Areas: Knee, shoulder, hip, ankle, elbow, wrist, hand, sacroiliac joint, and some low back connective tissues, muscle-tendon junctions, some nerves in limbs, skull, and low back.
Conditions: Osteoarthritis, partial tendon tears, rotator cuff problems, ligament laxity, Ehlers-Danlos and other hypermobility syndromes, some types of chronic low back pain, and sacroiliitis, trigger points (knots), tennis elbow, golfer’s elbow, certain types of headaches including tension and occipital neuralgia.
Exclusions: These must be managed/controlled before embarking on treatment: diabetes, autoimmune conditions, rheumatism, severe/traumatic injuries, poor wound healing from any other condition, thrombocytopenia (low platelets), leukemia, or other active cancers. Joint replacements cannot be injected directly, but areas around them can. Severe osteoarthritis may not respond to prolotherapy at all. The doctor will determine your eligibility individually during evaluation.
Alterations: Important factors that can alter but won't eliminate treatment: allergies to anesthetics, allergies to iodine or chlorhexidine, allergies to dexamethasone (minuscule amount, only in a single diagnostic injection).
The doctor will diagnose the problem first or confirm diagnoses from other providers with their included documentation/imaging.
Imaging will be ordered and reviewed as needed, usually an ultrasound exam in the office and/or x-rays. Sometimes MRI is necessary.
The Prolotherapy treatment path looks a bit like this, but your individual plan may differ. Underlined words indicate insurance billing as appropriate:
Appt 1 (40 min): Initial evaluation with Dr. O’Connell to diagnose clinically using history, physical exam, and any imaging. Basic dietary, movement, and supplement plans will be given to aid in healing systemically.
Appt 2 (30 min): Diagnostic injection of anesthetic to verify pain generator, often done with ultrasound guidance. You will keep a pain diary during this time to support diagnostic value.
Appt 3 (20 min): Follow up in 1-2 weeks to confirm treatment target. Plan Dextrose Prolotherapy injection series. It can be virtual or in person.
Appt 4 (30 min): 1st Dextrose Prolotherapy treatment. Begin physical therapy for 6 weeks. Recommend working with Dr. Max on mobilization, home exercises, and Graston/Guasha to stimulate tissue rebuilding.
Appt 5 (20 min): Follow up with Dr. O'Connell at 2 weeks after the first Dextrose Prolotherapy treatment. It can be virtual or in person.
Appt 6 through last injection appt (30 min): Remaining Dextrose Prolotherapy injections, spaced 4 to 6 weeks apart from each other. Anywhere from 3 to 8 injections are needed depending on severity.
Program follow-up (30 min): Scheduled 6 months after first Dextrose Prolotherapy injection. Go over any future maintenance plans and check in to make sure the program was satisfactory and troubleshoot as needed. It can be virtual or in person.
The evaluation, diagnostic injection, and follow-ups are all billable to most insurances, based on the provider’s credentialing. These may also be cash-pay as needed by un/underinsured patients. Ultrasound evaluation is a separate significant e/m code and thus a distinct cash charge. Pricing for work done with other providers is based on their credentialing/rates. PA is suggested for diagnostic injection codes.
The prolotherapy treatment series itself is always cash.
Single area injection: $200.00
Add-ons we may want to incorporate:
SP: Ligaplex I: $90.00 - 90 count.
sig: 2 caps 3x/day through program duration to support healing/strengthening
Mt. Peak: MSK Injury Formula: $51.12
x2 bottles of #90
sig: 2 caps 1-2 times per day through program duration
Verdant Leaf CBD topical: $40.00
sig: massage into joints/muscles daily (unbroken skin only), not to be used less than 48 hours after injections
Please call the office and make your appointment to see if you're a good candidate for Dextrose Prolotherapy with Dr. O'Connell.