These are some of the questions that we get asked frequently by our patients enquiring about prolotherapy at Blackberry Clinic. I hope this list helps to answer some of the queries you may have but do not hesitate to get in touch if you think of anything else you would like to know!
Question: What is prolotherapy?
Answer: The use of hypertonic dextrose solutions to treat lax (loose) ligaments and instability of any joints in the body.
Platelet Rich Plasma and Stem cell therapy also count as prolotherapy since the result is a ‘proliferation’ of normal body connective tissue and collagen found in ligaments and tendons.
Question: How many injections do I need?
Answer: A standard set of prolotherapy in the UK is three injections but if there is considerable improvement and the improvement is incomplete then a further three injections are frequently offered.
Question: How long does the treatment last?
Answer: On average, patients experience one year of improvement and relief from prolotherapy. However, there is a huge variation and sometimes improvement lasts from three months to 15 years. A repeat course of injections is often indicated and produces a similar period of relief.
Question: Do you offer sedation?
Answer: We do not offer intravenous sedation but we do have into Entenox gas which is a mixture of nitrous oxide and oxygen which provides an element of pain relief and sedation. Some patients who are already taking muscle relaxants such as diazepam can take a tablet before one hour for their treatment. Most patients do not find that either of these measures is necessary since the discomfort is usually tolerated sufficiently.
Question: What is the success rate?
Answer: About 80% of patients experience at least a 50% improvement in the symptoms.
Question: Is there a waiting list?
Answer: If you call the clinic you will find that most appointments are available within the week depending upon your own availability.
Question: Is it possible to do prolotherapy on the sacroiliac joint or lumbosacral ligaments without using X-ray?
Answer: Yes, but the fluoroscopic x-ray is extremely low dose, you get more radiation on a transatlantic flight!
Question: How safe is the sciatic nerve?
Answer: There is minimal danger to the sciatic nerve. The rislk may be more if the injection is done without x-ray guidance. There is 1:7000 chance of allergy, infection bleeding or nerve damage as with any spinal injection.
Question: How many prolotherapy injections in pelvic / low back area have you done at the Blackberry Clinic?
Answer: Around 14,500 over 32 years
Question: How many patients have had significant improvement after prolotherapy?
Answer: Around 80% of patients.
Question: Do you use dextrose as proposed by Dr Hackett in his original publications?
Answer: Yes we use a number of different solutions and techniques depending upon the problem being treated. Commonly used preparations include:
Dextrose: 5%. 15% and 25%
P2G: which contains dextrose 12.5% glycerol 12.5% and phenol 1%.
Question: Which ligaments of the SI joint do you inject?
Answer: Posterior SI ligaments, interosseus and occasionally sacro-tuberous and sacro-spinous ligaments.
Question: Which Blackberry Clinics do spinal prolotherapy?
Answer: Currently Blackberry Clinic Milton Keynes and Blackberry Clinic Oxford.
Question: Which parts of the body can prolotherapy be done on?
Answer: Prolotherapy can be used to treat the spine including lumbar, thoracic and cervical spine up to the level of C2 but we do not use this treatment any higher.
We can treat osteoarthritis of the knee and hip along with recurrent ankle sprains and shoulder instability or rotator cuff tendinopathy.
There are too many areas of the body to list here and it is worth a consultation to discuss your options.
Question: What is the full cost of the treatment?
Answer: For a standard set of 3 injections (done on three appointments from 1-4 weeks apart) the cost is £350 per treatment so a standard set is £1050.
In private hospitals these types of injections can cost £1500 per time!!
Question: Is it done under X-ray guidance?
Answer: Yes, for safety and accuracy whilst maintaining the comprehensive nature of the treatment.
Question: How much time in left between each prolotherapy injection?
Answer: 1-4 weeks depending on the problem
Question: How many courses of prolotherapy can you have?
Answer: There is no limit, but if you needed more than 3 courses in a year you may have to reassess the appropriateness of the treatment.
Question: Can I drive home afterwards?
Answer: Yes, our theatre staff will assess you after the treatment and so long as you are feeling fine they will let you go within 20 minutes of finishing the procedure.
Question: Can I continue to do normal activities after the injections?
Answer: Yes, so long as you were doing those things before the injection without much discomfort. We like you to avoid activities that caused you pain prior to your injections until 3-4 weeks after the course has finished.
Question: When can I get back to doing exercising/going to gym/swimming etc?
Answer: As long as you were doing these activities without much pain you should be able to start them soon after your injections. Please check with the doctor.
Question: Do I need to stop taking any medication that I am on?
Answer: Yes, please stop non-steroidal anti-inflammatory medication such as Nurofen, Ibuprofen, Naproxen and Diclofenac on the day of the procedure and do not resume until after the course has finished. Please discuss with the doctor at the first appointment. We suggest you stop Turmeric too.
Question: How many areas can be treated at once?
Answer: Usually one area of the body is treated at one visit.
Both sacroiliac joints can be treated on the same visit, this can include the lumbar spine also.
No more than 3 levels of the lumbar spine are treated at one visit.
Question: Can my podiatrist refer me directly to you?
Answer: A short letter from the podiatrist would be fine.
Question: Is the injection guided by fluoroscopy dye and x-ray?
Answer: It is guided by fluoroscopic x-ray for safety and efficacy, there is no need for contrast/dye.
Question: How immediately does it tighten the area?
Answer: We assess the full effect 4-6 weeks after the last of the three injections. However some patients feel a beneficial effect after the first injection.
Question: My joint dislocates itself usually just one week/half after it’s been reset. Any immediate effects?
Answer: The frequency of subluxation/dislocation should diminish as you progress through the process.
Question: How long is the waiting list for appointments?
Answer: The waiting list can be 1 day to 2 weeks depending on various circumstances but it is worth calling to find out the current wait.
Question: Contraindications and risks?
Answer: 1/7000 chance of allergic reaction, infection, bleeding or nerve injury which is similar to any spinal injection.
Question: Does it ever go wrong, and how?
Answer: 1/7000 chance of allergic reaction, infection, bleeding or nerve injury which is similar to any spinal injection.
The pain can feel worse for a day or so after the injection.
