger and tighter, but it does not become tighter than a healthy ligament.
The remainder of possible risks depend on the area being injected. For areas outside of the spine, such as the jaw/head region, the shoulder/arm region, or the hip/leg/foot region, there are few other risks. It is possible to touch a nerve with the needle which could give a brief shooting pain. The local anaesthetic can also cause some nerves to go numb temporarily. Prolonged numbness or weakness is rare. For injections in the spine area, it is possible to enter the spinal canal, but I stay away from the midline and always double check to avoid this before injecting. If this were to happen, it may result in a significant headache for 2 – 4 days. Laying flat alleviates the headache. For injections in the rib or chest area, there is a possibility of puncturing a lung (pneumothorax). This is rare. If you feel any change in your breathing, please notify me or my staff immediately.
A very small percentage of the population is allergic to local anesthetics. If you think you are, please let me know. An even smaller percentage of people are allergic to sugar, which is the source of medical Dextrose.
Are these injections painful?
Most people find prolotherapy injections mildly painful. The local anesthetic removes the pain quite quickly. In spite of this, or if you are having many areas or levels injected, you may have difficulty tolerating the pain. If so, we will discuss other ways to minimize the pain. This may mean that you take a painkiller by mouth (e.g. Tylenol 3) or a numbing cream for the skin one hour before your appointment time. You may ask your MD for a mild relaxant, such as Ativan. The addition of ozone to these therapies can help with pain also.
If the spine or rib area is being treated, or if you have taken a pain-reliever or medication which affects your alertness, it is not advisable to drive yourself home. If you are not driving, it is easier to change position. You should have less pain for 1 to 2 hours after the injection, but you may feel a little stiff. When the freezing wears off the injected area will feel funny, perhaps achy and swollen, but not necessarily painful. However, it may help to bring with you a painkiller or painkiller/muscle relaxant combination that you can take on the way home.
Please do not use anti-inflammatory painkillers (Ibuprofen, Advil, ASA, Celebrex etc). Many people find that heat on the area helps afterwards.
How Many Injections Will I Need?
For Prolotherapy and Prolozone in areas outside of the spine, number of treatments needed depends on the amount of ligament laxity or damage and the individual’s response. For the spine region, most men require three to six treatments. Women often require six to nine treatments. Treatments may be done as often as once a week for three weeks then repeated in one months time if needed. For some conditions, treatment will be done every two to four weeks. You can expect to see some reduced pain after one or two treatments, but the healing process actually continues for one to two months after the last injection.
Everyone has pain. Whether it's a sore lower back that won't go away no matter what you do, a sore knee from your more athletic days or a shoulder that you no longer can sleep on, these pains affect the activities that you do (or don't do) in your day to day life.
Dr Coombs has completed training with the American Osteopathic Association of Prolotherapy as well as Maui Regenerative Medicine for the extremities (knee, hip, ankle, shoulder, wrist, hand), the lumbar/ SI area or low back and the upper back/ thoracic and cervical/ neck areas. Dr. Coombs has also completed training with Dr. Shallenberger, the leading physician in ozone therapies and the creator of Prolozone.
Get back to the activities that you enjoy, book an assessment in Kelowna, BC with Dr. Coombs today!