When properly performed, prolozone is arguably the most economical and effective nonsurgical treatment for painful musculoskeletal disorders such as osteoarthritis and injuries of the wrist, elbow, shoulder, neck, back, SI joint, hip‡, knee and ankle; tendonitis; sciatica; old injuries; chronic dislocations; pinched nerves; pain associated with scars/prior surgeries and muscular trigger points.
Prolozone often provides immediate relief as well as long-term reduction in pain. At least 75% of our patients experience permanent elimination of pain and improvement in function following a recommended series of prolozone visits. Your body is the greatest healer. These treatments correct multiple obstacles-to-healing at the tissue and cellular levels in order to break the vicious cycle of pain and allow your body to heal. Prolozone also provides painful and diseased area(s) with the proper fuels and stimulation to encourage repair and regeneration of cartilage, tendons and other tissues.
How it works Anti-inflammatory prolozone
When an injured area is acutely or chronically inflamed and painful, multiple local factors must be addressed in order for it to become healthy again. These include inflammation, of course, but also impaired blood flow, decreased availability of nutrients and oxygen, acidic pH, unhealthy cell membranes, and dysfunctional cells which are unable to utilize local oxygen, glucose and other fuels in order to produce the cellular energy (ATP) needed to function properly and to heal (mitochondrial dysfunction).
Prolozone was designed to target each of these factors through a unique combination of ingredients that are injected together. These components work together synergistically to provide rapid relief of pain and stimulate the body to repair itself over time. An initial prolozone treatment consists of an injection of an “anti-inflammatory cocktail” which reduces pain, decreases inflammation, repolarizes cell membranes, replenishes vital nutrients and restores a healthy pH balance to the tissues†. Next, pure medical oxygen (O2) gas mixed with a small but powerful dose of ozone (O3) is injected into the joint or soft tissue through the same needle. Ozone restores healthy mitochondrial function (cellular energy production), promotes a long-term improvement of blood flow and oxygen delivery to the area and destroys pathogens on contact. Many pathogens (bacteria, fungi, viruses, etc.) thrive in low-oxygen/low-blood-flow areas, and there is evidence that they are present in many cases of osteoarthritis and back pain! Oxygen provides instant fuel for the healing process.
Because diseased tissues are “softer” than healthy tissues, this O2/O3 gas mixture naturally travels via the path of least resistance to the areas that need it most. For example, prolozone given in appropriate superficial areas of the back or neck travels deeply through the vertebral ligaments to arthritic facet joints and bulging discs. This means that compared to other types of injections like steroids, prolotherapy or PRP, you will likely receive fewer and/or less invasive (not as deep) injections and they will be more comfortable to receive. After your first anti-inflammatory prolozone injection, Dr. Haas will most likely recommend that you return in 2 weeks for your next visit.
Proliferative Prolozone and PRP
Once your pain and/or dysfunction is reduced by at least 50% (typically after 1 to 3 anti-inflammatory treatments), the “anti-inflammatory cocktail” is replaced with a slightly different “proliferative cocktail” which is even more specifically geared towards the regenerative and remodeling phases of the healing process.† This cocktail is also followed by the oxygen-ozone mixture. In conditions with loss of cartilage, partial rotator cuff, tendon, ligament or meniscus tears, instability, significant degeneration, and/or certain other characteristics, Dr. Haas may recommend adding ozone-activated platelet-rich-plasma (PRP) to these proliferative prolozone treatments. In these cases, PRP is then injected along with the “proliferative cocktail” and the ozone-oxygen mixture, so you get all the benefits of prolozone with the addition of the healing stimulus of the PRP.
Traditional PRP, which is a more mainstream (and often more expensive) treatment than prolozone at the time of this writing, starts with drawing blood from your vein into tubes as if you were getting labwork done. The tubes are then spun in a centrifuge, and the doctor, nurse or technician carefully extracts the portion of the plasma that contains most of the platelets (called platelet-rich plasma or PRP), activated with calcium and injected into the tissues with some numbing medicine. PRP seems to stimulate healing by releasing growth hormones via an excellent delivery system called "exosomes," which are taken up by nearby ligaments, cartilage and other damaged tissues, stimulating them to repair and regenerate. With traditional PRP, you don’t get all the nutrients, oxygen or ozone discussed above, and the PRP doesn’t spread out through the damaged tissues the way that it does with prolozone. This means that in general, combining PRP with prolozone is less painful during and after the procedure, and leads to more dramatic and more lasting (usually permanent) benefits compared to PRP by itself.
Another advantage of prolozone with PRP is that instead of using calcium to activate the platelets, the doctor uses ozone. Activating the PRP with ozone kills any pathogens that are present in the blood (you might be surprised to learn that blood is not sterile!), and ozone has been shown in-vitro to be superior to calcium in terms of increasing exosomes, platelet-derived growth factor, transforming growth factor b1, as well as the signaling molecule interleukin-8 which attracts circulating white blood cells into the region to clean up old damaged tissue(1).
Everyone is different, and a general rule of thumb is that the longer the condition has been present, the more treatments it will require to resolve. That said, most patients experience permanent pain relief and recovery of function after a series of 3-6 prolozone visits‡.
Additional adjuncts to prolozone that are available in select cases are AmnioFix and Stem Cell injections. More about these therapies on our website under “services menu.”
Injecting acupuncture points and trigger points with small doses of ozone, energetic remedies, procaine and/or the activated vitamin methyl-B12, called biopuncture, can increase the efficacy of prolozone. Up to 3 biopuncture injections may be included as part of your prolozone treatment at no additional charge. In some instances, more extensive biopuncture may be recommended instead of, or in addition to, prolozone. There is a discount for adding-on biopuncture to a prolozone treatment, similar to the discount for treating multiple locations with prolozone during the same visit.
What to expect and post-prolozone instructions
Each person’s experience is unique, personal and individual so we have to use generalizations here, but the following is what the majority of our patients report. Most people experience dramatic pain relief and improved mobility immediately after their first injection(s). There may also be a feeling of fullness, tightness or soreness in the area(s) treated for several hours (after anti-inflammatory) or up to 2 days (after proliferative with PRP). Occasionally, popping or locking may be more frequent in the first few days as well. After about 2-3 days, some degree (usually 25-75%) of lasting improvement in pain symptoms will be maintained, and continued improvement may be seen for up to 2 weeks (anti-inflammatory) or 4 weeks (proliferative). Improvements are additive as your tissues and cells become healthier. For example, 1st treatment 50% better + 2nd treatment 25% better = 75% better overall.
When PRP is used, a temporary increase in pain and stiffness can occur. This usually lasts about 1-2 days but in very rare cases can last up to 2 weeks. No one has ever reported a permanent increase in pain or dysfunction after receiving prolozone (with or without PRP) from Dr. Haas. Any discomfort after prolozone with PRP is part of a healthy healing response. Usually it is mild to moderate, but occasionally it can be “like a bad day before prolozone.” We have never heard that it was more painful than that. Avoid aspirin, non-steroidal anti-inflammatory medications (NSAIDs) such as ibuprofen, Alleve and steroids during the first 48 hours. Tylenol, sublingual or topical homeopathics like arnica and supplements like curcumin are fine. Heat is encouraged. Ice should be avoided or kept to a minimal.
Again, everyone is unique and some people may notice relief for only one to a few days after their first or second treatment. Others may notice no immediate relief but may find a gradual or sudden drastic improvement up to 2 weeks after an anti-inflammatory treatment or 4 weeks after proliferative. Sometimes the quality or location of pain shifts, or old pain patterns may re-appear. This is good! Treating chronic injuries is analogous to "peeling layers off an onion." Any shift in symptoms, no matter how brief, is encouraging that further treatments will be effective.
During your series of prolozone treatments, the body is busy healing itself and it is critical that you do not overdo it! These are our post-procedure instructions: in order to facilitate the healing process, it is very important to avoid any activities that would have caused you to have pain of 6/10 even for an instant (0 being no pain and 10 being the worst pain imaginable) OR would have left you sore/hurting for 15 minutes or more after you stopped that activity prior to your first injection. This means that if running caused your knee to hurt at 6/10 briefly or caused it to hurt for 15 minutes after you stopped running on the day you came in for your first prolozone shot, please wait until you have been pain-free for 2 weeks before attempting to run, and even then, start gradually and listen carefully to your body. Achieving and maintaining a healthy body is a marathon, not a sprint!
Pay careful attention to any changes that occur in the days and weeks following each treatment. Journaling or going through a mental checklist of symptoms and things you are now able to do may help you realize how much progress you are making, and reporting this information to Dr. Haas at each subsequent visit helps her further customize each treatment. Try to reduce your stress (a daily 30-minute "stress stroll" can work wonders for decreasing the stress hormone cortisol, or try a daily deep breathing exercise). Drink lots of filtered or spring water and support detoxification (infrared sauna, light exercise, increase intake of fiber-rich veggies, etc).
One last note: the physical body is only part of who we are. We are mental, emotional and energetic beings! Injured cells and tissues can harbor stuck emotions, so sometimes release and healing occurs on an emotional level during or after a prolozone treatment. Allow yourself this release by intending some quiet time to sit with the emotional discomfort and feel it unconditionally (without placing judgement on it or resorting to a mental story to explain it). Let go of your resistance and let go of any tears that want to flow. This process allows for integration of charged emotions and greater emotional freedom overall. For more information on this, check out: The Presence Process by Michael Brown
‡If there is an extensive mechanical component such as back fusion hardware, maintenance injections every 3-4 months may be required for continued pain relief. Sometimes it may take 2 or more treatments to notice significant lasting results. Occasionally, more than 6 treatments are likely to be needed to achieve the desired result. If progress is not going as expected, Dr. Haas may recommend adding AmnioFix or Stem Cells to your injection(s). After AmnioFix, one additional prolozone injection is usually recommended 4-6 weeks later. After Stem Cells, follow-up is as needed after 4-6 weeks. Severe hip degeneration (diagnosed by x-ray or MRI) typically responds less favorably to prolozone (compared to mild to moderate hip degeneration and other conditions listed).