Prolotherapy

You will have a thorough assessment to see which treatment is appropriate and the treatment will be explained to you.  You will be taken to our fluoroscopy theatre so the doctor can use the x ray or ultrasound equipment for guidance in placing the needle. The doctor will explain what is happening throughout the procedure.

A local anaesthetic will be used to reduce the pain and there are other methods of pain relief available if necessary.  These injections do cause some aching and stiffness for one to two days. The benefit is gradual and should be optimal after 6-8 weeks.

Prolotherapy is a course of three injections at intervals of between one to three weeks. A second course can be used if there is a significant but incomplete effect from the first.

Our Musculoskeletal (MSK) Doctors are experienced in these injections. See below for Doctors who offer these procedures and the Clinics where they work.

Please make a double appointment (same cost as a single consultation) with the doctor who you have been referred to (costs are available here)  He/she will then take a history, examine you and make a diagnosis and recommendation. He/she can also write to your GP.

If Prolotherapy is determined to be the appropriate course of treatment then you will need to make 3 further appointments at weekly intervals at a cost outlined here.

The injections are done under x-ray guidance and take about 3 minutes within your 30 minute appointment (Sometimes, if the pain is severe, he/she may advise a cortisone injection first which costs from £500 depending on the site. You will then need to leave 2 weeks before starting prolotherapy)

We hope that answers all of your queries. If not, please contact our theatre staff at the clinic in Milton Keynes on 01908 604666.

Please bring  the most recent MRI scan and report if possible

The use of hypertonic dextrose solutions to treat lax 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.

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.

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.

We do not offer intravenous sedation but we do have Entenox gas,  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 prior to one hour before their treatment. Most patients do not find that either of these measures is necessary since the discomfort is usually tolerated sufficiently.

About 80% of patients experience at least a 50% improvement in the symptoms.

If you call the Blackberry  Clinic of your choice you will find that most appointments are available within the week depending upon your own availability

Yes, but the fluoroscopic x-ray is extremely low dose, you get more radiation on a transatlantic flight! For accuracy we use fluoroscopic x ray.

There is minimal danger to the sciatic nerve. The risk 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.

Around 14,500 over 32 years

Around 80% of patients.

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%.

Posterior SI ligaments, interosseus and occasionally sacro-tuberous and sacro-spinous ligaments.

Currently Blackberry Clinic Milton Keynes and Blackberry Clinic Oxford.

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.

For a standard set of 3 injections (done on three appointments from 1-4 weeks apart) the cost is £500 per treatment so a standard set is £1500.

In private hospitals these types of injections can cost significantly more!!

Yes, for safety and accuracy whilst maintaining the comprehensive nature of the treatment.

1-4 weeks depending on the problem

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.

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.

Yes, so long as you were doing those things before the injection without much discomfort. We like you to avoid provocative activity (ie activity that usually caused your pain) until 3-4 weeks after the course has finished.

Yes, so long as you were doing those things before the injection without much discomfort you can start these activities again shortly after your treatment. Check with the nurse or doctor.

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.

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.

A short letter from the podiatrist would be fine.

It is guided by fluoroscopic x-ray for safety and efficacy, there is no need for contrast/dye.

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.

The frequency of subluxation/dislocation should diminish as you progress through the process.

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.

1/7000 chance of allergic reaction, infection, bleeding or nerve injury which is similar to any spinal injection.

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.