Injection Therapies FAQ
These questions are specifically about the Injection Therapies that Dr. Riddle offers. For general frequently asked questions, please view the FAQ page.
What do I bring on my first visit?
Please bring the following:
- Loose clothing as well as shorts if we will be examining the lower back and/or lower extremities.
- Copies of any imaging reports such as MRI’s, CT scans, x-rays, & ultrasounds, etc.
- Copies of any recent blood work.
What can I expect on my first visit?
Dr. Riddle will meet with you for 1/2 hour, where he will discuss your injuries and/or pain in detail. A physical examination will follow during this first visit. All of your questions about suggested courses of treatment will be answered in detail along with possible risks of treatment. On a case-by-case basis, he will decide whether you will need to be sent to have imaging done or whether therapy can commence on this first visit.
How will I feel following the injections?
Most patients experience “heaviness” in the tissue that was injected. This typically lasts from 2 hours to 2 days. Usually within the first 24-48 hours, there is improvement in either range of motion, pain or both. The degree and length of improvement will typically begin to subside before the next injection, however we expect that the period of time of increased activity & reduced pain will increase with subsequent injection sessions.
What should I do following the injections?
Drink at least 2 liters of water following all injection therapies. Dehydration is the number one reason for post-injection discomfort. Have soft tissue therapy (graston, ART, physical therapy, etc.) as soon as possible following the injection treatment. The gains made from soft tissue treatment immediately after injections seem to be very accelerated. Ice the area for 20 minutes following the injection therapy.
How many injuries can I get treated during one session?
We are generally limited to one area per session so that we can stay within the safe range of local anesthetic that the body can process at one time.
How many injection sessions will be required?
The answer to this questions depends upon many factors, but generally anywhere from 4-10 sessions is the average. Since prolotherapy therapy works by initiating an immune response, anything that reduces the body’s immune system can impair the effectiveness of each session. Current smokers & those with uncontrolled diabetes can often require more sessions. Patients currently taking either prescription anti-inflammatory medication or non-steroidal anti-inflammatories (NSAIDS) may also expect a greater number of treatment sessions.
Is PRP therapy painful?
Typically, there is some heaviness & discomfort that is experienced at the injection site following the therapy session that can last anywhere from 1-10 days. Somewhere in this time-frame, patients will typically experience a relief from the pain of the injury.
Are there any side-effects to PRP therapy?
PRP therapy uses a patient’s own blood for treatment, so the side effects are minimal. To work, PRP therapy must initiate an inflammatory response. The inflammatory response will cause some post injection discomfort. This is perceived by patients as ‘heaviness’ or ‘aching’ for a few hours to a few days.
What is the average recovery time for PRP therapy?
Patients are encouraged to continue with moderate activity following PRP therapy. We want new tissue to be laid down in the lines of tension and activity will ensure this processes. Within 24-48 hours, patients report that they are able to resume full activity following the PRP therapy. Occasionally, we have a patient who recovers more slowly.
What drugs may affect PRP therapy?
PRP therapy works by stimulating an immune response so drugs that reduce the body’s ability to generate an immune response will negatively affect therapy. Both steroidal and non-steroidal anti-inflammatory drugs (NSAIDs) can impair the healing process of PRP therapy. Ideally, these drugs should be discontinued 3-4 weeks prior to PRP therapy for the best effect. Fish oils and other natural anti-inflammatory supplements do not appear to adversely affect PRP.
Are there any contraindications?
We cannot perform any treatments on cancer patients, women who are pregnant, anyone who will be travelling by air the same day of treatment and anyone who has an allergy to one of the ingredients (such as dextrose – derived from corn or Procaine – a short acting anesthetic). PRP especially cannot be performed on any individual that is immuno-compromised, fighting a current infection or has an active autoimmune disorder.
The following conditions may require more sessions due to their association with reduced immune system function (please discuss these in detail Dr. Riddle):
- Smokers
- Patients with diabetes
- Patients taking daily NSAID’s (non-steroidal anti-inflammatory drugs)
- Patients taking immune suppressant drugs (prednisone, imuran, methotrexate, etc.)
- Patients with hormone deficiencies.
What is difference between prolotherapy and cortisone shots?
Cortisone shots are an injection of anti-inflammatory medicine, which is usually a combination of corticosteroid and a local anesthetic. These injections usually numb your pain initially, but do not heal your injury, nor are they permanent. Cortisone and prolotherapy injections are quite the opposite. While prolotherapy has positive effects on healing, repair, collagen growth, tendon & ligament strength and cartilage growth, cortisone inhibits any repair or healing to occur.
