1. Stiffness and soreness at the site of injection and in the associated muscles which may last anywhere from one day to two weeks.
  2. Temporary numbness of the skin in areas adjacent to and/or somewhat remote from the sites of injection.
  3. Dizziness or light-headedness.


  1. Immediate pain at the injection site as well as post injection pain.
  2. Allergic reaction to the local anesthetic.
  3. Spinal cord injury.
  4. Pneumothorax-puncture of the lung.
  5. Infection at the injection site(s).
  6. Injury to the nerves and/or muscles at the injection sites.
  7. Temporary or permanent nerve injury.
  8. Inadvertent spinal tap with resultant spinal headache (temporary).
  9. Death (1 single incident 45 years ago, none in my patients or those of any colleagues).


You may be given some pain or muscle relaxant medication approximately ½ hour prior to this procedure, so try to schedule your arrival accordingly.  You should have discontinued all anti-inflammatory medication for at least three days prior to treatment. If you take one baby aspirin a day for cardiovascvular risk prevention, you can continue to take that. You may want to arrange for someone to accompany you for this procedure. It may not be necessary, but it is comforting.



  1. Immediately post treatment, rest 10-30 minutes.
  2. Pain: Post-injection pain may be rather intense for the first few days. This depends on a given individuals pain threshold and the number of injections given. Post injection stiffness and soreness, may last as long as 2 to 3 weeks, but typically lasts one to three days. You may also notice some residual superficial numbness which is also temporary. Your treatment is designed to produce an inflammatory response so, DO NOT take any anti-inflammatory medication, including Motrin, Naprosyn, Aleve, Celebrex, Vioxx, Bextra, Voltaren, etc. A baby aspirin previously prescribed for the heart is okay. Acetaminophen, (Tylenol) up to 3 grams per day is your first pain medicine. Every prolotherapy patient will be given a prescription for an opiate (Tramadol, hydrocone or oxycodone) for breakthrough pain, but many people end up not needing it. Heat, with suitable insulation may be applied for 20-30 minutes at a time every two hours. Do not use ice or any topical anti-inflammatory applications. Two to three months after concluding treatment, the use of anti-inflammatory medication if absolutely necessary may be resumed after a consultation with your doctor.
  3. Subsequent to treatment, you may have gentle massage to the area. This may be applied periodically as needed thereafter.
  4. Strenuous activity and exercises, weight training, particularly those movements and stretches involving the pelvis and lower back, should be avoided until advised otherwise. This admonition specifically includes some yoga postures and exercises. Please check with your doctor before resuming. Otherwise, full, normal, daily activity should be resumed as soon as possible.
  5. Osteopathic or chiropractic manipulations involving "thrust" or high-velocity, low amplitude techniques should be avoided except when administered by a doctor in conjunction with prolotherapy procedures. (Unless otherwise specifically directed.)
  6. As soon as deemed appropriate, physical therapy including trunk, knee or shoulder stabilization will be instituted. Your compliance is an essential element in your treatment program.
  7. Do not hesitate to ask questions, personally, by telephone, or preferably, if not urgent, by e-mail to Don't guess, or make assumptions. ASK!

Adapted from Richard Bachrach, DO

By John H Juhl, DO