Looking for a Prolotherapy Specialist in NYC? "He who treats only at the site of pain is lost, and tragically so is his patient."
– Dr. Karel Lewit, Czech physician and pioneer in holistic medicine

Pretreatment is Key to Successful Prolotherapy

“The soul of man, with all the streams of pure living water, seems to dwell in the fascia of his body” – Andrew Taylor Still, MD, founder of osteopathy

Prolotherapy treatment is designed to strengthen different types of connective tissues like tendons, ligaments and fascia, to improve mobility and stability, but it would be irresponsible to administer needling therapies like Prolotherapy, Prolozone or PRP injections without first optimizing the tissues for treatment.

To function optimally, the locomotor system relies heavily on stability generated by myofascial tensegrity. But damaged fascia can form densifications and adhesions that pull against newly reinforced tissues, causing them to fray or rupture. Prior to Prolotherapy treatment, fascial distortions must be addressed.

Our Expertise Makes All the Difference

Accurate and effective needling procedures require advanced knowledge of human anatomy, derived from cadaver dissection studies and the use of high-resolution sonography. But knowledge of human anatomy is not enough. According to recent research, and based on our own experience, prolotherapy injections performed blindly can do more harm than good.

To be effective, Injection therapies need to precisely target specific tissues with the appropriate volume of solution. Without ultrasound guidance, it is impossible to know how much of the injected solution is required, or if it has successfully hit its mark. And even that may not be enough, because ultrasonography itself requires extensive study and experience, and guided injection procedures require the highest-resolution ultrasound equipment available.

When a prolotherapy solution is injected blindly into the intermuscular plane, it is impossible to know how much solution is enough. Practitioners typically rely on outdated standardized guidelines defined by the Hamlet and Hackett protocol, which is not based on precise imaging and testing, and which often recommends a much greater volume of solution than is needed. We may see temporary pain relief and improved tissue gliding, but instead of enhancing tensegrity, we end up with fibrosis, fascial densifications, and adhesions that cause long-term issues.

At NYDNRehab, our personalized holistic approach is redefining how regenerative and orthobiologic therapies are used. Prior to prolotherapy injections, we conduct rigorous clinical testing to determine which tissues will benefit, and whether there is any related loss of tensegrity or fascial gliding.

In cases where Prolotherapy is not immediately warranted, we may opt to start with physical therapy, fascial manipulation, or other regenerative therapies. By contrast, many pain management doctors simply inject the solution into the locus of pain, without considering that the pain may arise from other causes that require different types of treatment.

In instances where fascia is densified and adheres to other structures, ultrasound enables us to combine classic Prolotherapy with interfascial plane injections – a procedure where a saline or dextrose solution is injected into the extracellular matrix between organized fascia layers, to separate soft tissues and restore functional movement.

We integrate all of our regenerative injection procedures with fascial manipulation and ultrasound-guided fascial hydro release. When combined with the most advanced high-resolution ultrasound imaging, we are able to visualize minute details, to determine the appropriate solution concentration, and ensure that the injections reach their intended target.