What is prolotherapy?

Prolotherapy is a type of therapy that consists of a series of injections of natural substances that produces an irritative-inflammatory response in the treated area. This causes an attraction of growth factors and other substances produced by the same body to cure-regenerating areas of injury, remove-significantly reduce the pain and return the functionality to the affected area.

Do you accept medical insurance? Why not?

Unfortunately the ARS consider prolotherapy (as is based on natural substances) an alternative therapy or even experimental therapy. In spite of all the scientific evidence accumulated in benefit of the patients (over the years), this type of therapy is not covered by the ARS.

In what schedule do you attend and if it is by order of arrival?

We attend by appointments and work from Monday to Friday, from 8:30 AM. to 5:00 PM

What types of pains do you treat?

We treat all kinds of pain of origin skeletal muscle, osteo-articular, tendon, ligament, meniscus, etc. In other words cervical spine pain, thoracic spine, spine, lumbosacral, coccyx, shoulders, elbows, wrists, hand, fingers, hips, knees, ankles, fingers, plant of the foot, etc.

What is the ideal candidate to receive prolotherapy?

  1. Have a pain that originates from a ligament or tendon ?
  2. Has a strong immune system?
  3. Have the will to improve and make follow-up visits?
  4. Eat a balanced and healthy diet?
  5.  Has a positive Mental attitude?

Are there any contraindications to the use of prolotherapy?

  1. Use of anticoagulants
  2. Diabetes Mellitus decompensated
  3. Arterial Hypertension Decompensated
  4. Open fractures.
  5. Septicemia

Is the Prolotherapy a painful treatment?

Sessions are not painful, but it is a different feeling to what we are accustomed, “may in some cases be something annoying, situation that in the majority of patients, with a few tablets of acetaminophen and a couple of sessions of local heat, heating pad or local moist heat at home, is resolved”.

The procedure lasts three to five minutes. However, the visit specialist takes from 45 minutes to 90 minutes, from the time the patient enters the office.

What expectations should I have to improve my chronic pain with the prolotherapy?

90% of all pain muscle skeletal tend to heal or improve dramatically. (7 of each 8 improve almost unbelievable way)

What could be "possible" adverse effects of the prolotherapy? Possible does not necessarily mean that are highly probable, but that could occur (particularly in inexpert hands)

  1. Bleeding from the area
  2. Bruises
  3. Temporary increase of pain (due to inflammation)
  4. Infection
  5. Joint Effusion
  6. Injury of some nerve
  7. Pneumothorax (to treat the area chest)
  8. Temporary Headache
  9. Temporary  Stiffness
  10. Temporary swelling
  11. Injury to a ligament or tendon

What things should or not do before and after each session of prolotherapy?

Before coming to the clinic

  1. Do not take any NSAIDs (Anti inflammatory as: Voltaren, Enantyum Dexketoprofen, Sertal compound, Diclofenac, Ibuprofen (Motrin), Ponstan, Advil, naproxen, etc…) 4 days before coming to the clinic.
  2. Not take anticoagulants (aspirin, Plavix, Clopidogrel, etc..) 48 hours before coming to the clinic.
  3. Fill the session of questions that go in the e-mail, that way makes it easier for us to know what happens and we can also advance the process of the clinical history.
  4. Is convenient that you bring its latest analytical and images (should you have them) for the first date.
  5. Don’t attend your appoinment on an empy stomach

After therapy

  1. In case of pain, you can take only (for the first four days): Tylex, Tylenol, green Winasorb, Paracetamol, etc. If the pain is severe and has taken other times, then you may use powerful painkillers like Tramadol or ketorolac.
  2. In case of continuing pain from the fifth day (though not ideal) you can start with NSAIDs: Voltaren, Keral, Dexketoprofen Composite Sertal, Diclofenac, Ibuprofen, Ponstan, Advil, Naproxen, etc …
  3. Apply heat to areas of injections.
  4. Never apply cold in the areas of injections.
  5. Preferably NOT TAKE cold drinks on the day of treatment, if can take them from the next day.
  6. Leave made your next appointment before leaving.
  7. Don `t lift heavy things.
  8. No strenuous exercise. EXERCISE Golden Rule: For every day lost, it takes two days to regain form
  9. Remember that weight loss is an important factor for improving ligaments.

What is platelet rich plasma?

Platelets play a central role in blood clotting and healing. Tissue repair begins with clot formation and platelet degranulation, which releases growth factors required for the repair of injuries. Studies have shown a direct correlation between platelet concentration and the level of secretory proteins, and the amount of proliferation involved in healing of injuries. In short, it is the separation (by centrifugation of blood) and extraction of that part of the plasma which has been concentrated and therefore increased the percentage of platelets (rich in growth factors) and therefore ready for use in repair and regeneration of musculoskeletal injuries.

When does it apply?

The scientific literature is full of reports of cures or impressive improvements in soft tissue injuries treated with PRP including tendinopathy, tendinosis, acute and chronic muscle tension and muscle fibrosis, ligament sprains and laxity of the joint capsule, in addition to various joint degenerative disorders . Especially interesting is the use of PRP in cartilage regeneration, such as in the treatment of knee osteoarthritis.

We combine Prolotherapy Intensive Standard with the PRP and thus offer a safer and more effective to heal joint injuries, so manner so that its use entails avoid or delay surgery, in cases commonly usually corrected surgically, as is the case of Torn Meniscus, labral tears (or impeller) of the hip and shoulder, etc.

What are the benefits different from Standard Prolotherapy?

Specifically, fibroblastic PRP improves events (forming collagen) involved in tissue healing including chemotaxis, cell proliferation, protein synthesis, repair, extracellular matrix deposition, and tissue remodeling. The bottom line here is that tissue injury can heal faster with the treatment of platelet-rich plasma or PRP.

Are all the PRP equal?

Definitely not. Much depends on the way of extracting the PRP, the existence of leukocytes, the final concentration of platelets, activation or priming thereof, of the amount obtained, whether the extraction system is closed or open , if a camera is used laminar flow (to avoid contamination), and especially the experience and skill of who owns and who injected into the injured area.

How often PRP sessions should be used?

PRP sessions, can be used with a frequency of 4 to 8 weeks apart, depending on the chronicity and severity of the injury.

Why think or nonsurgical management measures for chronic pain?

Surgery is traumatic; It causes stress and tension in the body and can cause a person to feel less confident using the operated limb.

Surgery could change the anatomy of the individual.

Surgery involves potentially many types of complications.

Surgery can lead to arthritis long term due to the elimination of significant tissue needed to help support the weight structures of the body, such as cartilage, meniscus and disc tissue.

Rehabilitation is much longer after surgery than with prolotherapy. (With prolotherapy you can go to work the next day and start exercising in 5 days)

Surgery does not always solve the pain, which either means that the cause of pain is not treated, or surgery that caused another problem.

Surgery is more expensive.

What are Stem cells?

The “cell Prolotherapy” encompasses not only Platelet Rich Plasma (PRP) but also stem cells. Stem cells are cells that generate self-renewing body repairing and replacing old or damaged tissue new tissue cells. Injection of these cells into the damaged tissue directly has been demonstrated improves tissue integrity and reduces pain.

They are also called progenitor cells that can be totipotent, pluripotent or that are pluripotent depending on the capacity to produce tissues and/or cells totally new.

How many types of stem cells exist?

There are four types of stem cells depending on their degree of differentiation:

  • Totipotent stem cells: Those that can grow and give rise to a whole organism, both the embryonic components (organs, tissues …) and the extraembryonic (placenta …)
  • Pluripotent stem cells: those that can not form a complete organism, but any type of cell of the embryonic leaves (endordermo, mesoderm and ectoderm).
  • Multipotent stem cells: can only generate cells of the same germ layer.
  • Unipotent stem cells: they can only form a particular cell type.


Depending on the degree of development of the organism, various types of stem cells are distinguished:

  • Embryonic stem cells: stem cells are pluripotent. They are used as a model to study embryonic development and to understand the mechanisms and signals that allow differentiation of a pluripotent cell are.
  • Mothers germ cells: They are embryonic stem cells derived from embryonic gonadal blanks (structures that subsequently form the reproductive organs). The isolation of this type of cell is more difficult than embryonic cells.
  • Fetal stem cells: They appear in fetal tissues and organs and characteristics similar to their counterparts in adult structures, but have greater expandability and differentiation.
  • Adult stem cells: They are multipotent cells. They are undifferentiated cells found in adult tissues and organs and can be differentiated. Its ability to generate specialized cells is limited. Are ongoing clinical trials to replace damaged tissues derived from these cells.

From where can they be extracted?

The most common forms of extract is from Bone Marrow warm or Posterior Superior Iliac Crest (hip) or mini lipoaspirate abdominal fat, buttocks or inner thigh.

These lipo combined with platelet rich plasma (PRP) from a blood or bone marrow recovered from the iliac crest. This proliferative solution is injected into the ligament, tendon, injured damaged, or in the painful joint. Attached tendons and ligaments of the joint are also treated with prolotherapy dextrose-based standard.

In our experience, where prolotherapy injections are given it is also an important factor, not only what is injected. This means that therapy stem cells or Cell Prolotherapy includes not only a couple of injections of stem cells but also the whole area of the painful joint is treated for the underlying instability which is likely the cause of the injury (in first place). If this aspect of the patient’s condition is not treated, we find that it can not produce complete healing.

How useful are stem cells in repairing injuries?

Not all lesions require the use of stem cells to cure. In our center, the success rate with the Traditional Prolotherapy (Hackett-Hemwall) is around 90% in most of the patients we see. However, for cases of very aggressive advanced arthritis, tendonitis (tendon degeneration), meniscal tears, labral tears (or impeller articular hip or shoulder) injuries where there rubbing bone to bone, or injury where there are few cells, we can choose to use the cell Prolotherapy based Stem cell in combination with standard Prolotherapy to strengthen and stabilize the support structures around the injury as well as for the regeneration of the meniscus (or severely injured another area) and best recovery and / or curing it.


Other uses of stem cells are cases:

  • Avascular Necrosis in a bone (joint)
  • Cartilage injuries
  • Chronic ligament injuries
  • Degenerative joint disease
  • Labral tears shoulders and hips
  • Meniscus tear
  • Osteoarthritis
  • Osteochondral defects
  • Tendinosis (tendon degeneration)
  • Many more

What I can expect after being treated with stem cells?

After being treated with stem cells, next to the PRP and Intensive Prolotherapy, which is the protocol that always follow in the Center of Intensive Prolotherapy and Regenerative Medicine for the same reason that any construction, we need the material that is to be build (rods, cement, sand, gravel, gravel, blocks, etc.), these elements are Stem cells. The PRP provides builders who will work with those materials, will place the mixture, working with blocks, rods, etc. and finally finishing, painting, details, curtains, awnings, etc., that is provided by Prolotherapy (hypothetical case). The patient may still feel improvement even within the first 6 months. The PRP could be reinforced every 4-8 weeks (1 to 2 times) and every 4 weeks can give Prolotherapy session, to complete 3-6 sessions

How important are images in the management of patients with chronic pain?

Images are important in making differential diagnoses, are important to know when anatomical changes or alterations to the normal structure of bone or joint frame. However it is becoming more frequent inaccuracy when discriminating the cause of chronic pain. Doctors, like all humanity, have been modernized us, but with the advances of modernity we have lost our identity as clinical investigators, if friends-detectives who walk on the trail of an enemy that is chronic pain want . We learned many years ago that semiotics: A good, complete and detailed medical history with a thorough physical examination, we gave about 90% of the diagnosis. Today we have given that capacity, to imaging tests. He has forgotten us touch the patient (not forgetting that contact is itself part of the healing of the patient), listen carefully, ask questions and let answers without interrupting (studies show that every 20 seconds physicians interrupt a query and for others we have been narrowing over time), create a cozy atmosphere, annotate everything we can, because everything is important, knowing how to read body language does not verbalized, what the patient is telling us to face, with its form reaching the office, with its way to joining the chair or stretcher, etc. Search where he might be the cause of physical pain (whether it is just physical, or is a consequence of elements in their psyche, their past history, their emotions, their difficult life, their marital relationship, family, work, spiritual) . Just going to the source we can truly help those who suffer in body and soul chronic pain. Is trying to become one with the person, and know refer to other health professionals, since we are not gods, only human beings whom He used to heal or relieve the pain of others.

What factors are involved in chronic pain?

Pain is a complex issue; everyone will experience at some point in their lives. In fact pain is the # 1 reason why people visit the doctor. 90% of the population (9 of 10 people) at some point in their life will experience chronic pain.

The experience of pain is affected not only by the type of injury or injury but by other factors that are unique to each person; such as the pain threshold (if it’s high, tolerate pretty well the pain, on the other hand, if it is low, the lesions usually hurt you much more than ordinary people) also past life experiences, emotions , stress and last but not least, your genes. So when we say that pain is personal, we mean it literally. This is what causes the pain is so difficult.

None of us, doctors, parents, or friends, can truly enter into the pain of another person. Pain is the most private feeling and each person has a unique threshold for pain.

Many studies indicate that those who continue with pain 30 days after suffering an injury, pain continue 5 years later.

What changes are recommended in the lifestyle to improve my condition chronic pain?

The management of chronic pain is multifactorial because he himself is due to many reasons that come together.

  1. Having a good hormone balance, an excess of the hormone estradiol in women or testosterone hormone deficiency in men, it is involved in a number of disorders that also has catabolic or destructive effects on connective tissue. If the levels of anabolic hormones an individual are low, natural hormone supplements are prescribed. It would also be advisable that neither oral contraceptives or other synthetic forms of estrogen is not taken. Some dietary adjustments could be made with natural supplements to help regulate levels of estradiol.
  2. Because nutrition plays a very important role in the treatment of chronic pain, the type of diet that evaluates and identifies the metabolism of an individual by examining a number of different factors, including oxidative stress, blood type, body type and pH of urine, blood and saliva, is also performed. Dietary recommendations are made based on the results.
  3. Fatigue and sleep-related problems, strongly influenced by high levels of cortisol, are often a major concern with chronic pain. The adrenal gland secretes less cortisol usually at night, allowing sleep. However, anyone suffering from chronic pain, is in a constant state of stress. This keeps high cortisol levels. In fact, in an individual under stress, the adrenal gland is actually stimulated to produce more cortisol, which can result in chronic insomnia. To make matters worse, without adequate sleep, insufficient amounts of growth hormone are secreted, one of the anabolic hormones necessary for growth and repair connective tissue. The vicious circle is probably becoming very evident. Less healing of soft tissue injuries, chronic pain leads to more, leading to increased cortisol levels, this leads to less sleep and more stress, less healing and% cure and so on!
  4. We have also found that fungal infections and allergies may play a role. We should administer appropriate test and if positive for yeast infection have solved part of the problem. It turns out that many people with fibromyalgia or chronic pain have chronic yeast or Candida infections, the main symptoms of which are a tired and aching body, premenstrual syndrome and chronic fatigue. At this point it should be mentioned again that the long-term use of NSAIDs (nonsteroidal anti-inflammatory), a common treatment of modern medicine for chronic pain, can actually lead to chronic yeast infections! In addition, infections and allergies untreated yeast can also lead to irritable bowel syndrome, one more thing that complicates the complex nature of chronic pain and may even worsen it.
  5. Good stress management and all the conditions that tend to get us out of our comfort zone. Resilience learn to exercise; knowing that it is impossible to live without stressful situations, the important thing is whether we have the right tools to deal with them and not give permission for them to get us out of our comfort zone and lead us down paths of darkness and spiritual, emotions and body illness. Take some time for meditation, for prayer, for contemplation, to think about what we are, how blessed we’ve been, and promising future that awaits us, because it is rooted in the firm rock which is Jesus Christ.
  6. Playing sports or physical activity. It is healthy, liberating, burns calories, enables us cardiovascularly, clears us of the problems and importantly releases endorphins, especially serotonin, which is the “hormone” of happiness.

What is injury to the rotator cuff?

The rotator cuff is a group of muscles that hold and support the shoulder. The shoulder joint is unique because it is the only one that can rotate 360 degrees and you need a good external support for the insertion of the humeral head remains stable in the glenoid fossa. The 4 muscles that make up the rotator cuff are the supraspinatus, infraspinatus, teres minor (teres minor) and the largest of them, the subscapularis. If these are overloaded work cause the tendon to swell and hurt. The most common scenario occurs when a chronically unstable shoulder forcing the shoulder muscles, especially the rotator cuff muscles and tendons, to work beyond their capacity to stabilize the shoulder while moving through its complex movements. These small rotator cuff muscles were not designed to stabilize the shoulder or carry out the main work in shoulder movement, but must work to perform shoulder rotation. Chronic ligamentous instability can lead to rotator cuff tendinitis. Treatment with prolotherapy can treat both instability and secondary tendinitis below.

Prolotherapy is the root of shoulder instability and rotator cuff tendonitis not only by strengthening the tendons of the rotator cuff, but also correcting the weakness of the shoulder ligaments.

What are the most common conditions treated at the Center for Intensive Prolotherapy and Regenerative Medicine?

We try all kinds of chronic musculoskeletal pain, however as described in the literature, lumbosacral pain due to protrusions or herniated discs, changes in architecture, pinched nerve roots, radiculopathy, sciatic pain , etc., are the injuries most often see and treat. Second and third place are respectively sore shoulders and knees, may be due to injury to the rotator cuff, frozen shoulder, bursitis, degenerative osteoarthritis, injury, bone to bone, damage to the meniscus or medial or collateral collateral ligament lateral , frequent subluxations or dislocations (people who are often “breaks away” shoulder), gouty arthritis, meniscal problems, persistent pain after arthroscopy, etc.

We also have pain in cervical spine herniation or protrusion, rectification neck spasms or contractures, Vertebro Syndrome Basilar, Barré syndrome-Lieou, etc.,

We have a whole spectrum of injuries in athletes, baseball players, football players, tennis players, golfers, swimmers, weight lifters, body builders, basketball players, etc., that high-impact exercise practitioners end up affecting ligaments, tendons and joints and those treatments applied have returned them to the sport they love.

Golfer’s elbow or tennis, sore wrists, sore fingers, sore ankles, plantar fasciitis, ankle sprains to repeat, pain iliotibial band (IT), pubalgia, coccigodinea (pain in the coccyx), etc.

The range is very large. To all try to improve with Prolotherapy Standard, although we know that some only Prolotherapy Cell (PRP, stem cells from the bone marrow or Minilipoaspirado), can radically change them you live.

How often patients should be treated with Prolotherapy sessions?

Prolotherapy sessions are administered every 4 weeks to mimic the natural process of healing that uses the same body in similar cases. Anyway there is a window that goes from 4 to 6 weeks.