Am I a candidate for Prolotherapy and PRP?
A: Many problems related to musculoskeletal conditions are can be successfully treated with Prolotherapy (Regenerative Injection Therapy):
1.Degenerative Joint Diseases (Osteoarthritis)-OA:all locations:
neck, TMJ, shoulders, scapulaes, clavicles, ribs, elbows, wrists, fingers, thoracic and lower back pain, “disc’s problems”, hips, knees, ankles, feet, toes.
2.Consequences of ligamentous, cartilagenous and tendinous injuries (with some limitations). Partial tears of tendons, muscles and ligaments can be successfully treated with combining various techniques :
Prolotherapy + PRP (Platelets Rich Plasma)
Prolotherapy + Mesenchymal stem cells + PRP
Prolotherapy + Neural prolotherapy.
3.Some form of arthritis may have infectious, allergic, autoimmune or metabolic causes. In such cases we will order special diagnostic tests to help patient in selection of appropriate treatment.
4.Patients with infected joints,non-healing wounds around joints,cancerous spread into the bones(metastasis,multiple myeloma, leukemias) ARE NOT A CANDIDATES FOR PROLOTHERPAY.
5.Elderly and debilitated patients may not respond well to prolotherapy.
6.Degree of joint damage (stage of the OA), age, weight, smoking status, nutritional status, use of certain medication (Steroids , NSAID) will negatively affect prognosis of the treatment.
6. Patients with illnesses related to medico-legal problems (Motor Vehicle and industrial Accidents) must have official pre-authorization from their insurances or Court order for treatment.
7. Other factors may play role too: anticoagulation therapy, anti-platelets therapy etc
During initial consultation we will perform detailed physical examination, review imaging tests, and available laboratory tests,will perform diagnostic musculoskeletal ultrasound in the office .
This will help us select right strategy for treatment.
How much does it cost?
A.: The initial evaluation cost depends on the complexity of the problem and how much time is needed to do the evaluation. One hour is usually the time set aside for the first visit. A few first visits are less complex, taking 30 minutes, while a few may require 90 minutes. A call to the office will allow us to give an estimate of a consulation/evaluation fee.
When treatment is given during the office visit, there will be an additional charge for the treatment. Charges vary according to the area(s) treated.
Will my insurance pay for this treatment?
A.: Insurance companies vary a lot. Most insurances including Medicare and Medicaid DO NOT pay for this services. Some pay well for prolotherapy treatments. Some pay part of the time and not other times. Some companies will not pay for it at all. Please contact your insurance and ask this question . CPT code for Prolotherapy is “ M0076 “
How many treatments will I need?
A.: It is not possible to tell ahead of time how many treatments a patient might need before they are pain-free. The doctor will give an estimated range of the number of treatments that you will need, depending on the severity of your condition.
How far apart are the treatments?
A.: Treatments are usually given at three-four weeks intervals. There are exceptions to this, depending on other circumstances.
How soon after treatment can I work out or play sports?
A.: If your sports or work-outs involve the area that is being treated, you will get the best results with treatment when you avoid exercising or stressing the area until 3 or 4 weeks after the last treatment. If you must continue to exercise the treatment area, it may take a lot more treatments to get the desired result. You may continue to re-injure it with the exercise or sports activity, preventing it from getting strong enough to protect it.
What is in the medicine that is used in the injections?
A.: There is no cortisone used in prolotherapy. The solution is normally a mixture of a very concentrated dextrose (glucose) with a local anesthetic like lidocaine. A small amount of sodium morrhuate ( a water soluble form of cod liver oil) is added for extra stimulation of the healing reaction in some cases.
What is the success rate with prolotherapy?
A.: Prolotherapy generally has about a 70% good to excellent response among the doctors across the country that keep track of their patients’ responses to treatment. About 10% of the patients are in the poor response, or less than 50% improvement category.
Is there a guarantee that prolotherapy will work for me?
A.: There is nothing in medicine that is guaranteed.
How do I contact the office for an appointment?
A.: Please call our office at 508-754-9950 for an appointment. The staff will be happy to schedule your appointment and give you further information.
What are the office hours?
A.: Our office hours are 8:00 AM to 12:00 NOON and 1:00 PM to 5:00 PM, Monday through Friday.
What should I bring to the doctor’s office for the initial evaluation?
A.: Please bring the completed paper work that the office sends to you and any X-ray or films of any other studies that you may have had.
What happens at the first visit?
A.: Medical assistant will greet you, collect your paper work and take you to the examination room. The doctor will review your paper work, ask you questions about your problem, examine you, read your X-rays and explain them to you, give you his opinion about what he believes is causing your pain or other problems, order any new studies that may be needed and make recommendations for treatment. He will explain the treatment and answer your questions. You will be given Consent form for treatment and estimated cost. No treatment will be performed during consultative visit.
Will I need a driver?
A.: Most of the time patients do need a driver. You will receive a treatment which may affect your ability to drive safely for 12-24 hours.
Will I need to be off work after the treatment?
A.: Most patients do not need to be off work the day after the treatment if it is sedentary work.
What are the risks with prolotherapy?
A.: There are risks with all treatments and medications, not just prolotherapy. If the doctor feels that you are a candidate for prolotherapy, he will explain the risks to you and try to answer all of your questions.