Changepain

Prolotherapy
What is Prolotherapy?

Prolotherapy is a treatment for ligament or tendon injuries. This treatment causes thickening and strengthening of weak ligaments and tendons. Prolotherapy is useful for many types of musculoskeletal pain. It may help heal joints, ligaments, tendons or other connective tissues when other more conventional therapies haven’t worked.

Ligaments hold bones together. Ligaments can become weak or injured from wear and tear or accidents. Healing of injured ligaments is slow and not always complete and after an injury, and ligaments may not heal to their original strength. Ligaments have many nerve endings. A person may feel pain in areas where ligaments are damaged or loose. Tendons are similar to ligaments, but they connect muscles to bones. Tendons may also become injured and cause pain.

When ligaments and tendons become damaged or over-stretched, bones no longer fit well together. This makes the muscles work harder and causes spasms and pain.

How will I know if it will help?

A changepain physician needs to assess you first and will recommend this treatment if he or she thinks it may help you.

How much does it cost?

Prolotherapy is not covered by MSP. Prolotherapy fees depend on the area to be treated, extent of injury involved, and number of sessions required. Please ask your physician for an estimate of the total cost of treatment for your condition.

Service
Duration
Cost

Note: Most people need an assessment plus 4-8 treatments per area. 

Some extended health plans and other insurers may cover some or part of the cost of treatment. Please check with your insurer to find out if you are covered. 

PROLOTHERAPY FAQs

Prolotherapy involves multiple injections to create a controlled and localized inflammatory response, which mimics the normal healing from an injury and causes new tissue growth.

At changepain, our goal for prolotherapy is to restore healthy biomechanics of the body, provide pain relief and improve overall function. With pain relief given from prolotherapy, you may be able to benefit more from other therapies, such as physical therapy, even if these have failed in the past.

Prolotherapy is recommended to be combined with:

  • Treatment of myofascial pain, such as Intramuscular Stimulation (IMS) or Trigger Point Injections (TPI)
  • Physical therapy and movement
  • Lifestyle changes such as increased activity, a healthy diet and good sleep

With prolotherapy, a solution containing a local anaesthetic, glycerine, phenol, and dextrose (sugar) is injected into joints, ligaments or tendons to stimulate tissue repair. You will have several injections during one treatment session. During the first session, your physician will focus the treatment on one agreed area to test response and tolerance.

Most patients require 4-8 treatments, and treatments are usually administered every 2-6 weeks. The number of sessions required depends on your goal, the injury, the area, and how your tissues heal.

The ligaments and tendons may take several months to heal. For those who respond, usually patients notice benefit a few weeks after the 3rd or 4th treatment.

Like many medications, some patients will have side effects and others won’t. Your doctor will discuss these risks with you.

Common side effects:

  • Stiffness, soreness and swelling that lasts on average 2-3 days occasionally up to 10 days (patients who get very stiff and sore usually require less treatment sessions)

Rare side effects:

  • Bleeding, bruising or swelling
  • Muscle weakness or numbness

Extremely rare side effects:

  • Fever. You might experience fever symptoms in the first day after the procedure.
  • Infection. Severe pain with fever lasting more than 24 hours might be due to infection and it may be treated with antibiotics.
  • Allergic reaction

Possible Risks

Overall, this procedure is most unlikely to worsen a chronic pain condition on the long term, unless a complication is encountered. These include: bleeding, infection, and allergic reaction to the injectate.

Other possible complications depend on the actual areas treated. Your doctor will discuss these with you

The results are different for each person. If prolotherapy addresses the underlying problem, the pain may be completely resolved.

There is the potential for no improvement in pain levels. For some people, prolotherapy will have little or no effect on pain levels.

How to Prepare

You should stop taking anti-inflammatories 2 weeks before the treatment as they interfere with its effectiveness. Examples include: Aspirin, Advil, Naproxen, Ibuprofen, Diclofenac, Aleve etc.

Anti-anxiety and/or pain medication may be used before the procedure only if needed.

Aftercare

After prolotherapy you can continue all normal activities but be careful not to overdo it. Physical therapy is recommended as soon as possible and can increase the benefit of prolotherapy. A healthy, protein rich diet, and Vitamin C (500mg daily) may also improve your results.

For more pain relief after treatment, you can consider:

  • Heat or ice as needed, heat preferred
  • Gentle mobility
  • Pain medication, such as Tramadol (Ultram) 50mg 1-2 tablets every 4-6 hours as needed.

Please contact our changepain Private Pay Services Coordinator: privateservices@changepain.ca or 604-566-9101 ext 105.

Cancellation and Refund Policy

We require 48 hours notice to cancel or reschedule your appointment. If less than 48 hours notice is provided, we will charge the full fee.

We do not give refunds. This includes if the procedure must be stopped for safety reasons or if there is no benefit from the procedure.

Please contact our Private Pay Services Coordinator

Call 604-566-9101, ext. 105 or
Email privateservices@changepain.ca

GALLERY

Cost of Initial Assessments - Non-MSP Medical


Private Medical Consultation (PMC) Multidisciplinary Private Assessment (MDPA)
Description Expedited, focused assessment to determine fit for non-MSP covered services requested:
IV Lidocaine Infusion, Ketamine Therapies, Prolotherapy, BOTOX, Platelet Rich Plasma (PRP).
Comprehensive functional and medical assessment with a multidisciplinary report addressing the biopsychosocial issues identified.
Care Team Pain Specialist Pain Specialist
Functional Movement Specialist
Duration 30 minutes 2 hours
Cost $450.00 $3,500.00

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Cost of Initial Assessments - Allied Health


Assessment Duration Cost
Chiropractic Initial 60 minutes $165.00
Physiotherapy Initial 60 minutes $160.00
Kinesiology Initial 45 minutes $90.00 (+ tax)
Counselling Initial 90 minutes $250.00
Acupuncture Initial 45 minutes $140.00
Ketamine Counselling Initial for Ketamine Assisted Psychotherapy 60 minutes $250.00

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Tatiana Santini

Counsellor
Tatiana Santini, is a Psychotherapist, Clinical Counselor, Trauma Therapist, and a Ketamine Assisted Psychotherapist. She holds a Bachelor degree in Health Science, and Master’s degree in Adlerian Psychotherapy and Counseling. In addition, Tatiana has a Postgraduate Certificates in Psychedelic Assisted Therapies and Research, MDMA Assisted Therapy, Ketamine Assisted Psychotherapy, and she is a Somatic Experiencing Practitioner.Tatiana has been working extensively with Ketamine Assisted Psychotherapy as well as other psychedelic assisted therapies in clinical and research context, and as a trainer and an educator. Tatiana has been a faculty at City University in teaching clinical supervision capacity. Tatiana has been working in the public and private sector with patients struggling with trauma, substance and alcohol use disorders, PTSD, veterans, and first responders. She is an experienced clinician who has been working as a group therapist and on individual basis using various therapeutic modalities, from Somatic Experiencing, EMDR, Mindfulness Based cognitive therapies, to short term psychodynamic psychotherapy.Tatiana is passionate about assisting her clients on their healing journey, facilitating exploration of non-ordinary states of consciousness, and mind-body relationship. Tatiana’s compassionate and non-judgmental approach allows individuals to explore unconscious aspect of their psyche, thoughts, feelings, and urges that are outside their awareness, while allowing clients to gain insights into how those are related to their life, current physical and mental health, as well as their interpersonal relationships.

Prior to psychotherapy, Tatiana worked as a respiratory and anesthesia therapist, for almost two decades in various intensive care and trauma units, ER’s as well as operating rooms. Tatiana is a Registered Clinical Counsellor, member in good standing with British Columbia Association of Clinical Counselors, Registered Psychotherapist in Ontario, and a Registered Respiratory Therapist with Canadian Society of Respiratory Therapists.

In her spare time, Tatiana enjoys forest bathing, classical music, hiking, and yoga

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Amy Kiara Ruth

BSc (Kin, Ed)

practicing kinesiologist, certified Pilates method instructor, associate somatic movement professional

Amy brings a grounded presence and a spirit of collaborative inquiry to her sessions. Her philosophy is that movement is an integral part of life and she works to support the emergent expression of health inherent in each individual.

A life-long interest in movement led Amy to become a kinesiologist and somatic movement practitioner. Her movement experience began as a child, studying dance. As a young adult, she was introduced to the Pilates method by Dianne Miller and completed her Pilates method certification training in 1997.  She has a Bachelor of Science in Kinesiology, minor in Education, from Simon Fraser University. In 2008 she completed Foundation and Advanced level training in Self-Regulation Therapy, a gentle, somatic, trauma-resolution modality.

Amy maintains a commitment to continuing education and has extensive experience as a student of Tai chi / Qigong, as well as Continuum / Continuum Montage and other mind-body movement approaches. In her personal life, Amy explores what it means to be an embodied being and how to be in relationship to seasonal rhythms & tides while living & working in an urban setting.

Amy is delighted to be working in an interdisciplinary setting at changepain.

She offers individual kinesiology sessions, as well as group GMV sessions, to support participants in developing increased ease and embodiment in movement and presence.  These sessions may include use of specific movement forms, mindfulness awareness practices, breathwork, assisted stretching & hands-on alignment guidance, trauma resolution, movement explorations, and sensory & perceptual awareness work.

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Maria Liaskas

Kinesiologist

Maria Liaskas, a UBC trained Masters level Kinesiologist and National level athlete joins the changepain team with a broad and deep range of training expertise.

She has seven years of experience competing at the Canadian national level in rhythmic gymnastics and five years of competing at the provincial and national level in volleyball. These feats are a testament to her passion for movement.

After sustaining multiple injuries and visiting a range of sports medicine doctors and physiotherapists, she became increasingly intrigued by the assessment of human movement, pain, and best practices for implementing a plan for recovery. This interest is what motivated her to pursue and complete her undergraduate and subsequent Masters level degree in Kinesiology at UBC.

As part of her training, she was selected to work at the Massachusetts General Hospital where she was part of the Harvard Medical School research team. Here she witnessed and contributed to work in understanding, treating, and preventing brain metastases, specifically in breast cancer patients. She also contributed to research under the UBC BE-FIT: Breast Cancer & Endocrine Therapy FITness program.

Maria joins the changepain team after most recently working in private kinesiology practice supporting the public as well as continuing to help those with chronic disease reach their functional goals.

Maria brings to her practice a patient centred approach to managing chronic disease. She strives to maintain a professional yet compassionate and understanding relationship with each client she interacts with. She believes this is the first step towards building a trusting client-practitioner relationship and sets the foundation for effective work.

Maria is a Vancouver local who is passionate about movement during and after work. She is a long-time member of the volleyball community. When not helping her clients, you will most likely find her buried in sand at the beach volleyball courts.

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Laura Montgomery

Counsellor

Laura Montgomery, is a Masters Level Clinical Counsellor, and Registered Social Worker, who brings a passionate belief in each person’s innate wisdom to heal, navigate, and grow from their life experiences. She brings her humanity and lived experience with her own pain journey, as well as her extensive post-graduate training, counselling skills and experience to her work with her clients.

Laura received her Masters of Social Work from the University of British Columbia in 2008; there she completed original research through the British Columbia Cancer Agency on the factors that contribute to post-traumatic growth after a cancer diagnosis. She has trained in trauma-informed somatic therapy with the Sensorimotor Psychotherapy Institute, attachment-based parenting with the Neufeld Institute and is currently in supervision to complete her certification in Accelerated Experiential Dynamic Psychotherapy (AEDP). Laura also currently enjoys helping other clinical counsellors learn new skills through being an assistant with the AEDP Institute. Prior to becoming a clinical counsellor Laura worked as a social worker at Providence Healthcare. She also spent years as a stay and home mother, her most rewarding and challenging position!

In sessions with Laura you can expect warmth, collaboration and understanding; as well as the challenge to together move through stuck places towards resilience and inner resources. Sessions may include slowing down with emotions or sensations as well as discovering tools and knowledge that you can take with you into your life.

Laura enjoys spending time with her family, the ocean, writing, movement, meditation and hanging out with her cat.

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Dr. Lindsay Rite

BSc(Kin), CSEP-CEP

Director of Integrative Services | Chiropractor, Kinesiologist, Exercise Physiologist | Clinical Facilitator Surgical Patient Optimization Program

Lindsay Rite is the Director of Integrative Health at Changepain Medical & Allied Health Clinic (CPC). She acts to oversee the clinic’s Allied Health and Rehabilitation Team, Pain Programs, and Pain Neuroscience Education Services. Simultaneously she maintains a Chiropractic practice and assists with Physician-led Shared Care pain consultations. She has advanced training in movement and exercise therapy and is a Registered Kinesiologist and CSEP Clinical Exercise Physiologist.

Dr. Rite takes an empowering approach to care for her patients. Personalized education and active therapy prescription is a significant part of her practice. She is trained in multiple manual techniques and utilizes a diversity of hands on and instrumented assisted therapies to aid in alleviating pain and suffering in her patients. She is experienced in assessing and treating complex pain with much of her practice focused on those with widespread pain, chronic fatigue syndrome, CRPS, central sensitivity syndromes, or other persistent pain conditions and related comorbidities.

Dr. Rite’s research and professional initiatives extend beyond her work at CPC. She played an integral role in the development of the pain management joint program between the BCCA and Pain BC. Similarly, with Pain BC, she has participated in various collaboratives including the BC ECHO for Chronic Pain, Resource Data Base Initiative, Psychosocial Community of Practice, and was a Reviewer for the Pain Foundations Course. She co-lead the first Military Veterans Alpine Challenge, and continues to contribute to the Chronic Pain Centre of Excellence for Canadian Veterans (CPCoE) collaborative. Additionally, she has also contributed to various research publications at Changepain Medical & Allied Health Clinic.

She has previously acted as a Best Practice Collaborator with the CCGI, she was the Vice Chair for the Patients Relation Committee of the CCBC, an Examiner with the CCEB, and an active member of the BC Chiropractic Practice-Based Research Network.

In addition to her work in chronic pain, she is experienced in sport management. She has been part of the Integrated Sports Team for various teams including Athletics at the Pan American Games, Rugby Sevens Fijian championship team, and Canada West Wrestling athletes.

Dr. Rite not only supports her patients in developing an active and wholehearted lifestyle but enjoys living it herself. In her free time, you can find her in the local mountains enjoying our BC trails and nature.

Certifications:
  • Chiropractor
  • Registered Kinesiologist
  • CSEP Certified Exercise Physiologist
  • CSEP Certified Personal Trainer
  • Sports First Responder
  • S-FMA Selective Functional Movement Assessment Level 1
  • Active Release Techniques® (Lower and Upper Extremity) Provider
  • Functional Anatomical Palpation® Provider (Upper and Lower Limb & Spine)
  • Kinesio Taping Certified Provider
  • M1 Graston Techniques® Provider

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Conor O'Flaherty

Kinesiologist

Conor is a Kinesiologist in his 3rd year at changepain. He has experience working with a variety of individuals through a range of chronic pain conditions and movement limitations.

Conor believes in a pragmatic approach to promoting movement and a healthy lifestyle. Focusing on the individual and their history, he believes that integrating education and understanding into the patient’s daily life so that they can continue to enjoy what drives them. Guiding people on a journey of self-discovery, Conor empowers his clients to take control of their pain experience.

Conor is Irish and moved to Canada in 2016 and completed his BKin at UBC. Conor completed his Master’s in Kinesiology in May 2023, while working at changepain. Throughout his bachelor’s he coached in the UBC Smith and Laycoe Weightroom coaching athletes from basketball, swimming, rugby, soccer, and football. He maintains his Certified Strength and Conditioning Specialist certification and continues to coach rugby and work with athletes.

Growing up in Brussels, Belgium, Conor has played sports his whole life. He has played a variety of field sports, before focusing on rugby union. He played 6 years on the UBC Thunderbirds, winning two Rounsefell Cups, two University National Championships, and was named to the Canadian University First XV in 2022.

When he’s not assisting people to manage their pain, Conor is eating around Vancouver and spending time with his cat.

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Ashleigh Low

MSc. (PT), HBSc.

Physiotherapist

Ashleigh has received her Bachelor of Science degree from MacMaster University in Hamilton, Ontario, and completed her Masters in Science of Physical Therapy from Queen Margaret University in Edinburgh, Scotland.

She provides an individualized and patient-centred approach to acute and chronic injuries. Her goal-oriented mindset was crafted over her years as a competitive slopestyle skier with the first-hand experience of injury. With her unique skills as a high-level athlete,

Ashleigh focuses on both the mental and physical rehabilitation of her patients. Ashleigh also practices preventative care and can apply her high level of knowledge to specific treatment plans aimed at creating a pain-free and holistic approach to her patient care.

Professional Memberships:

College of Physical Therapists of British Columbia.
Canadian Physiotherapy Association.

Credentials:

Active Release Technique- Full Body Certified.
Shift Concussion Management.
MPS (Micropoint Stimulation).
IMS (Intramuscular Stimulation)

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Leroy Ho

MScPT, BScKin 

Physiotherapist

Leroy believes the key to rehabilitation and performance is to first understand the individual -Your goals are his goals. With years of experience empowering people in chronic pain, Leroy uses his diverse skillset of both physical and psychological approaches to show that exercise can be done safely and enjoyably for everyone. He has played competitive hockey with Oxford University and enjoys applying his experience to personal training, athletic rehab and geriatric longevity. Leroy also has a special interest in treating hip and knee osteoarthritis and is also certified by GLA:D Canada. He is passionate about enabling people to live to their healthiest potential no mater what stage of life you’re in.

Leroy has worked in multiple hospital settings with a variety of populations including those with musculoskeletal, neurological and cardiovascular diseases including patients in the Covid ICU. He also has volunteered at many health-related organizations around the Lower Mainland which include the SFU Sports Medicine Clinic, Kids Physio Group, Canucks Autism Network and BC Children's Hospital. During his free time, Leroy is often spotted having a laugh at a local brewery, planning for his next vacation or attempting to revive his career at the ice rink.

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Noli Catapang

Registered Acupuncturist (R.Ac)

Noli received an HBSc. from the University of Guelph, Ontario, and a Diploma for Doctor of Traditional Chinese Medicine from the International College of Traditional Chinese Medicine of Vancouver, BC.  He has been a Registered Acupuncturist since 2006.

He employs the tenets of Chinese Medicine to diagnose and design treatment plans that are holistic and individually tailored.  With any lifestyle medicine, the path must always address, not only the client’s chief concern, but the factors and psycho-emotional landscape that affect it.

Furthermore, Noli recognizes that wellness is most readily achieved by working in partnership with his clients.  These partnerships are built on compassion, education, understanding and choice.  The goal is helping the client to re-establishing balance thereby minimizing the need for treatment.

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