Prolo Hawaii

FAQs About Prolotherapy


Prolotherapy has long been practiced, studied, reported on, and taught in medical workshops, yet it is largely unknown. More than any other reason, lack of public familiarity is due to the influence of the pharmaceutical, surgical, and medical device industries that dominate the medical system. Former U.S. Surgeon General C. Everett Koop, M.D., an advocate of Prolotherapy, points out that the very simplicity of the treatment itself for such a wide variety of musculoskeletal problems makes skeptics of many physicians who do not understand the method. To skeptics it sounds too good to be true. Prolotherapy is recognized and taught by the American Association of Orthopedic Medicine. However, it is not taught in Medical schools. Physicians must take time, as I did, to learn through intensive hands-on training. There are only a few hundred physicians in North America with the proper specialized training qualified to perform Prolotherapy.


It is very safe when administered correctly by trained physicians. Gustav Hemwall, M.D., one of the pioneers for Prolotherapy, treated more than ten thousand patients with more than four million injections without incident. "Not even a pimple" formed at injection sites, he once said. However, any medical treatment, including injections, bears a risk of adverse reactions and complications. In the case of Prolotherapy, the risk is very small. Injections are done near nerves and vessels. The injections are done directly to touch bone, which minimizes the potential damage to nerves and vessels but damage can occur. As with all medical procedures, side effects and risks can occur but rarely: these include increased pain, numbness, and infection, allergic reaction to medication, weakness, headache, pneumothorax, dizziness, nausea and death.


Individuals who have unresolved chronic pain or who have suffered a recent painful injury should consider Prolotherapy treatment. The technique received an endorsement from the Mayo Clinic. In their April, 2005 health letter, the clinic stated that when chronic ligament or tendon pain fails to respond to more conservative measures, like physical therapy and prescribed exercises, prolotherapy may be helpful. And when surgery is the only remaining option to relieve chronic pain, prolotherapy is a much less invasive and expensive technique that may be worth a try. Prolotherapists are trained to follow a diagnostic routine that uncovers the presence of damaged ligaments. Many times CAT or MRI scans cannot detect ligament abnormalities that cause chronic pain, and particularly so for the common, yet typical undiagnosed problem of damaged ligaments referring pain elsewhere in the body. The most important diagnostic tool available, believe it or not, is the thumb. I apply pressure to a particular site of chronic pain or a point I suspect as the source of "referred pain." If the patient "jumps" because of the tenderness of the particular ligament, this indicates that the pain-producing structure has been identified. There are other indicators of ligament weakness: pain aggravated by movement, a cracking sensation in the joint with movement, a chronic misalignment of a joint, and temporary relief from physical therapy, massage, or chiropractic adjustments. Prolotherapy often gives relief where other techniques may fail, or it enhances the benefits of other techniques such as chiropractic and physical therapy. If you are under the care of a chiropractor, acupuncturist, or other allied health professional, suggest using the thumb palpation test on a suspect ligament. If the pressure produces a good deal of pain, a ligament problem is likely present that will benefit from Prolotherapy treatment. Hormonal and nutritional deficiencies are factors that can interfere with efficiency of Prolotherapy treatment. These deficiencies undermine immune function. A strong immune system is necessary to ensure a good healing response from the treatment. In my clinic, hormonal and nutritional problems are routinely addressed as part of a holistic approach to better health. Ligament weakness can be caused by poor circulation, blocked meridians, and joint misalignments. These abnormalities need to be corrected for maximum Prolotherapy results.


The number of injections to obtain relief varies considerably from patient to patient and injury to injury. For healthy patients, one injection can relieve their pain totally, but usually a series of three to four treatments are sufficient. At the most, patients need ten treatments. If there is no improvement in pain, prolotherapy will usually not be continued. If progress is being made, treatments are usually performed every four to six weeks. Most ligaments heal within this time. If multiple sources of pain are involved - for instance, neck and back pain - I will usually inject one site first and then the other several weeks later. Subsequent injections are administered about four to six weeks after the previous injections at a given site.


The injected solution contains an anesthetic (Lidocaine) that often generates immediate pain relief. After the effects of the anesthetic subside, patients tend to experience various degrees of soreness and swelling around the injection site for several days. This is the result of healing and inflammatory substances rushed to the area by the body. Applying ice or taking anti-inflammatories are not recommended. You want the inflammatory process to run its course, which results in strengthened tissue. Relief of the original pain usually continues for a few weeks after the first treatment. However, after initial stabilization, some pain may return. This occurs because full regrowth of ligament tissue is not complete. Follow-up evaluations and /or treatment are recommended every four to six weeks. Sometimes pain is entirely relieved after a single treatment. Residual pain generally diminishes with each treatment. In the case of an acute injury, healing can occur within a few weeks of injection.


Prolotherapy involves precise injection on the site of the torn or stretched LIGAMENT OR TENDON. Depending on the site and size of the area involved, this may necessitate many injections during one office visit. These injections are uncomfortable because they involve multiple needle sticks. Many patients tolerate this well but some patients, prior to procedure, may require oral sedative, like valium. Local anesthetic to produce skine wheels is also used over the area to be injected, making it more comfortable .


Initial consultation for a problem can be billed to your  insurance as this will require a review of records, discussion or what  types of treatment you have undergone,  obtaining a history and performing a physical examination as well as discussion of the treatment options for your problem.

If you have no insurance coverage,   the consultation fee is $200 

If you are established patient and a new body area is assessed, we bill your insuracne a follow-up consultation fee or $100 fee if  you do not have insurance coverage.

If you choose to have prolotherapy procedure, we will not bill insurance companies for prolotherapy. Fees are paid at the time of service and we will supply you with a superbill upon request, to turn in to your insurance company for any reimbursement.

Procedure fees vary depending on body part, which can range from $200- $350 per session.  A second body part on same day session is discounted 50%.

If you expect to receive the procedure on the same day of the consultation, please do not take any anti-inflammatory medicines at least one week before your appointment. If you have any questions, please feel free to call the office or email me at This email address is being protected from spambots. You need JavaScript enabled to view it.

AREAS COST                               AREAS COST                               AREAS COST
Low Back (Lumbar) $350                               Shoulder $250                               Hip $250
Neck (Cervical)  $300                               Elbow $200                               Knee $250
Thoracic (Midback) $300                               Wrist/Hand  $150                               Ankle/foot    $200


I treat patients ranging in age from teenagers to nonagenarians. Occasionally I treat younger children who have been injured in accidents. Youngsters usually require fewer treatments than older individuals, and often can be totally relieved in one or two sessions. Older people tend to heal more slowly and thus may require more treatments. However, the use of nutritional medicine, including oral supplements or even intravenous nutrients, can significantly shorten healing time and improve overall health. It is amazing - and very gratifying - to witness the relief on the face of older patients who have suffered chronic pain · For more information on prolotherapy, check out: and

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