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Prolotherapy FAQS


What is Prolotherapy?

Prolotherapy, uses a series of carefully placed injections to administer medicines to painful, injured, strained and arthritic joints or tendons.  Careful examination identifies the damaged ligaments prior to treatment.  Injections are placed at the site where the ligament is attached to the bone.  After a series of treatments you can expect increased function, mobility and stability in the effected joint as well as decreased pain.  By supplying ingredients natural to cartilage, prolotherapy helps restore joint tautness and integrity.  


What are some uses of Prolotherapy?

Prolotherapy is effective for chronic joint pain in areas such as the neck, back, shoulder, elbow, wrist, hip, knee and ankle.  In addition it is effective for conditions such as arthritis, tendonosis, tendonititis, cartilage injuries, carpal tunnel syndrome, fibromyalgia, back pain, sciatica, ankle sprains and other injuries.


Why does Prolotherapy work?

Because ligaments have poor blood supply, healing after an injury results in restoration of only 50% to 70% of the original strength.  Further, a poorly healed joint can result in degenerative changes such as arthritis and lead to joint disability.  Prolotherapy promotes blood flow to the area and works by initiating a healing response.  It does this by promoting mild inflammation at the injured location.   During inflammation, several types of growth factors that repair and rebuild the injured area are released.   The above results in the deposition of new collagen which tightens the ligaments, providing new strength and stability to the joint.  Prolotherapy therefore takes its name from its ability to produce cellular proliferation. 


Dr. C Everett Koop, former U.S. Surgeon General speaks on Prolotherapy.

I was at one time almost incapacitated because of pain and eventually was incapacitated because of paralysis of my right arm.  I had been diagnosed as having intractable pain… Prolotherapy has been responsible, completely and totally, for restoring me to active surgical health and it has been my experience over and over again that I have been able to do the same for other so people diagnosed.”

I can attest to the fact that prolotherapy is safe, effective and in cases such as my own and many patients I treated was effective when nothing else was.


What is in a Prolotherapy syringe?

A typical prolotherapy syringe contains the anesthetic procaine, normal saline or sterile water and sugars of dextrose and B12.  Occasionally glucosamine , vitamins, Homeopathics, or proteins can be added for an additional cost and may be recommended due to advanced disease or arthritis.


What are other types of Prolotherapy?

PRP or Platelet Rich Plasma Prolotherapy uses the bodys’ own platelets and stem cells.  This is more effective at regenerating cartilage and tendons due to the high concentrate of stem cells and growth factors. Platelets secrete numerous growth factors and other bioactive substances that contribute to healing through their initiation and regulation of the body’s inflammatory wound-healing cascade.  In addition to facilitating the inflammatory cascade, concentrated platelets also promote the migration, proliferation, and differentiation of repair cells to the area of injury.

PRP is obtained through a simple blood draw prior to Prolotherapy. The blood is centrifuged to separate the platelet rich portion of the blood, which is then injected into and around the afflicted joint


Is Prolotherapy like cortisone injections?

Not at all!  Although both treatments use needles to deliver medicine to painful joints, the similarities stop there.  Prolotherapy works in accordance with our bodies own healing mechanism giving the joint a “second chance” at healing.  Prolotherapy helps joints heal by stimulating an immune response and by supplying ingredients innate to joint structure.  Cortisone on the other hand merely masks the symptoms by shutting off the immune response. Injections of cortisone are actually discouraged because long term studies show retardation of tissue healing and weakened ligaments. 


Is Prolotherapy safe? 

In the hands of a properly trained doctor who possesses knowledge of anatomy, prolotherapy is very safe.  However, there are always some risks during any injections, like infections.  These risks vary according to the area treated and will be discussed fully prior to treatment.   You should know that the risks of prolotherapy are significantly less than those incurred by taking Ibuprofen, aspirin or other non-steroidals for pain. 


Does it hurt?

A pinch is felt as the needle passes through the skin.  A topical anesthetic applied 20 minutes prior to treatment can be used if desired.  A couple days of soreness and stiffness may follow the procedure.   You will be encouraged to remain active, but should not retain normal high impact physical activity for a couple months (running, hiking, intense biking, etc).  


How many treatments will I need?

Typically four to six treatments at four to six week intervals are required.  Occasionally dramatic improvement or relief is gained after just one or two treatments.


Do I need to do anything to prepare?


Patient must not take any anti-inflammatories 48 hours before (or after) injections such as aspirin, ibuprofen, Aleve, Advil, or other NSAID, as we are trying to initiate healing through minor inflammation. If necessary, Tylenol/acetaminophen can be taken since it only inhibits pain and not the healing process. You can also use heat over the area, but NO ICE.




Dr. Preston

Founder of Cynergetics Naturopathic Medicine, Dr. Preston received her training from the Southwest College of Naturopathic Medicine & Health Sciences, in Tempe AZ.  She is licensed by the state of California as a naturopathic doctor. Dr. Preston specializes in the application of holistic life-style approaches such as medical nutrition, botanical medicine, prolotherapy, bio-identical hormones and weight management to a variety of medical conditions.


Prolotherapy is performed by Dr. Preston.  She has received advanced training in prolotherapy and is a member of the American Association of Naturopathic Physicians  For additional reading go to

For more information or to make an appointment call 562-794-9027 or book online above








Cynthia Preston, ND

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