Prolozone vs. PRP: How Dr. Hanson Decides Where to Start

• By Jeff Hanson, ND
• Regenerative Medicine & Injection Therapy Specialist, Embody Wellness
• Folsom, California

When patients come to see me for knee pain, shoulder pain, arthritis or an injury that hasn’t healed the way they hoped, one of the most common questions I hear is:

“Do I need PRP, or should I start with Prolozone?”

The answer isn’t the same for everyone.

After more than 15 years working with regenerative injection therapies and performing more than 15,000 patient treatments, one principle has become especially important in my practice: I don’t believe every patient should automatically start with the most aggressive — or most expensive — treatment.

At Embody Wellness, I prefer an individualized, stepwise approach. We look at what is actually going on, how painful or inflamed the area is, what you’ve already tried, the severity and duration of the problem, and how your body responds before deciding what comes next.

PRP is intended to stimulate a healing response, and it can sometimes temporarily increase soreness or irritation. When an area is already highly inflamed, I may prefer to first use Prolozone, which includes medical ozone, and then reassess how the patient responds before considering PRP.

The important point is that neither treatment is automatically “better.” The goal is to determine which treatment makes the most sense for the patient and the condition at that particular point in time.

When appropriate, Prolozone can be a useful starting point — particularly when the joint or treatment area is very painful, swollen or irritated. One reason is that ozone can be useful as part of a strategy aimed at calming an irritated area before considering a treatment such as PRP.

PRP works by stimulating a healing response. In an area that is already highly irritated or inflamed, that response can sometimes temporarily increase soreness or aggravate symptoms. For those patients, I may prefer to first use Prolozone and see whether we can reduce irritation and improve the environment in and around the joint before considering PRP.

This is also one reason I don’t automatically recommend PRP simply because it is a more involved treatment. Some patients respond very well to Prolozone alone and never need to move on to PRP. For others, Prolozone becomes the first step; once the area is less painful and irritated, we can reassess and determine whether adding PRP makes sense.

But this isn’t a rigid protocol. Every patient and every injury is different.

PRP may become appropriate when the nature or severity of the problem suggests we need a different regenerative stimulus, or when a patient hasn’t improved as much as we’d like with a more conservative approach.

PRP — platelet-rich plasma — is prepared from the patient’s own blood. The platelets are concentrated and injected into the targeted treatment area, where they provide growth factors and signaling molecules involved in the body’s healing response. At Embody Wellness, PRP may also be combined with ozone as part of an individualized treatment plan.

But the decision isn’t based simply on a diagnosis. Two people can both walk into my office with “knee arthritis” and leave with different recommendations.

There are several things I consider:

• How painful, swollen or inflamed the area is right now
• The type of injury or condition
• How long the problem has been present
• The severity of the problem and available imaging
• Treatments the patient has already tried
• How the patient responds to an initial treatment
• The patient’s activity level and goals

A competitive athlete trying to return to a sport may have different priorities than someone whose primary goal is comfortably walking the golf course or playing with their grandchildren. That’s why regenerative medicine should be personalized.

Patients sometimes think of these treatments as a simple hierarchy: Prolozone is basic, PRP is stronger, and more expensive must mean better. I don’t think that is the best way to look at it.

They are different tools. The goal isn’t to choose the treatment with the highest price tag — it’s to determine which tool is appropriate for the problem we are trying to address.

Some patients may start with Prolozone and get the improvement we’re looking for. Others may be better candidates for PRP earlier in their treatment plan. And occasionally the right answer is that regenerative injection therapy isn’t the best option at all.

There are additional regenerative options beyond Prolozone and PRP that may be considered for certain patients with more significant or persistent joint problems. But the same philosophy applies: I don’t believe in escalating treatment simply for the sake of escalating treatment.

We evaluate how the patient is doing and make the next decision based on the individual response, condition and goals.

For patients who want a broader explanation of the options available at Embody Wellness, I’ve also written The Embody Wellness Guide to Regenerative Medicine, which explains our overall approach in greater detail.

Read the Embody Wellness Guide to Regenerative Medicine →

Many patients come to Embody Wellness because they want to explore non-surgical options before deciding on surgery.

Regenerative injection therapy can be an option worth discussing for certain joint, tendon, ligament and musculoskeletal problems. However, it isn’t appropriate for every condition, and no responsible provider should promise that an injection will eliminate the need for surgery.

The first step is understanding what is actually causing the problem and whether regenerative treatment is appropriate for that individual patient.

I’ve spent more than 15 years working with regenerative injection therapies, including years working alongside Dr. Frank Shallenberger and years teaching Prolozone, ozone and injection techniques to other healthcare providers.

After more than 15,000 patient treatments, I’ve learned that regenerative medicine works best when we treat the patient rather than simply treating the MRI or the diagnosis.

The question I want to answer isn’t “What’s the most advanced treatment I can give this patient?” It’s “What’s the most appropriate place for this patient to start?”

Sometimes that’s Prolozone. Sometimes it’s PRP. Sometimes it’s another treatment. And occasionally the right answer is that regenerative medicine isn’t the best option at all. That’s why every treatment plan at Embody Wellness begins with an individualized evaluation.

Dr. Jeff Hanson is a California-licensed Naturopathic Doctor with more than 15 years of regenerative injection experience and more than 15,000 patient treatments. He has worked extensively with Dr. Frank Shallenberger at The Nevada Center and has taught Prolozone, ozone and regenerative injection techniques to healthcare providers through the American Academy of Ozonotherapy’s annual training.

Dr. Hanson has practiced at Embody Wellness since 2016 and is the author of The Embody Wellness Guide to Regenerative Medicine.

Meet Dr. Jeff Hanson  |  Read the Regenerative Medicine Guide

Individual results vary. Regenerative injection therapies are not appropriate for every patient or condition. This article is for educational purposes and is not a substitute for an individualized medical evaluation.