Aftercare Instructions
After Your Prolotherapy Procedure
A clear, step-by-step guide for the days and weeks following your prolotherapy treatment at The Fascia Institute and Treatment Center®.
Most Important Rule
Do not apply ice for the first 7 to 10 days.
Ice blocks the inflammatory cascade that drives healing after prolotherapy. Suppressing that response works directly against the procedure. After day 10, ice becomes safe and useful again.
Understanding the Soreness
You will get sore. That is the treatment working.
Prolotherapy does not heal tissue by adding new material. It heals by triggering your body to do something it has been failing to do on its own — break down old scar tissue and fascial adhesions, clear the debris, and lay down healthy, organized collagen in its place.
The dextrose solution we inject creates a controlled, localized inflammatory response. Within hours, your immune system arrives at the treated tissue. Macrophages and neutrophils begin clearing out the disorganized, fibrotic scar tissue and fascial adhesions that have been driving your pain. Fibroblasts move in behind them and start building new collagen along functional lines of force.
The soreness you feel is that cleanup crew at work. It is the same biological process your body uses to heal an acute injury — except this time we have aimed it at tissue that had given up trying to repair itself. Soreness is not a side effect. It is the procedure.
This is why we ask you to avoid NSAIDs, steroids, and ice. Each one suppresses the exact biological response we just paid biology to start.
Section 1
Medications to Avoid
Do Not Use — NSAIDs
Avoid all prescription and over-the-counter anti-inflammatory medications while undergoing prolotherapy and for 12 weeks following your treatment. These medications suppress the healing cascade we are working to create.
This includes: Aspirin (adult dose), Motrin, Advil, ibuprofen, Aleve, Naprosyn, naproxen, Voltaren, diclofenac, meloxicam, Mobic, and Celebrex.
Do Not Use — Steroids
Discontinue prednisone, cortisone, and any other oral corticosteroid medications for at least 4 weeks following your treatment. If you take steroids for another medical condition, please discuss with our clinic before stopping.
Generally Safe to Continue
Baby aspirin 81 mg may be continued. If another physician prescribes a new medication, or if you are uncertain whether a medication is safe during your treatment course, send us a portal message before taking it.
Check with your prescribing physician before discontinuing any medication you take for another health condition.
Section 2
Wound Care & Ice
First 12–24 Hours
Keep each injection site clean, dry, and covered with a Band-Aid. You may shower at any time.
Days 1–10
No ice. No NSAIDs. Let the body’s healing response do its work without suppression.
After Day 10
Ice is now permitted. You may apply it to the injection site for 20 minutes every 2 to 3 hours as needed for comfort.
Swelling & Bruising
Localized swelling and bruising at the injection sites can last up to two weeks. This is expected and resolves on its own.
Section 3
What to Expect — A Typical Recovery Timeline
Day 0 — The Day of Your Procedure
You may feel some immediate soreness or fullness at the treated sites. This is the dextrose drawing fluid into the tissue and the first wave of immune cells arriving.
Days 1–4 — Peak Inflammatory Response
This is when most patients feel the most sore. Your immune system is breaking down scar tissue and fascial adhesions and clearing the debris. Stiffness, aching, and a “deep bruise” sensation are normal. Tylenol is allowed; ice and NSAIDs are not.
Days 5–14 — Proliferation Begins
Soreness should be steadily improving. Fibroblasts have arrived and are starting to lay down new collagen. Many patients begin to notice the original pain feels different — sometimes better, sometimes shifted.
Weeks 2–6 — Remodeling
New collagen is being laid down and re-organized along functional lines of force. This is the window where physical therapy, movement, and load do their most important work.
Weeks 6–12 — Maturation
The new tissue continues to mature and gain tensile strength. We will reassess at your follow-up and decide whether additional sessions are warranted.
If your soreness is still not improving after one week — or if it is getting worse instead of better — send us a portal message with an update and we will guide next steps.
The Science Behind the Soreness
Published research on the prolotherapy healing response.
The aftercare instructions on this page are not arbitrary. They follow directly from how prolotherapy works at the tissue level — well documented in the peer-reviewed literature. A few of the references that have shaped our protocol:
Reference 1
Hauser RA, Lackner JB, Steilen-Matias D, Harris DK.
A Systematic Review of Dextrose Prolotherapy for Chronic Musculoskeletal Pain.
Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders. 2016;9:139–159. Reviews the inflammatory healing cascade dextrose initiates and the evidence across tendon, ligament, and joint indications.
Reference 2
Hauser RA, Dolan EE, Phillips HJ, Newlin AC, Moore RE, Woldin BA.
Ligament Injury and Healing: An Overview of Current Clinical Concepts.
Journal of Prolotherapy. 2013;5:e967–e1006. Explains why ligaments and dense fascial tissue heal slowly on their own — and why a controlled re-inflammation is often the only way to restart the process.
Reference 3
Hauser RA, Steilen D, Sprague IS.
Chronic Neck Pain: Making the Connection Between Capsular Ligament Laxity and Cervical Instability.
The Open Orthopaedics Journal. 2014;8:326–345. Describes how prolotherapy addresses ligamentous laxity by re-triggering organized collagen deposition.
Reference 4
Reeves KD, Sit RWS, Rabago DP.
Dextrose Prolotherapy: A Narrative Review of Basic Science, Clinical Research, and Best Treatment Recommendations.
Physical Medicine and Rehabilitation Clinics of North America. 2016;27(4):783–823. Foundational review covering mechanism, dosing, and post-procedure best practices including the rationale for NSAID avoidance.
Reference 5
Hypertonic Dextrose Prolotherapy in Osteoarthritis: Mechanisms, Efficacy, and Future Research Directions.
Frontiers in Endocrinology. 2025. Recent mechanistic review of how dextrose drives fibroblast proliferation, growth factor release, and extracellular matrix remodeling.
Reference 6
The Effect of NSAID Use on Dextrose Prolotherapy in Patients With Knee Osteoarthritis: A Prospective Case Series.
Published in PMC, 2024. Clinical evidence that NSAID use during prolotherapy treatment courses blunts the inflammatory healing cascade and reduces clinical outcomes.
Section 4
Managing Discomfort
Acetaminophen (Tylenol) — Permitted
If you are sore within a few hours of the injection, you may take Tylenol 1000 mg every 8 hours as needed, unless we have given you different instructions.
Tylenol does not interfere with the inflammatory healing response and is the preferred over-the-counter option during your prolotherapy treatment window.
Section 5
When to Contact Us
Send a Portal Message If You Notice
— Drainage from the injection site
— Bleeding that does not stop with light pressure
— Fever after the procedure
— Pain that is worsening rather than improving after one week
If You Feel Severely Unwell
Do not hesitate to go to urgent care or the emergency room. Reach out to us afterward so we can coordinate follow-up care.
Section 6
Physical Therapy & Bodywork
We strongly recommend beginning physical therapy as soon as possible following your prolotherapy procedure. The remodeling window — roughly weeks 2 through 6 — is when movement helps lay down new tissue along functional lines of force.
Preferred Modalities
Light massage, gentle stretching of the treated area, and myofascial release all work well alongside prolotherapy.
Please Avoid
Do not dry needle a treated area during your prolotherapy treatment course. Dry needling can interfere with the controlled healing response we are building.
Section 7
Activity & Exercise
Avoid repetitive exercise and heavy lifting of the treated area until your provider clears you. The newly stimulated tissue is laying down its scaffold, and overloading it too early risks re-injuring the very region we are trying to repair. We will guide return to activity at each follow-up.
A Note on the Journey
Your body can take many months to heal. Your injury is complex.
Commit to the process. Each session builds on the one before. The goal is not a single moment of relief — it is durable structural change that holds.
— The Fascia Institute and Treatment Center®
Questions Between Visits
Send us a message through the patient portal and our clinical team will reply during business hours. For urgent concerns outside of business hours, please call our office or seek in-person care.