Prolotherapy, “Prolo” for short, is a successful injection treatment used to stimulate the repair of a damaged or injured joint or body area. This treatment is also known as Regenerative Injection Therapy or RIT. It is used in musculoskeletal conditions, such as for back pain relief, knee arthritis, or sports injuries to permanently fix the originating cause of the pain. In the foot, “Prolo” has been very successful for the treatment of Plantar Fasciitis, Neuromas, Arthritis, Achilles tendon injuries and other inflammatory conditions of the feet and ankles.
Solutions: What ingredients are used in comprehensive Prolotherapy?
The ingredients used in Prolotherapy are, in the simplest terms, designed to create an inflammatory healing response and help to ease pain. One of the many benefits of coming to a Prolotherapy specialist is we have decades of experience with various ingredients. Some patients have injuries that respond best to very strong solutions, such as adding a fatty acid solution or Platelet Rich Plasma (PRP) Prolotherapy to the basic dextrose solution. Other patients respond best to a solution with additional anesthetic to help ease acute pain more immediately. A potential problem with going to just any physician or podiatrist is that you may get the, “Let me give you a cortisone injection” approach. One of the reasons patients come to see Dr. Abrahamson and his associates is for what we call “Comprehensive Prolotherapy.” An important part of this approach is getting a strong enough solution to help the foot repair itself from the inside out.
Why technique matters when looking for a Prolotherapy doctor
While using a strong enough solution in the foot is important to have success with Prolotherapy, we believe Hackett-Hemwall Prolotherapy, or Comprehensive Prolotherapy, offers patients the best bang for the buck. It is also the fastest way to get an athlete and patient back in the game and on their feet. Comprehensive Prolotherapy means that all of the tender points of the joint and its attachments are treated with a strong enough solution, and that enough solution is used to get a good healing response. The end result is that the patient will probably respond faster and become one of the many positive Prolotherapy statistics seen at Aadvanced Foot Care. Our founder, Dr. Joseph Abrahamson began using Prolotherapy back in the 1940’s and passed his knowledge and wisdom to his son (Dr.Ivan) and grandson (Dr. Hal).
Why would anyone want more injections?
The foot is a series of bones held together with connective tissue—ligaments and tendons. Upon injury or overuse, the connective tissues become like overstretched rubber bands and cannot properly support the joint(s) and the arches of the feet. Over time, too much wear and tear on the surrounding structures of the joints, including cartilage, continue to degenerate the weakened joints and cause multiple foot problems that you perceive as pain.
We try to explain to patients that Cortisone is a potent anti-inflammatory. It breaks tissues down and weakens them. That is why you must not have too many cortisone injections. You certainly do not want to have a cortisone injection near a tendon. All too often we have seen ruptured tendons and ligaments from other physicians giving cortisone injections in or near these already weakened structures.
Think of Prolotherapy like spot welding for painful joints, tendons and ligaments. You need to secure all the loose, weakened surrounding structures of the joints in order for those joints to be strong again. If a patient is only receiving a few injections to a large area, the results may not be seen as quickly, and the overall Prolotherapy results can be suboptimal. In our experience, doing more injections within each session actually leads to faster pain relief with fewer treatments. In certain cases, either custom molded foot orthotics or a specialized ankle foot orthotic (AFO) brace will need to be worn during the healing process. We will also recommend Laser Therapy as well as certain shoes or sneakers which must be worn with your orthotic or brace. This is to prevent further injury to the foot and its structures.
Prolotherapy research: Where is the science?
Dextrose Prolotherapy has been practiced since the 1930’s, in addition to studies appearing in journals around the globe for decades. To say it has a long-term safety record is an understatement. We believe that through the vast number of patients treated clinically and in studies, it surpasses the safety record of any surgery or pain drug available. While we at Aadvanced Foot Care Associates are foot and ankle surgeons, our practice philosophy has always been to leave surgery as the last option. We perform multiple surgeries per week on patients who need surgery, but not on those patients who do not.
Prolotherapy Reviews: Why have you not heard of Prolo?
Although this therapy has been around for many years, it is a specialty that is not taught in most medical schools, nor is it pushed forward by the pharmaceutical industry or surgical instrument companies. Realize that Prolotherapy is a pain treatment driven by technique more than the latest and greatest drug ingredients, and it actually can prevent the need for surgery in almost all cases we see in our offices. Hence, there is not the financial interest in those circles to make it known, and you will not see a TV commercial for Prolotherapy like you will for a drug. Unfortunately, most people do not hear of Prolotherapy until they have failed other therapies and surgeries, encountered post surgical foot and ankle pain, or suffered through years of failed physical therapy and pain medications. Eventually the person takes matters into his or her own hands and starts doing internet research on alternative treatments, or a concerned friend or family member makes a referral to see Dr. Abrahamson because of their successful treatments received. These are a few of the top reasons people tell us they travel from all over the globe to Aadvanced Foot Care to see us for treatment.
Prolotherapy treatments: How many sessions are normal?
Our patients typically require three to six treatments, given about one month apart, depending on the severity of the condition and the patient’s overall health status. If you think about options for chronic pain treatment, that’s an amazingly low number of sessions. Patients who see a physical therapist often have to pay for weeks or months worth of sessions, going anywhere from once to four times per week! It is no wonder why so many chronic pain patients are frustrated. Just getting treatment takes up a huge chunk of time every week, let alone the results do not necessarily last very long. One of the best attributes of Prolotherapy is that the results are typically permanent, as long as you do not re-injure the area.
Some patients contact us because they received cortisone injections from other doctors, often reporting that their pain never went away. If this sounds like your case, please read more about the comprehensive Prolotherapy approach practiced by Dr. Abrahamson. If you are interested in delving further into why you may not be healing, call us for a second opinion consultation.
Will my insurance cover this?
Insurance coverage of Prolotherapy varies widely depending on your carrier, the area being treated, and your specific diagnosis. Our current patient feedback indicates that most insurance carriers are stating that this is experimental so they do not have to cover it. The insurance companies will pay for the injection but not for the actual prolotherapy solution. You may wish to use your FSA or HSA funds/credit card to pay for your treatment. Medicare, Medicaid, or Tricare do not cover Prolotherapy, and our services may NOT be billed to these insurance plans. When evaluating whether to pursue getting Prolotherapy at Aadvanced Foot Care, please realize that it is often less expensive to pay out-of-pocket for Prolotherapy, compared to paying co-pays (sometimes upwards of 30-50%) on very expensive surgeries, hospitalizations, and resultant rehabilitation.
There you have it – experience, results, and the knowledge to treat any part of the foot and ankle suffering from chronic pain or sports injuries. Contact us via email or give us a call at (718) 896-4433 in Queens or (516) 822-9595 on Long Island.