Post Care: Prolotherapy and PRP

Regenerative Injection Reactions:

It is normal and expected to have an aggravation of pain, possible swelling and discomfort in the area post treatment. In most people these aggravations only last for a day or two, but occasionally they may continue for longer than a week and involve swelling, pain or stiffness. If this aggravation does occur do not be overly concerned as it does not indicate a negative response and should not discourage you from completing a course of treatment. Higher concentrations of dextrose and stronger irritants like P2G will produce a much stronger reaction and perhaps a more prolonged recovery period.

With PRP injections, following any initial aggravation there is occasionally a 2nd aggravation two weeks after treatment due to the migration of stem cells to the area.

Please remember that each treatment takes 6-8 weeks to maximize its regeneration of ligament and tendon tissue. Even after regeneration has occurred, rehabilitation is required for a return to normal range of motion and function and muscle strengthening and flexibility. As the body heals and decompensates, occasionally older unresolved injuries may come to light as “new” pains. Inform the doctor of these changes. Most research studies use 3 months after treatment as the benchmark to gauge improvements, although improvements with PRP may still occur 6 months after treatment.

The final benefits of RIT may take months. Often some people feel a relatively quick, but short lived, relief of symptoms after initial treatment. Although this is a good indication that the treatment was applied correctly to the right areas, it is not a reflection of resolution of the underlying dysfunction. Most likely you will find over the course of treatment that your symptoms will improve and then reappear. Usually the pain will be less intense, frequent or of shorter duration during aggravations. What are important are the overall regenerative changes, evidenced by a gradual trend towards improvement, not the daily upsand downs.

If you are concerned please do not hesitate to contact the office and they connect you with your doctor.

Use of Medication:

If the pain is enough to interrupt your sleep or ability to function and you want to take medication please remember that all anti-inflammatory (NSAIDS) drugs are contraindicated. These drugs can directly interfere with the healing process initiated by the prolotherapy or PRP injections.

Drugs which can be used for pain but are not NSAIDS:

Acetaminophen, Paracetamol, Tylenol, Tylenol 1 with codeine (non-prescription) Tylenol 3with codeine. Opioids, Oxycontin, Morphine. Lyrica, Gabapentin

Do not take any of these or similar medications for pain: Aspirin, Anacin, Ascriptin, Bayer, Bufferin, Excedrin, Percodan, Ibuprofen (Advil, Motrin, Motrin IB), Naproxen (Aleve), Indomethacin (Indocin), Diclofenac (Voltaren), Celebrex, Celecoxib, cortisone injections.

Naturopathic Supplementation and Treatment:

Although natural remedies do not have the same potency for short term pain relief, they will in the longer term be helpful for tissue healing. Some supplements that may be considered are essential fatty acids, MSM, glucosamine sulphate, B vitamins, Vitamin C, D and K. Natural anti- inflammatory such as bromelain, curcumin, proteolytic enzymes, quercitin and fish oils do not seem to interfere with the prolotherapy healing response. A good all round support product is Joint FX, available in the Integrative dispensary. Many patients find the use of Traumacare or Agil homeopathic cream to be effective. Also consider hot Epsom saltbathes.

Exercise and Activity:

It is important to continue with your exercise program and activity, but do not quickly increase the intensity or duration during your course of RIT treatment. Directly following treatment be modest with your activity level and allow your body to rest. Exercise and mobilization oftreated areas is essential for recovery and continuing core strength, gym, weights, swimming, walking and exercise activity is imperative. Be moderate with stretching, avoid deep yoga stretches.

If you do an activity that causes mild pain or discomfort at the time anddoes not worsen upon stopping, then this level of pain and activity is acceptable. Remember to follow the 50%rule: where if you feel no pain at the time of activity but later experience an aggravation than you have over exerted and in future should only do 50% of the activity that caused this aggravation. Gradually you will be able to build your level of strength.

Serious Side Effects:Before beginning prolotherapy treatments you were informed of the possible risks andside effects. If any of the following symptoms occur after treatment please contact us:

• Difficulty breathing or completing a full breath. This may be an anxiety responseor it may be caused by a pneumothorax. This is not a medical emergency but weshould be informed.
• A severe headache that is only relived by lying down.
• Any sign of infection like extremely red, painful and hot inflammation (as opposed to normal swelling without redness), fever or a general sense of illness.
• Any red lines or tracts emanating from the injection site are a serious sign of potential infection and constitute a medical emergency, In this case proceed directly to hospital emergency for treatment!

If you have any concerns, please contact the clinic, 604 738 1012 x 1 and the front desk staff will connect you with your doctor. If it is an emergency, proceed directly to the hospital.