Frequently Asked Questions

  1. Is Prolotherapy safe?
  2. Is Prolotherapy new?
  3. Can I expect to have a Prolotherapy injection on my first visit?
  4. What can I expect after Prolotherapy injections?
  5. Does any other treatment need to be done along with the Prolotherapy?
  6. Are all patients with chronic pain candidates for Prolotherapy injections?
  7. Are prolotherapy injections covered by insurance companies?
  8. May my children come with me to the office during my evaluation or other appointments?
  9. Does your office give reminder calls for appointments?
  10. Can/will Dr. Dubick give me an injection in the office or on the first visit?
  11. Am I allowed to eat, drink, and take medications prior to my injection appointment?
  12. Do I need a driver to and from the facility when I have a procedure?
  13. How many days after my Prolotherapy injection may I return to work?
  14. How many days after my anti-inflammatory injection may I return to work?



    Is Prolotherapy safe?

    Prolotherapy is a very safe procedure. The risks are far less than taking NSAIDS or opioids for a lifetime to temporarily alleviate chronic pain. There is, however, a slight risk in any medical procedure. In Prolotherapy, the risks and side effects will vary depending on the area being treated. Injections are almost always performed at the fibro-osseous junction, the major site of the damaged tissue and an area with few nerves or blood vessels. The combination of injection at the fibro-osseous junction and using fluoroscopic guidance to visualize the tip of the needle helps make Prolotherapy very safe. Rarely, however, injection material can be deposited near nerve tissue. This may cause a temporary increase in pain or numbness that will resolve in time. Other complications may include infection, allergic reaction, pneumothorax, dizziness, or nausea.

    Is Prolotherapy new?

    Prolotherapy originated in the late 1930’s. Dr. Earl Gedney, an osteopathic physician from Philadelphia, was the first to use an injection to strengthen sacroiliac ligaments and termed it Sclerotherapy. Dr. George Hackett, a surgeon from Canton, Ohio, active in the late 1950’s, correlated pain patterns from strained ligaments and instability. He treated thousands of patients with ligament strengthening injections which he renamed Prolotherapy and reported a 90% improvement in his patient’s chronic pain problems.

    Can I expect to have a Prolotherapy injection on my first visit?

    No. Our typical office procedure includes a patient questionnaire that is mailed/faxed upon scheduling the first appointment. The first visit involves a comprehensive review of this questionnaire, and a history and physical examination at Dr. Dubick’s office. If he feels that a patient is a good candidate for Prolotherapy, he/she will be scheduled for a local anesthetic/ non-steroidal anti-inflammatory injection under x-ray guidance. This injection is used both as a diagnostic tool to identify the exact areas of pain/dysfunction, and for its possible longterm therapeutic effect. The patient is also scheduled to see a physical therapist or chiropractor (if they don’t already see one) for a structural examination and joint mobilization. The results of that injection and the results of the joint mobilization by a chiropractor or physical therapist are reviewed at a subsequent office visit, and the decision is made whether to recommend Prolotherapy or not. For those patients traveling long distances to see Dr. Dubick, modifications are made to accommodate these individuals.

    What can I expect after Prolotherapy injections?

    After the procedure, most patients feel a fullness and numbness in the areas injected. Often, pain is relieved for several hours because of the local anesthetic that is injected along with the proliferant. The pain will usually become quite evident several hours later and usually peaks in 3-8 hours, although some patients never experience much discomfort at all. For the next 24-48 hours there may be considerable discomfort at the injection sites prior to the pain intensity lessening. The pain will continue to decrease over the next 3-7 days. Approximately 60% of the healing occurs in the first three weeks, while the remainder takes place over the next 6-12 months. The injections are usually repeated every 2-3 weeks, with 3-4 injections being performed at each area. Patients normally notice the greatest improvement 3-6 months after completing the injection series. Occasionally, repeat procedures may be needed if significant dysfunction still persists 6 months after the injections are completed.

    Does any other treatment need to be done along with the Prolotherapy?

    Joint mobilization is a very important adjunct to Prolotherapy treatments. In order for the damaged structural elements to heal properly, the joints they support must be in correct anatomical alignment. Patients are encouraged to have chiropractic adjustments or physical therapy joint mobilizations performed just prior to and 1-2 weeks after injections. After the individual injections, patients are encouraged to complete regular flexibility and stretching exercises. However, they are advised to limit stress of the injected area as this may prevent proper healing from taking place. Once sufficient healing has taken place (4-5 weeks), more strenuous exercise may begin under supervision, including strengthening and stabilization exercises. Supplements are also recommended to take before and during Prolotherapy injections. These include glucosamine, chondroitin, Vitamin C, and multi-vitamin/minerals. In addition, a diet high in lean protein and omega 3 fatty acids is extremely beneficial.

    Are all patients with chronic pain candidates for Prolotherapy injections?

    Proper patient selection is crucial to the success of Prolotherapy treatment. Prospective patients must have a structural problem with a ligament(s), tendon, or joint capsule causing much of their pain. Patients require a healthy healing potential and a strong immune system to benefit from this treatment. Good nutrition, exercise, and sleep habits are very important. Poor prognosis is associated with patients who have primary discogenic or radicular (nerve) pain. Individuals who are alcohol or drug abusers, heavy smokers, suffer from chronic illnesses, including diabetes and immunosuppressive diseases, are bedridden with chronic pain, have secondary gain issues, or have a pain scale totally out of proportion to the clinical findings also do not do well with Prolotherapy.

    Are prolotherapy injections covered by insurance companies?

    Many insurance companies, including all federal companies do not cover Prolotherapy.  Some private and state insurance companies may cover this procedure, which will be reviewed by our billing department on an individual basis.  If Prolotherapy is a covered service, authorization is received from the insurance company prior to the injections being performed.  

    May my children come with me to the office during my evaluation or other appointments?

    Dr. Dubick will need your full attention during any appointments, so we ask that you do not bring your children to any appointments.

    Does your office give reminder calls for appointments?

    Only for your first appointment and for any procedures you have scheduled with Dr. Dubick. We do NOT call and remind you about follow-up office visits.

    Can/will Dr. Dubick give me an injection in the office or on the first visit?

    No, Dr. Dubick does not give injections in the office or during your first visit.

    Am I allowed to eat, drink, and take medications prior to my injection appointment?

    Yes, you may eat and drink prior to any procedures with Dr. Dubick. You may also take your normal medications as recommended by your doctors unless directed otherwise by your physicians.

    Do I need a driver to and from the facility when I have a procedure?

    Yes, you will need a driver to take you and pick you up from any injection procedures you have with Dr. Dubick.

    How many days after my Prolotherapy injection may I return to work?

    Most patients return to work one to three days after their procedure.

    How many days after my anti-inflammatory injection may I return to work?

    Most patients return to work the next day. If you did not receive any sedation prior to or during your injection you may also return to work that day depending on how you feel.