BENEFITS

Nonsurgical treatment
Strengthens and thickens tendons and ligaments
Natural healing process
Proven safety and efficacy

Treatment Overview

Living an active lifestyle can be challenging for many due to joint pain or stiffness. This condition can affect not only physical health but also mental wellbeing, impeding quality of life. Fortunately, Prolotherapy offers a solution for various types of joint pain and discomfort.

This treatment focuses on ligament and tendon injuries by promoting new growth in weak areas. Damaged or loose ligaments can cause pain in affected areas as they contain numerous nerve endings. When ligaments and tendons are over-stretched or injured, bones may no longer fit well, resulting in muscle strain, spasms, and pain.

At Anti-Aging Medical & Laser Clinic, we provide cutting-edge injection treatments, including Prolotherapy, to address joint pain and discomfort. This treatment involves injecting a dextrose solution into the affected area to encourage tissue repair and strengthen the injured site. Our Sports Medicine Physician, Dr. Teri Fisher, administers this treatment using ultrasound guidance, ensuring precise and effective delivery.

If you’re struggling with joint pain or discomfort, Prolotherapy may be an ideal treatment option to consider.

What to expect

Planning Your Treatment

Patients are encouraged to self-refer (i.e. a referral from your family doctor is NOT required). However, you should be assessed initially by a GP and have a provisional diagnosis. Also, x-rays are required prior to the consultation with Dr. Fisher. The purpose of the consultation with Dr. Fisher is to determine if private therapeutic injections would be appropriate for you (not to diagnose the condition).

Once you have a provisional diagnosis and xrays, we will schedule a consultation with Dr. Fisher, where he will review your history, do a focused sports medicine physical exam, review your imaging, discuss your diagnosis, outline the pros and cons of the various injections, and recommend the most appropriate injection therapy based on your individual needs and preferences. Please be sure to bring any imaging reports that you have (e.g. x-rays, ultrasounds, MRI, MRA, CT scans) to the consultation. Depending on your specific situation, Dr. Fisher will either perform the ultrasound-guided injection at that time, or we will schedule a future appointment for the injection (and for subsequent injections, if necessary).

Before the Treatment

Depending on the specific injection therapy selected for you, Dr. Fisher may advise you to stop taking certain medications or supplements prior to the procedure (e.g. such as blood thinners or anti-inflammatories). You should wear loose, comfortable clothing that allows easy access to the injection site, such as shorts for lower extremity concerns or a tank top or sports bra (for women) for upper extremity concerns.

During the Treatment

You will be placed in a comfortable position while the affected area is cleaned. Local anaesthetic will be provided if necessary. Dr. Fisher will then use the ultrasound machine to guide the needle to the correct location, ensuring accurate placement of the injection. The injection itself typically takes only a few minutes, after which the needle is removed and a small bandage is applied to the site.

All of our musculoskeletal injection techniques are done by Dr Fisher using ultrasound to guide to location of the injections. There are many advantages of using ultrasound to guide therapeutic injections:

Ultrasound Guided

Increased Accuracy: Ultrasound allows Dr Fisher to have real-time visualization of the targeted area, which helps ensure accurate needle placement. This means that the injectable solution is more likely to be delivered precisely where it is needed, improving the effectiveness of the injection.
Reduced Pain: When injections are given blindly, there is a risk of hitting nerves or other sensitive structures, which can cause pain. Ultrasound-guided injections can help reduce pain by allowing Dr. Fisher to avoid these sensitive areas.
Improved Safety: Ultrasound-guided injections are generally considered safer than blind injections because Dr. Fisher can visualize the needle as it is inserted and ensure that it is placed in the correct location.
Increased Patient Satisfaction: Patients who receive ultrasound-guided injections often report higher levels of satisfaction because the procedure is less painful and more effective.

After the Treatment

Dr. Fisher may advise you to rest the affected area and avoid strenuous activity for a certain period of time. You may also be advised to avoid certain medications for a specific length of time. Dr. Fisher will review your specific post-injection recommendations to ensure optimal results.

Recovery

Recovery from a therapeutic injection for musculoskeletal pain can vary depending on the type of injection and your individual response. In general, you may experience some mild discomfort or swelling at the injection site for a few days after the procedure. For some types of injections, such as hyaluronic acid or PRP, it may take several weeks and/or multiple injections to see the full benefits of the treatment. Prolotherapy typically involves a series of injections over several weeks or months, with gradual improvement in symptoms over time.

How it works

Prolotherapy involves injecting a solution of dextrose to stimulate the growth of new tissue and strengthen ligaments and tendons. The specific mechanism of action for each type of injection may vary, but they all work by targeting the underlying cause of musculoskeletal pain to promote healing and improve function of the affected area.

Following your Prolotherapy session, which typically lasts for around 30 minutes, your body undergoes an inflammatory response that boosts blood flow and triggers the development of fresh tissue. Over the coming days and weeks, your body works to repair and rejuvenate the injured areas in and around your joints and ligaments.

Maintenance

Recommended number of sessions and maintenance:

Prolotherapy (Dextrose):
3-8 injections, 2-4 weeks apart

The number of sessions required depends on your goal, the injury, the area, and how fast your tissues heal.

Pricing

How much does this treatment cost?

The consultation fee is $550.

It’s important to note that before any treatment is given, Dr. Fisher conducts a thorough assessment of the patient’s condition to determine the most appropriate course of action. The cost for this assessment is $550. If you are interested in any of the treatments offered by Dr. Fisher, it is recommended to schedule a consultation and assessment to discuss your options and determine the best approach for your individual needs.

Prolotherapy (Dextrose): $500 per treatment; $1900 for 4 treatments; $2700 for 6 treatments

Certain health plans and insurance providers may cover the expenses associated with the treatment. To determine if you have coverage, it’s recommended that you consult with your insurer.

Treatable Areas

Prolotherapy involves injecting a solution comprising a local anesthetic and dextrose (sugar) into ligaments, tendons, or joints in different parts of the body such as the shoulder, elbow, wrist, hands, ankles, and feet. While a GP referral is not a requirement, patients are expected to have undergone medical assessment and diagnosis before undergoing this treatment.

Please note: X-rays must be taken before consulting with Anti-Aging, and additional imaging tests such as ultrasound, MRI, or MRA may also required. We do NOT treat neck, back and hip conditions.

RESULTS

The results of Prolotherapy can vary depending on the individual patient and the specific condition being treated. In general, patients may experience a reduction in pain, swelling, and inflammation in the affected area. The injections can also improve mobility and range of motion in the joint or affected area, allowing patients to perform daily activities with less discomfort.

All treatments are administered by Dr. Teri Fisher, who is a highly skilled and experienced aesthetic and sports medicine physician. Prolotherapy injections are conducted under ultrasound guidance, enabling precise targeting of the treatment area for increased injection accuracy and efficacy.

To learn more about Dr. Teri Fisher, click here.

Assessment Process

Steps to take if diagnosis or x-rays are not available

Please see your family doctor or make an appointment at Old Orchard Medical Clinic for an initial assessment/diagnosis and to get x-rays done. Please have your x-rays (and other imaging studies) done at one of the local hospitals or at one of the West Coast Medical Imaging locations. This will ensure that we will be able to access your x-rays online when you come to our clinic.

The closest West Coast Medical Imaging clinic to our clinic is the Arbutus location at:

2184 West Broadway, Unit #390
Vancouver, BC V6K 2E1
Phone: 604-731-2200

Requirements for patients with prior diagnosis and x-rays

If you possess prior imaging reports, kindly get in touch with us to book your personal musculoskeletal injection evaluation with Dr. Fisher. Please be sure to bring any imaging reports that you have (e.g. x-rays, ultrasounds, MRI, MRA, CT scans), particularly if they were not done at one of the locations listed above.

At the consultation, Dr. Fisher will review your history, do a focused sports medicine physical exam, review your imaging, discuss your diagnosis, outline the pros and cons of the various injections, and make a recommendation of the type of injections that would be the most appropriate for your condition.

Depending on your specific situation, Dr. Fisher will either go ahead and perform the ultrasound-guided injection at that time, or we will schedule a future appointment for the injection (and for subsequent injections, if necessary).

A follow-up appointment (included in the injection fee) will be scheduled approximately 2 weeks after your final injection.

Begin Intake Questionnaire

Frequently asked questions

Have Questions?

Call Us

(604) 261-9121

What prerequisites must be met prior to undergoing this treatment?

At Anti-Aging, patients are encouraged to self-refer, which means that a GP referral is not necessary. However, it’s important to note that patients should have already been assessed by a physician and have received a diagnosis before seeking treatment at Anti-Aging.

Additionally, before the consultation, patients are required to have X-rays taken, and in some cases, an ultrasound, MRI, or MRA may also be necessary. This is important for the medical team at Anti-Aging to get a clear understanding of the patient’s condition and to determine the most effective course of treatment.

Who is excluded from musculoskeletal injections?

Our clinic has established exclusion criteria to ensure the safety and effectiveness of our treatments. The following factors are taken into consideration when determining a patient’s eligibility for treatment:

– Pregnant or breastfeeding women due to safety concerns.
– Patients with active cancer are excluded due to potential risks and complications.
– Patients with neck, back, or hip pain and chronic pain syndromes.
– Patients who have undergone surgery to the affected area within one month before or after consultation as treatment may interfere with the recovery process.

It is important for patients to be aware of these criteria when seeking treatment and to disclose any relevant medical information to the medical team during the consultation.

How many prolotherapy treatments are needed?

The number and frequency of treatment sessions depends on the diagnosis and severity of the pain and/or injury. The usual frequency of treatment sessions is every two to four weeks. The total number of treatments is usually between 3 and 8 treatment sessions.

How soon can I expect pain relief after prolotherapy?

It is normal to experience soreness and tenderness in the injected area for a few days, and some swelling may persist for up to a week. However, over the course of two weeks, joint mobility and comfort should gradually improve.

How long does pain relief last?

The outcome of Prolotherapy varies for each individual. If the treatment targets the underlying issue, it can lead to complete pain relief. The initial treatments can determine the effectiveness, as there should be noticeable improvement with each session. However, there is a possibility of no reduction in pain levels, as Prolotherapy may not work for everyone.

What medications should I avoid before prolotherapy?

Anti-inflammatory medications can decrease the efficacy of these treatments. Therefore, do NOT use any steroidal or nonsteroidal anti-inflammatory drugs for 2 weeks prior to the treatment and for 2 weeks after your treatment.

Anti-inflammatory drugs to AVOID include:
– Steroidal anti-inflammatory drugs: e.g. cortisone and prednisone
– Nonsteroidal anti-inflammatory (NSAID) drugs: e.g. Advil/Motrin (ibuprofen)
– Aleve (naproxen)
– Aspirin (ASA)
– Celebrex (celecoxib)
– Voltaren (diclofenac), or any other NSAID.
– Other supplements with anti-inflammatory properties: e.g. boswellia, white willow, curcumin/turmeric, or Omega-3 fish oils.

What are contraindications for prolotherapy?

There are a number of situations where prolotherapy may not be appropriate (i.e. contraindications). These include the following:

– Active infection at the injection site or in the body.
– Certain skin conditions, such as eczema or psoriasis.
– Allergy to any of the substances used in the prolotherapy treatment.
– Certain blood disorders, such as bleeding or clotting problems.
– Pregnancy or nursing.
– Pre-existing medical conditions (e.g. diabetes, heart disease) may pose a higher risk of complications.

What are the possible risks associated with prolotherapy?

The possible risks or complications of prolotherapy include:

– Minimal or no effect from the treatment.
– Local bruising and/or bleeding at the injection site.
– Minor aching at the injection site.
– Immediate pain at the injection site and/or post-therapeutic pain flare, lasting up to 3-4 days or more. Occasionally this may be severe, however it usually lasts only 4–24 hours and is treated with Tylenol or other analgesia (NOT anti-inflammatories).
– Allergic reaction to any of the substances used during the procedure, such as the injection, dressing, local anesthetic or antiseptic.
– Dizziness or fainting.
– Infection. Infections take at least a day or two to manifest. If you develop fever, chills, redness or heat in the injected area after 48 hours, go to Urgent Care/ER urgently.
Temporary or permanent muscle, nerve, or other tissue injury (extremely rare).

Are there any restrictions after prolotherapy?

To ensure optimal recovery after the injection, it is recommended to follow these guidelines:

– Refrain from applying ice or heat to the injection site for the first three days.
– If you wish to take a hot shower or bath, limit the duration to less than 10 minutes.
– Do not use lotions, oils, or makeup on the injection site for six hours.
– It is advisable to abstain from smoking or drinking alcohol for at least three days after the procedure.

Rest for 3 days after injection but do not immobilize the treated joint. Gentle movement and stretching are important for healing ligaments and tendons. It’s always important to use pain as a guide for the appropriate level of activity. If you do experience pain, you may take analgesic medication that is not an anti-inflammatory, such as over-the-counter options like Tylenol.