Very small (20 gauge) spinal needles are used in this procedure. After the skin is cleaned (to avoid infection), the physician may inject a local anesthetic under the skin in the area to be treated. You will feel the pinprick of the needle that delivers the numbing agent. But after that, you won’t feel the actual prolotherapy injections.
Your doctor may inject specific sites such as the spinal ligaments and the spinal (facet) joints. Or he or she may palpate for tender points and just inject those areas. With the palpation technique, a numbing agent isn’t used. The patient may find that pushing on the tender points is uncomfortable.
The physician may be able to decrease the number of needle pokes by targeting several ligaments from one needle insertion point. After placing the needle under the skin, it is gently pulled out slightly and redirected to another area without removing and reinserting it.
A very small number of doctors perform prolotherapy with the patients fully sedated (asleep). Patients who are extrememly anxious may want to request this approach, but it does require treatment at a surgical center.