After Treatment Guidelines
The main side-effect from prolotherapy is one to two days of soreness and stiffness following the procedure. The injected areas may feel achy, and it is common to experience muscle stiffness for a few days. This can be alleviated through alternating hot and cold compresses over the affected area, as well through the application of a "deep heat" like liniment, such as Tiger Balm.
It is very important to avoid anti-inflammatory medication while undergoing treatment, as these will defeat the very purpose of prolotherapy which is to increase inflammation temporarily. This includes anti-inflammatory agents such as Advil, Ibutrophin, Aspirin Clinoril, Voltaran, Motrin, Vioxx, Celebrex, Prednisone, Cortisone etc. All of the above will be counterproductive to the healing process of soft tissues and ligaments initiated by the prolotherapy. It is best to take no medication at all but if the pain is bad enough and relief is required, Tylenol, Tylenol with Codeine or prescription opioids may be used. The regular use of MSM and Glucosamine Sulphate may also lessen the secondary pain reaction. Many patients find the use of homeopathic Traumeel from Heel or Agil from Pasco to be very helpful. Natural anti-inflammatories, such as bromelain, curcumin, proteolytic enzymes, fish oils etc. are now believed to assist and not inhibit the healing response. It is recommended that although these substances are generally helpful in the healing of injured joints, their use should be suspended the day of prolo treatment to allow the natural inflammatory response to occur.
It is important to note that aggressive exercise may worsen ligament injury and is thus not recommend until Prolotherapy / RIT has strengthened the joint sufficiently to provide pain relief. A useful rule of thumb is "It if hurts, don't do it". Once the healing begins, movement and range of motion exercises are useful to facilitate healing. A formal exercise program is helpful as the ligament strengthens and the joint stabilizes to prevent further injury. It is also important to remember the effect of diet and lifestyle choices on the overall recovery process. Nutritional deficiencies are epidemic in our modern society and this affects both overall health and the healing of ligaments and tendons. Ligaments require proper vitamins, minerals, amino acids and collagen factors to repair. Proper diet and nutrition is imperative for healing to occur. Similarly, lack of proper hydration will hinder healing and cause ligaments to shrink. It is recommended that you drink at least 6-8 glasses of water per day.
Each injection has a strengthening effect that takes about 6 weeks to maximize. It is important to note that it still requires 1-2 months of being pain free after the course of treatment is completed for optimal healing to occur. So don't overdo your activity just because you have less pain. Let nature take its course.