Frequently Asked Questions
Everything you need to know before treatment.
Prolo Dextrose Therapy
1. What is dextrose prolotherapy?
Dextrose prolotherapy is a regenerative injection treatment that uses a concentrated sugar (dextrose) solution to stimulate the body's natural healing response. The solution is injected into injured or weakened ligaments, tendons, or joint attachments with the goal of promoting tissue repair and improving stability. Unlike corticosteroid injections, prolotherapy is intended to encourage healing rather than simply reduce inflammation. It is commonly used for selected patients with chronic musculoskeletal pain that has not improved with conservative treatment.
2. What conditions can dextrose prolotherapy treat?
Dextrose prolotherapy may be helpful for selected patients with chronic musculoskeletal conditions, including: •Ligament laxity and joint instability •Chronic tendon injuries (tendinopathy) •Knee osteoarthritis •Sacroiliac (SI) joint pain •Chronic low back pain related to ligament injury •Shoulder instability •Tennis or golfer's elbow •Plantar fasciitis •Certain sports injuries Not every condition responds equally well, and an accurate diagnosis is essential before treatment.
3. Is prolotherapy painful, and how many treatments will I need?
Because prolotherapy involves injections into injured tissues, some temporary discomfort during and after the procedure is expected. Most patients experience soreness for a few days, which gradually improves. Treatment is usually performed as a series of 3 to 6 sessions, spaced several weeks apart, although the exact number depends on the condition being treated, the severity of the injury, and your response to therapy. Many patients notice gradual improvement over several weeks to months as healing progresses.
4. Is prolotherapy supported by scientific research?
Research on prolotherapy has grown over the past two decades. Clinical studies suggest that dextrose prolotherapy may improve pain and function for certain conditions, particularly some forms of chronic tendon disorders, knee osteoarthritis, and ligament-related pain. However, evidence varies depending on the specific condition being treated, and prolotherapy is not considered the standard treatment for every musculoskeletal disorder. Your physician will discuss whether current evidence supports its use for your diagnosis and whether other treatment options may be more appropriate.
5. How is prolotherapy different from PRP or stem cell treatments?
All three treatments aim to support healing, but they differ in what is injected. •Dextrose prolotherapy uses a sterile dextrose solution to stimulate the body's natural healing response. •Platelet-Rich Plasma (PRP) uses a concentration of your own platelets, which contain growth factors involved in tissue repair. •Bone Marrow Aspirate Concentrate (BMAC) contains cells and biologically active components obtained from your own bone marrow. The most appropriate treatment depends on your diagnosis, the severity of tissue damage, your overall health, previous treatments, and your treatment goals. During your evaluation, we will recommend the option that best fits your individual situation rather than using the same treatment for every patient.
General Regenerative Therapy
1. What is regenerative musculoskeletal (MSK) medicine?
Regenerative musculoskeletal (MSK) medicine is a field of medicine focused on helping the body repair injured muscles, tendons, ligaments, joints, and other connective tissues. Rather than simply masking pain, regenerative treatments aim to support the body's natural healing processes when appropriate. Depending on the diagnosis, treatment options may include shockwave therapy, prolotherapy, platelet-rich plasma (PRP), bone marrow aspirate concentrate (BMAC), physical rehabilitation, and other evidence-based therapies. Not every patient is a candidate, and treatment recommendations are individualized after a comprehensive evaluation.
2. What conditions can regenerative MSK treatments help?
Regenerative treatments may be appropriate for selected patients with chronic musculoskeletal conditions such as: •Arthritis of certain joints •Tendon injuries (tendinopathy) •Ligament sprains and instability •Plantar fasciitis •Rotator cuff disorders •Tennis and golfer's elbow •Knee pain •Hip pain •Certain spine-related conditions •Sports injuries and overuse injuries A careful diagnosis is essential because different conditions respond to different treatments.
3. Are regenerative treatments a replacement for surgery?
Not always. Regenerative medicine is not intended to replace surgery in every situation, but it may offer a non-surgical option for carefully selected patients. Some individuals improve enough to postpone or avoid surgery, while others may still benefit from an operation if structural damage is severe. Our goal is to recommend the treatment that offers the greatest likelihood of improving pain, function, and quality of life—not simply the newest treatment available.
4. How do I know if I am a candidate for regenerative treatment?
The first step is a comprehensive medical evaluation. We review your medical history, symptoms, physical examination, imaging studies (such as X-rays or MRI), previous treatments, and your personal goals. Factors such as the type of injury, severity of tissue damage, overall health, activity level, and expectations all help determine whether regenerative treatment is appropriate. Some patients benefit most from regenerative therapies, while others may be better served with physical therapy, medications, interventional procedures, or surgery.
5. How long does it take to see results from regenerative treatments?
Healing takes time. Unlike treatments that temporarily numb pain, regenerative therapies are designed to support the body's natural repair process. Many patients begin noticing improvement over several weeks, while others continue to improve over two to six months, depending on the condition and the treatment used. Recovery times vary, and no treatment can guarantee a specific outcome. Your physician will discuss what you can realistically expect based on your diagnosis.
Ketamine Therapy for Depression
1. What are ketamine infusions for depression?
Ketamine infusion therapy is an intravenous (IV) treatment that may help adults with treatment-resistant depression, meaning depression that has not improved adequately despite appropriate treatment with antidepressant medications, psychotherapy, or both. Unlike traditional antidepressants, which often take several weeks to become effective, ketamine works through different pathways in the brain, including the N-methyl-D-aspartate (NMDA) receptor. Some patients experience improvement in depressive symptoms within hours to days, although individual responses vary. Treatment is provided under close medical supervision with continuous monitoring.
2. Who is a candidate for ketamine infusion therapy?
Ketamine infusion therapy may be considered for adults with: •Treatment-resistant depression •Major depressive disorder that has not responded adequately to conventional treatments •Depression associated with significant functional impairment •Certain patients with severe depressive symptoms, after careful evaluation Not everyone is an appropriate candidate. Before treatment, we perform a comprehensive medical and psychiatric assessment, review your medications and medical history, and discuss the potential benefits, risks, and alternative treatment options.
3. What happens during a ketamine infusion?
During the infusion, ketamine is administered slowly through an intravenous (IV) line while your blood pressure, heart rate, oxygen level, and overall condition are continuously monitored. A typical treatment lasts about 40 to 60 minutes, followed by a recovery period before you are discharged home. Because ketamine may temporarily affect judgment, coordination, or vision, you should arrange for someone to drive you home after each treatment. Most patients receive an initial series of infusions, after which your physician will determine whether maintenance treatments are appropriate based on your response.
7. What is the difference between ketamine infusions and Spravato®?
Both ketamine and Spravato® (esketamine) are used to treat certain patients with treatment-resistant depression, but they are different medications delivered in different ways. Ketamine infusions: •Administered through an intravenous (IV) line. •Use ketamine, a medication that contains two mirror-image forms (R- and S-ketamine). •The dose can be individualized by your physician. •Used off-label for depression. Spravato® (esketamine): •Is an FDA-approved prescription nasal spray for specific patients with treatment-resistant depression and certain cases of major depression with acute suicidal thoughts or behavior. •Contains only the S-form (esketamine). •Must be administered in a certified healthcare facility under the FDA's Risk Evaluation and Mitigation Strategy (REMS) program. •Is prescribed together with an oral antidepressant. Both treatments require medical monitoring, and your physician can help determine which option may be most appropriate based on your diagnosis, medical history, treatment goals, and insurance coverage.
4. Is ketamine infusion therapy safe?
When administered in an appropriate medical setting with careful patient selection and monitoring, ketamine infusion therapy has an established safety profile. Temporary side effects may include: •Feeling detached or "dream-like" •Dizziness •Nausea •Blurred vision •Sleepiness •Temporary increases in blood pressure or heart rate These effects usually resolve shortly after the infusion is completed. Before recommending treatment, we review your medical and psychiatric history to determine whether ketamine therapy is appropriate for you.
5. How soon does ketamine work, and how long does it last?
Some patients notice improvement in depressive symptoms within hours to several days, while others require multiple treatments before experiencing meaningful benefit. The duration of improvement varies from person to person. Some individuals benefit for weeks or months after an initial treatment series, while others may require periodic maintenance infusions. Ketamine therapy is generally used as part of a comprehensive treatment plan that may also include ongoing psychiatric care, psychotherapy, and other appropriate treatments.
6. Is ketamine FDA-approved for depression?
Intravenous (IV) ketamine itself is not currently FDA-approved for the treatment of depression. Ketamine has been FDA-approved for many years as an anesthetic, but its use for depression is considered "off-label." Off-label prescribing is a common and accepted medical practice when supported by scientific evidence and clinical judgment. Numerous clinical studies have demonstrated that ketamine may provide rapid improvement in depressive symptoms for carefully selected patients with treatment-resistant depression. Your physician will discuss whether ketamine therapy is appropriate for your individual situation, as well as its potential benefits, risks, and alternatives.
8. Does insurance cover ketamine infusions for depression?
Insurance coverage for ketamine infusion therapy varies considerably. Because IV ketamine is used off-label for depression, many insurance plans do not routinely cover the cost of treatment. Some plans may reimburse portions of the medical evaluation, monitoring, or infusion services, while others may not provide coverage. In contrast, Spravato® (esketamine) is FDA-approved for certain forms of depression and may be covered by some insurance plans when specific medical criteria are met. Our staff can help explain expected costs, discuss payment options, and determine whether any portion of your treatment may be eligible for insurance reimbursement. We encourage patients to contact their insurance carrier for information about their specific benefits.
Ketamine & Lidocaine IV Therapy
1. What is a lidocaine infusion for neuropathic pain?
A lidocaine infusion is an intravenous (IV) treatment used to help relieve certain types of chronic neuropathic (nerve) pain. Lidocaine is a local anesthetic that, when administered intravenously in carefully controlled doses, can reduce abnormal pain signaling by stabilizing overactive nerve cells. Unlike opioid medications, lidocaine does not work by blocking pain perception. Instead, it targets the nerve pathways involved in neuropathic pain. Treatment is performed under continuous medical supervision with monitoring throughout the infusion.
2. What conditions can lidocaine infusions treat?
Lidocaine infusions may be beneficial for selected patients with chronic neuropathic pain, including: •Painful diabetic neuropathy •Peripheral neuropathy •Postherpetic neuralgia (pain after shingles) •Complex Regional Pain Syndrome (CRPS) •Small fiber neuropathy •Certain nerve injuries •Other chronic neuropathic pain conditions that have not responded adequately to conventional treatments Your physician will determine whether lidocaine infusion therapy is appropriate based on your diagnosis, medical history, and previous treatments.
3. What happens during a lidocaine infusion?
During treatment, lidocaine is administered slowly through an intravenous (IV) line while your heart rate, blood pressure, oxygen level, and overall condition are continuously monitored. Most infusions last 30 to 90 minutes, depending on the treatment protocol. Many patients return home shortly afterward, although someone else may need to drive you home depending on your response to treatment and your physician's recommendations.
4. Is lidocaine infusion therapy safe?
When administered by experienced medical professionals using appropriate monitoring and patient selection, intravenous lidocaine has an established safety profile. Some patients experience temporary side effects such as: •Lightheadedness •Dizziness •Ringing in the ears •Metallic taste •Mild numbness around the mouth •Nausea •Temporary changes in heart rhythm or blood pressure (uncommon with proper monitoring) Before treatment, we review your medical history, medications, and, when appropriate, your heart health to help ensure that lidocaine therapy is safe for you.
5. How many lidocaine infusions will I need?
The number of treatments varies depending on your condition and your response to therapy. Some patients experience meaningful relief after a single infusion, while others benefit from an initial series of treatments followed by occasional maintenance infusions. Relief may last from several days to several weeks or longer, depending on the individual and the underlying cause of the neuropathic pain. Your treatment plan will be tailored to your specific condition and adjusted based on your progress. These FAQs are also optimized for common Google searches such as: •lidocaine infusion for neuropathy •IV lidocaine for diabetic neuropathy •lidocaine infusion for nerve pain •treatment for painful neuropathy •non-opioid treatment for neuropathic pain •IV lidocaine side effects •how long does a lidocaine infusion last •lidocaine infusion near me These search terms tend to attract patients actively seeking alternatives to oral medications or opioids.
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