-If you are on prescription blood thinners. We may ask you to stop these for a period of time before treatment if your physician approves. If this is not possible, we may modify treatment.

-Inform prior to us of any medication allergies.

-Notify us if you have been told to take antibiotics before procedures. (If you have a heart murmur, heart valve, heart valve disease, knee or hip replacement or internal prosthetic of any kind)

– Pregnancy is something we should know about. It may affect how we treat and when we treat.

-There are No restrictions with Food or Drink before your procedure, unless you are receiving oral sedation. Keep yourself hydrated before procedure. Ideal liquids: Water, Juice, Milk, protein shakes etc.

Vitamin C 1000 mg twice per day for 48 hours before and 14 days after treatment.

Zinc 30 mg per day for 3 days before and 2 weeks after injections. Change dose to every other day should a metallic taste develop or stop it entirely if side effects occur that are intolerable for either.

Based on the number of treatable areas and their depth, we decide how to make the treatment as comfortable as possible.

Some patients prefer to take Preventive Pain medications (Non-NSAIDS- like Acetaminophen, Tramadol) and or antianxiety medications such as diazepam (Valium) or lorazepam (Ativan) 1 hour before injections. These medications require a prescription.

Bring pain medications (non-NSAID) with you so post-injection pain management can be clarified.

-Do not drive if you are receiving sedation. So we suggest you consider having a driver other than yourself.

-If you have a long ride home, consider frequent stops on the way home to maintain flexibility and reduce swelling/pain.

-Supplements in addition to eating a balanced diet are very important for optimal response to Prolotherapy. We strongly recommend them few days before and after the treatment.

-Smoking cessation (quitting) permanently and at once is strongly recommended as smoking decreases the effectiveness of the injection healing, potentially increases the number of injections and could make the entire procedure unsuccessful.

Avoid alcohol, which inhibits and depresses the cells needed for tissue repair

-Wear loose-fitting clothing like sweatpants or shorts.

-It is best to use the restroom facilities before entering the procedure room, as the treatment is meticulous and can last a while.

-The areas to treat will be marked with a marker. Prior to your departure, these marks will be lightened, but there may be some marks that remain a few days.

*AFTER your Prolotherapy Treatment:-

What to EXPECT POST Prolotherapy treatment?

#Stiffness and Soreness: You can expect to be stiff and sore post treatment. This could last from 2 to 7 days. If it lasts longer it is best to call back and keep us informed on how you are doing. We may need to see you back in the Clinic to review the situation rather than just covering up a pain flare with medication.

#Numbness:  You may notice some numbness post treatment. This is not unusual as we have nerves all over our bodies and a solution may have irritated one. If this happens, your nerve will heal itself over time.

#Bruising:  Bruising is quite common; do not be alarmed by it. Bruising is good for us, as it has growth factors in it.

-Pain Medication: It is normal and expected to have an aggravation of pain and perhaps swelling (sometimes a lot) and discomfort in the area post treatment due to the inflammatory response generated by the injections that stimulate the initial healing process. In most persons, these aggravations last for 3-5days, but on occasion may continue for longer.

Use pain medications (Non NSAIDS) as directed. Baby Aspirin may be taken if it is intended to prevent stroke or heart attack. Typically, patients do not need narcotic pain medication after treatment except, perhaps, that evening of the treatment, or the next day. Patients commonly receive a prescription for a limited amount of post-injection pain medication.

-Apply moist heat to the treatment areas.
Ice may also be used, but this tends to reduce blood flow through the tissues and may result in a slower response to the injection.

-We advise not accessing public water sources (lakes, hot tubs, pools) for first 2 days. This is to avoid infection from these sources.

-Driving and working: You can drive after you receive Prolotherapy. You may feel a little stiff but will be able to continue with your activities of daily living. We do suggest walking for about five minutes before driving. You will also be capable of working. There are no work restrictions. You may choose not to work if your job involves a lot of standing or lifting.

-Exercising:  Exercising is encouraged, but please do not over do it. The stress of movement helps to produce organized, normal, strong ligaments and connective tissues. Pay attention to what your body tells you. If it hurts, take a break! Do not push yourself just because you feel better. You may pay for it later. Use heat to help calm pain or muscle spasms. Range of motion is usually improved as the joints become more stable.

-Nutrition: It is also important to remember the diet and lifestyle choices on overall recovery process. Nutrition deficiencies are epidemic in our modern society and this affects overall health and healing of ligaments and tendons.  Ligaments require proper vitamins, minerals, amino acids, and collagen  formation for repair, and proper diet and nutrition is thus imperative for healing to occur. Similarly, lack of proper hydration will hinder healing and caused ligaments to shrink.  It is recommended that you drink at least 6-8 glasses of water per day.
It is strongly advised to take the Supplements to help support optimal healing.

-Sleep: Lack of sleep is a significant component of chronic pain and chronic pain is a strong factor in sleep disruption.  Chronic pain affects cortisol levels (a response to stress the body perceives-affecting the adrenal glands).   Where cortisol goes up the feeling of restlessness and insomnia occur.  The secretion of cortisol stops when the pain cycle is stopped. Other benefits of deep restful sleep is that it produces growth hormone which is released from the pituitary gland and is anabolic (which means growth as repair).

-Hormones: Healing in prolotherapy requires inflammation and the assistance of the endocrine system which secretes and produces many hormones to help this.  (eg: cortisal, thyroid, growth hormone, prostaglandius, metatarin, testosterone, etc.) Hormones decrease with age naturally.  Therefore knowing the present levels is important to determine of your treatment. Deficient levels may need to be treated by supplementation or support to optimize benefit of treatment.

-We utilize ProLo-TOP cream to complement the Prolotherapy and SN-MERIT. You will be given a “cream application” map that will indicate areas of the body and method of application. An application of 2-4 times a day is best for active pain and twice a day for maintenance. ProLo-TOP cream is not just a simple cream, but it’s Unique, Innovative Therapeutic formulae increases the effectiveness of treatment.

-Call if Redness/Problems occur

#Note:- Occasionally aggravations may continue for a week or longer and much swelling, pain or stiffness may occur, this does not mean anything bad has occurred and should not discourage you from completing a course of treatment. Often enough, the following treatments can begin to calm the previous reactions. Please do not give up on following through with a treatment plan, because you are feeling worse in the short term, speak with me first. In either case, it is important to keep in mind that it still takes time for weakened areas to return to optimal function after injury. Even once regeneration has occurred, proprioceptive changes in function, muscle strengthening and body de-compensation are still occurring.

#Note:- Most post-prolotherapy patients fall into one of the following three groups.  In the first, the pain is immediately relieved due to the injection of the numbing medicine into the area of pain.  Then during the next 24 to 48 hours, their pain may return and may be initially, more severe.  The pain will gradually decreased in intensity as healing and strengthening occur.  The second group of patients, have little or no pain post injection and the pain stays relieved permanently.  Another group of patients find that their pain is relieved initially but returns after 2-3 weeks, necessitating further injections.