Services

Prolotherapy

Prolotherapy is a fantastic choice for any soft tissue injury, particularly ligamentous or tendon injuries, such as those in the shoulder, low back, SI joint, elbow, wrist, and ankle. It can also be helpful for injuries to the discs within the spine (depending on the severity) and injuries to menisci or ligaments within the knee. As such, this injection falls more into the “regenerative” basket than some of the others. Injuries to the soft tissue all heal at different rates, especially when it comes to comparing an injury to a muscle, a ligament, or a tendon. Muscles have a very rich supply of blood flowing through them at all times, this brings oxygen and nutrients to any micro or macro injury that may occur, allowing our muscles to heal very readily. In other words, muscles receive lots of attention from the body to heal.  Tendons and ligaments are different; they have less of this “attention” from the body, as by design, they are malleable, meant to stretch, bend, and contort, offering mostly stability to the bone to bone or muscle to bone connection for which they are attached. If a tear (complete or partial) occurs to a ligament or tendon, sometimes, it is too much for the body to repair during the 3 phases of healing. This could be due to re-injury, repetitive use, inadequate rest, and so on. Prolotherapy is used to draw the body’s healing response to this old injury that may be “forgotten” in a way. There is a small amount of anesthetic, dextrose, and saline injected targeting said injury. The dextrose is the main driver of this injection. It is slightly inflammatory, so one it reaches this area of  injury, the body’s healing response is triggered to bring its attention back to this area, and remodeling occurs. Typically, the more robust the immune system of the person being injected, the more success we can expect to see. Everyone and every injury is different, but generally, most folks need at least 3-4 injections, spaced 2-4 weeks apart. 

Neural-prolo Therapy

Neural-prolo therapy (also called perineural therapy), similar to prolotherapy above, utilizes dextrose as the main driver. The difference, however, is this dextrose is much more dilute, to the point where is its not inflammatory, rather nourishing to the areas it reaches within the body. This solution is most often used for diffuse pain, often with nerve pain or nerve root injuries as the pain driver. A common example is sciatica: here, the sciatic nerve could be pinched at various sites, and this irritation to the nerve could referred pain and/or peripheral nerve irritation. You can think of these nerves firing at a “louder” level than they should in a homeostatic state. Here, neural-prolo therapy is injected very superficially into the area of discomfort, targeting the superficial nerves that reach close to the skin. This solution tonifies and nourishes the irritated nerves so that the volume is turned down, offering relief. This can also be used for more difficult types of pain, such as that caused by fibromyalgia, chronic compartment syndrome, and chronic regional pain syndrome. This injection falls more into the pain management basket of injections.

Platelet Rich Plasma (PRP) Therapy

Platelet rich plasma (PRP) therapy* is one of the most powerful types of injections for regeneration. PRP begins by drawing 20 mL of your blood, adding this blood to a kit that harvests the platelets, then spinning the sample down in a special centrifuge. Once the processing is complete, doctors harvest roughly 6-7 mL of the plasma that is now rich with the platelets that were once in that initial 20 mL of blood. This is then injected back into the area we are targeting. Why platelets? Well, any time there is an injury within the body or even to the skin barrier, platelets are the first responders for the healing response. They lay a lattice like structure that starts the foundation of healing, remodeling, and regeneration. As such, you are essentially taking from the blood of the patient exactly what the body prefers for jumpstarting the healing response and putting it exactly where the body needs. This can be used for ligamentous or tendon injuries throughout the body, injuries to the spinal discs or ligaments, and meniscal or ligament injuries within the knee. This has much, much more “oomph” than prolotherapy for remodeling and regeneration. Similar to prolotherapy, sometimes more than one injection is needed depending on the severity or age of the injury. PRP can also be used for aesthetic purposes, as it is also powerful at stimulating collagen production and regeneration. As such, it can be used for hair loss, wrinkle reduction / prevention, and even healing acne or other facial scars.  You could use this for a number of reasons – sometimes the injury is just too progressed for prolotherapy, and it warrants jumping right to PRP. Sometimes you start with prolotherapy to get some remodeling, but need the PRP to go in and “finish the job”. Sometimes, for people who have a less robust immune system or maybe patient is of an older age, PRP would offer most of the benefits over prolotherapy.

Lastly, PRP is a fantastic tool that can be used for sexual wellness. For women or individuals with a vagina who experience reduced sexual arousal, difficulty reaching orgasm, or inability to reach orgasm, PRP can be utilized to stimulate regeneration in both the clitoris and in the vaginal canal, in the space next to the urethra and vaginal wall. Both of these areas are critical for enhancing sexual arousal. Patients will be completely numb with a topical anesthetic during the procedure, and may experience mild injection soreness once the anesthetic wears off. This injection can also be used for some cases of prolapse following childbirth leading to urinary stress incontinence (although patients should always try pelvic floor therapy first!).

For men or individuals with a penis, PRP can also be used for sexual wellness and function. For men who experience reduced tactile sensation, reduced sexual arousal, erectile dysfunction, infrequent or weaker orgasm, this type of injection can also be very helpful. These patients will also receive a topical anesthetic as well as a small amount of anesthetic injected at the base of the penis, serving as a superficial nerve block. The same procedure will be utilized above (20 mL blood taken, spun in the PRP kit etc..)  

Typically, most patients utilizing PRP for sexual wellness require 3-4 injections spaced 2-4 weeks apart for optimal benefit and improvement. Should you have any questions regarding any of the above procedures or wondering which one may be the best choice for you, please reach out at any time.

*PRP won't be available until mid 2023.

Note: None of these injections are covered by insurance. Reach out for a quote.