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    <lastmod>2021-09-17</lastmod>
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      <image:title>Biography - dr. Aryn Bartoshyk</image:title>
      <image:caption>Naturopathic Physician Focus: Optimizing performance through hormone balance and integrative pain management. I am fortunate to work with an integrated team at Rise Health in Victoria, BC. I hold a general practice with a focus in optimizing performance through hormone balance and integrative pain management. Outside the clinic I have a passion for fitness and especially enjoy Crossfit, yoga, and hiking. My approach is based on the principles of naturopathic medicine: ● First do no harm ● Identify the cause of illness or disease ● Treat the whole person (mind, body, spirit) ● Educate and empower ● Utilize the healing power of nature ● Teach to healthy living &amp; preventive medicine It is my goal to empower people to be happier, healthier and stronger.</image:caption>
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    <lastmod>2022-09-10</lastmod>
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      <image:caption>Breathe</image:caption>
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      <image:caption>Hydration</image:caption>
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      <image:caption>Heals + transforms the brain.</image:caption>
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      <image:caption>In need of some “calm”?</image:caption>
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      <image:caption>Calcium for the bones.</image:caption>
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      <image:caption>The blood sugar balancer. COMING SOON!</image:caption>
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      <image:caption>(Fe)eling fatigued?</image:caption>
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      <image:caption>Zinc for skin, sex, sickness. COMING SOON!</image:caption>
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      <image:caption>Vegan Overnight Oats</image:caption>
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      <image:caption>Jumbo Chocolate Chunk Cookies</image:caption>
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      <image:caption>Chocolate Protein Shake</image:caption>
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      <image:caption>Kale Salad</image:caption>
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      <image:caption>Breakfast Muffins</image:caption>
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      <image:caption>BBQ’d Deer COMING SOON!</image:caption>
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      <image:caption>Adrenal Fatigue - Is It Real?</image:caption>
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      <image:caption>Testosterone 101</image:caption>
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      <image:caption>Your Period is Your Superpower COMING SOON!</image:caption>
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      <image:caption>Urinary Tract Infections</image:caption>
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      <image:caption>PCOS COMING SOON!</image:caption>
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      <image:caption>Prolotherapy</image:caption>
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      <image:caption>Neural Therapy COMING SOON!</image:caption>
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      <image:caption>Pre- &amp; Post-Injection Care</image:caption>
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      <image:caption>Platelet Rich Plasma (PRP)</image:caption>
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      <image:caption>Perineural Therapy COMING SOON!</image:caption>
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    <lastmod>2021-09-25</lastmod>
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      <image:loc>https://images.squarespace-cdn.com/content/v1/5bf19d322714e5493ab412ef/1632544023254-5S1C41WBJP3GU0TUU5O3/0O0A1603-2.jpg</image:loc>
      <image:title>Clinical Nutrition</image:title>
    </image:image>
  </url>
  <url>
    <loc>https://www.arynnd.com/contact</loc>
    <changefreq>daily</changefreq>
    <priority>0.75</priority>
    <lastmod>2019-03-26</lastmod>
  </url>
  <url>
    <loc>https://www.arynnd.com/self-care</loc>
    <changefreq>daily</changefreq>
    <priority>0.75</priority>
    <lastmod>2021-09-25</lastmod>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/5bf19d322714e5493ab412ef/1632543383409-HVQDVJECXVTUZPBQSI62/0O0A1569.jpg</image:loc>
      <image:title>Self-Care</image:title>
    </image:image>
  </url>
  <url>
    <loc>https://www.arynnd.com/sleep</loc>
    <changefreq>daily</changefreq>
    <priority>0.75</priority>
    <lastmod>2022-01-07</lastmod>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/5bf19d322714e5493ab412ef/1632543514806-01LN40X2RXNJO7SA7TUA/0O0A1628.jpg</image:loc>
      <image:title>Sleep</image:title>
    </image:image>
  </url>
  <url>
    <loc>https://www.arynnd.com/oxygen</loc>
    <changefreq>daily</changefreq>
    <priority>0.75</priority>
    <lastmod>2022-08-03</lastmod>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/5bf19d322714e5493ab412ef/1553464331062-JB2IC5B8QK123ZH0CQHW/IMG_7028.jpg</image:loc>
      <image:title>Oxygen</image:title>
    </image:image>
  </url>
  <url>
    <loc>https://www.arynnd.com/movement</loc>
    <changefreq>daily</changefreq>
    <priority>0.75</priority>
    <lastmod>2021-09-25</lastmod>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/5bf19d322714e5493ab412ef/1632542528703-36LVLSKOBF07UCS8QKSZ/DSC_3523.jpg</image:loc>
      <image:title>Movement</image:title>
    </image:image>
  </url>
  <url>
    <loc>https://www.arynnd.com/nutrition</loc>
    <changefreq>daily</changefreq>
    <priority>0.75</priority>
    <lastmod>2021-09-25</lastmod>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/5bf19d322714e5493ab412ef/1632543804116-WH51SIJPMDB0FZOFVZ26/0O0A1607.jpg</image:loc>
      <image:title>Nutrition</image:title>
    </image:image>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/5bf19d322714e5493ab412ef/1552968490307-HBH1U6YQG7EFBCDKMTA5/image-asset.jpeg</image:loc>
      <image:title>Nutrition - High Quality Protein</image:title>
      <image:caption>HIGH QUALITY PROTEINS Essential for GROWTH, HEALING, and SATIETY. Athletes require amino acids for muscle growth and repair while children and pregnant women require protein for adequate development Meat: Grass-fed beef, bison, lamb Poultry: Organic chicken, turkey, eggs, duck Fish: Salmon (wild), mackerel, sardines, herring Legumes: Chick peas, kidney beans, navy beans, pinto beans, lima beans, lentils</image:caption>
    </image:image>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/5bf19d322714e5493ab412ef/1552969289299-2ECXD92R6SIQZ4771UCS/image-asset.jpeg</image:loc>
      <image:title>Nutrition</image:title>
      <image:caption>HEALTHY FATS Required for LONG-TERM ENERGY, HEALTHY HORMONES and SATIETY Raw nuts &amp; seeds: Almonds, cashews, pistachios, macadamia, walnuts, pumpkin seeds, hemp seeds, chia seeds Oils: COLD TEMPERATURES (salad dressings): olive, walnut, flax, almond; MEDIUM TEMPERATURES (sautéing, frying, baking): coconut, sesame, olive, sunflower, sesame, grape-seed; HIGH TEMPERATURES (deep frying, searing, stir-frying): avocado, rice bran, safflower, peanuts Other: Grass-fed butter, avocado, fish (salmon)</image:caption>
    </image:image>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/5bf19d322714e5493ab412ef/1552969380206-2QY38V93AD8FS5B5P1B5/image-asset.jpeg</image:loc>
      <image:title>Nutrition</image:title>
      <image:caption>CARBOHYDRATES Provide IMMEDIATE ENERGY to support physical and mental activity (e.g., exercising, writing an exam, or giving a presentation) Vegetable: ROOT: yams, sweet potato; CRUCIFEROUS AND/OR GREEN LEAFIES: broccoli, brussel sprouts, kale, lettuce, asparagus, zucchini Fruits: BERRIES: blueberries, raspberries, blackberries, strawberries Gluten-free whole grains: Quinoa, wild or brown rice, steel cut oats or gluten-free rolled oats, buckwheat, millet</image:caption>
    </image:image>
  </url>
  <url>
    <loc>https://www.arynnd.com/hydration</loc>
    <changefreq>daily</changefreq>
    <priority>0.75</priority>
    <lastmod>2021-09-25</lastmod>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/5bf19d322714e5493ab412ef/1632543106389-ESEJACEAZA87FICXXZOU/unsplash-image-WRfgYQWezh8.jpg</image:loc>
      <image:title>Hydration</image:title>
    </image:image>
  </url>
  <url>
    <loc>https://www.arynnd.com/what-i-treat</loc>
    <changefreq>daily</changefreq>
    <priority>0.75</priority>
    <lastmod>2021-09-17</lastmod>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/5bf19d322714e5493ab412ef/1631890506675-D0QUGXW4HLM7JXFIXPIH/0O0A1662.jpg</image:loc>
      <image:title>What I Treat</image:title>
    </image:image>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/5bf19d322714e5493ab412ef/1631890594785-4JH0WF5ZMU7T2AS2AA1R/0O0A1515.jpg</image:loc>
      <image:title>What I Treat</image:title>
    </image:image>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/5bf19d322714e5493ab412ef/1631890665270-1R94IPB7UC3GH7UQ9TBR/0O0A1555.jpg</image:loc>
      <image:title>What I Treat</image:title>
    </image:image>
  </url>
  <url>
    <loc>https://www.arynnd.com/health-assessment</loc>
    <changefreq>daily</changefreq>
    <priority>0.75</priority>
    <lastmod>2021-09-25</lastmod>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/5bf19d322714e5493ab412ef/1553624430549-9LMALCAE0F2PLZ4UG2YH/DSC_3164.jpg</image:loc>
      <image:title>Health Assessment</image:title>
    </image:image>
  </url>
  <url>
    <loc>https://www.arynnd.com/low-dose-allergen-immunotherapy</loc>
    <changefreq>daily</changefreq>
    <priority>0.75</priority>
    <lastmod>2021-09-25</lastmod>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/5bf19d322714e5493ab412ef/1632578678685-43AYG1RDK2RDU0M56GKU/0O0A1436.jpg</image:loc>
      <image:title>Low Dose Allergen Immunotherapy - Make it stand out</image:title>
      <image:caption>Whatever it is, the way you tell your story online can make all the difference.</image:caption>
    </image:image>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/5bf19d322714e5493ab412ef/1632578708195-JISX2G64Q76WYSW3J8NQ/0O0A1442.jpg</image:loc>
      <image:title>Low Dose Allergen Immunotherapy - Make it stand out</image:title>
      <image:caption>Whatever it is, the way you tell your story online can make all the difference.</image:caption>
    </image:image>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/5bf19d322714e5493ab412ef/1632578734302-M5UDVWGUJG3EPD0QOC31/0O0A1448.jpg</image:loc>
      <image:title>Low Dose Allergen Immunotherapy - Make it stand out</image:title>
      <image:caption>Whatever it is, the way you tell your story online can make all the difference.</image:caption>
    </image:image>
  </url>
  <url>
    <loc>https://www.arynnd.com/prescriptive-authority</loc>
    <changefreq>daily</changefreq>
    <priority>0.75</priority>
    <lastmod>2021-09-25</lastmod>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/5bf19d322714e5493ab412ef/1632543240719-8TF9CFRBH5LC7DJDTO83/IMG_9746.JPG</image:loc>
      <image:title>Prescriptive Authority</image:title>
    </image:image>
  </url>
  <url>
    <loc>https://www.arynnd.com/lithium</loc>
    <changefreq>daily</changefreq>
    <priority>0.75</priority>
    <lastmod>2022-01-08</lastmod>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/5bf19d322714e5493ab412ef/1632530951099-1GGROOKK14L3L1KA4B37/gettyimages-1187825196-612x612.jpg</image:loc>
      <image:title>Lithium</image:title>
    </image:image>
  </url>
  <url>
    <loc>https://www.arynnd.com/magnesium</loc>
    <changefreq>daily</changefreq>
    <priority>0.75</priority>
    <lastmod>2022-01-08</lastmod>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/5bf19d322714e5493ab412ef/1632531747715-X4DUXXKY0FUYZTAN8GL3/unsplash-image-UhrHTmVBzzE.jpg</image:loc>
      <image:title>Magnesium</image:title>
    </image:image>
  </url>
  <url>
    <loc>https://www.arynnd.com/calcium</loc>
    <changefreq>daily</changefreq>
    <priority>0.75</priority>
    <lastmod>2022-01-03</lastmod>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/5bf19d322714e5493ab412ef/1632532887114-XQJ1IW8LHUTIV9KF2ZGY/unsplash-image-8ItUpip_h14.jpg</image:loc>
      <image:title>Calcium</image:title>
    </image:image>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/5bf19d322714e5493ab412ef/1633238249239-VKHG5SS5NY4NAWZIMRGL/Screen+Shot+2021-10-02+at+10.17.17+PM.png</image:loc>
      <image:title>Calcium - Make it stand out</image:title>
      <image:caption>Whatever it is, the way you tell your story online can make all the difference.</image:caption>
    </image:image>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/5bf19d322714e5493ab412ef/1633240207977-UC9BTDR04NUNM7OT02RS/Screen+Shot+2021-10-02+at+10.49.58+PM.png</image:loc>
      <image:title>Calcium - Make it stand out</image:title>
      <image:caption>Whatever it is, the way you tell your story online can make all the difference.</image:caption>
    </image:image>
  </url>
  <url>
    <loc>https://www.arynnd.com/iron</loc>
    <changefreq>daily</changefreq>
    <priority>0.75</priority>
    <lastmod>2021-11-20</lastmod>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/5bf19d322714e5493ab412ef/1632540438984-Y9TMVN4719GA5NYV64ML/gettyimages-585303388-612x612.jpg</image:loc>
      <image:title>Iron</image:title>
    </image:image>
  </url>
  <url>
    <loc>https://www.arynnd.com/overnight-oats</loc>
    <changefreq>daily</changefreq>
    <priority>0.75</priority>
    <lastmod>2021-10-09</lastmod>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/5bf19d322714e5493ab412ef/1633795978958-9HXZ85ITJYO2M4703W11/IMG_0039.jpg</image:loc>
      <image:title>Overnight Oats</image:title>
    </image:image>
  </url>
  <url>
    <loc>https://www.arynnd.com/jumbo-chocolate-chunk-cookies</loc>
    <changefreq>daily</changefreq>
    <priority>0.75</priority>
    <lastmod>2021-11-03</lastmod>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/5bf19d322714e5493ab412ef/2310b8f4-f21d-477e-9332-d28c8d9fef18/IMG_0690.jpg</image:loc>
      <image:title>Jumbo Chocolate Chunk Cookies</image:title>
    </image:image>
  </url>
  <url>
    <loc>https://www.arynnd.com/kale-salad</loc>
    <changefreq>daily</changefreq>
    <priority>0.75</priority>
    <lastmod>2021-10-15</lastmod>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/5bf19d322714e5493ab412ef/1634276181368-GKRM1A4FAV5RBZM4GKRY/IMG_0427.jpg</image:loc>
      <image:title>Kale Salad - Make it stand out</image:title>
      <image:caption>Whatever it is, the way you tell your story online can make all the difference.</image:caption>
    </image:image>
  </url>
  <url>
    <loc>https://www.arynnd.com/breakfast-muffins</loc>
    <changefreq>daily</changefreq>
    <priority>0.75</priority>
    <lastmod>2021-11-20</lastmod>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/5bf19d322714e5493ab412ef/1d9266e8-7efe-4f6e-8e79-832fba8f3e8c/tempImageF6pvTZ.jpg</image:loc>
      <image:title>Breakfast Muffins</image:title>
    </image:image>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/5bf19d322714e5493ab412ef/efae0fe3-3f7a-4a4e-9a01-2d1b75caf6b8/tempImageAa49Ed.jpg</image:loc>
      <image:title>Breakfast Muffins - Make it stand out</image:title>
      <image:caption>Whatever it is, the way you tell your story online can make all the difference.</image:caption>
    </image:image>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/5bf19d322714e5493ab412ef/f94ee759-0891-467c-969f-4efa491244fd/IMG_0813.jpg</image:loc>
      <image:title>Breakfast Muffins - Make it stand out</image:title>
      <image:caption>Whatever it is, the way you tell your story online can make all the difference.</image:caption>
    </image:image>
  </url>
  <url>
    <loc>https://www.arynnd.com/chocolate-protein-shake</loc>
    <changefreq>daily</changefreq>
    <priority>0.75</priority>
    <lastmod>2021-10-15</lastmod>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/5bf19d322714e5493ab412ef/1634276741472-I9IEM8DH5ULB7WNYRWMY/IMG_0411.jpg</image:loc>
      <image:title>Chocolate Protein Shake</image:title>
    </image:image>
  </url>
  <url>
    <loc>https://www.arynnd.com/adrenal-fatigue</loc>
    <changefreq>daily</changefreq>
    <priority>0.75</priority>
    <lastmod>2021-10-11</lastmod>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/5bf19d322714e5493ab412ef/1633990892501-149SO6H2N39R78ZLZQ8Z/Picture3.png</image:loc>
      <image:title>Adrenal Fatigue - Make it stand out</image:title>
      <image:caption>Whatever it is, the way you tell your story online can make all the difference.</image:caption>
    </image:image>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/5bf19d322714e5493ab412ef/1633990677450-T6KUFOL2RI2DFHXH273K/Picture1.png</image:loc>
      <image:title>Adrenal Fatigue - Make it stand out</image:title>
      <image:caption>Whatever it is, the way you tell your story online can make all the difference.</image:caption>
    </image:image>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/5bf19d322714e5493ab412ef/1633990917498-RP43D47AROH0OHS6NKZQ/Picture2.png</image:loc>
      <image:title>Adrenal Fatigue - Make it stand out</image:title>
      <image:caption>Whatever it is, the way you tell your story online can make all the difference.</image:caption>
    </image:image>
  </url>
  <url>
    <loc>https://www.arynnd.com/uti</loc>
    <changefreq>daily</changefreq>
    <priority>0.75</priority>
    <lastmod>2021-11-20</lastmod>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/5bf19d322714e5493ab412ef/1636905785917-6G6M1I6WES25V746M13A/GettyImages-1144339490.jpg</image:loc>
      <image:title>UTI</image:title>
    </image:image>
  </url>
  <url>
    <loc>https://www.arynnd.com/acne</loc>
    <changefreq>daily</changefreq>
    <priority>0.75</priority>
    <lastmod>2022-01-11</lastmod>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/5bf19d322714e5493ab412ef/1641068897145-65YQTJQ6QG32N901UKQZ/unsplash-image-__FCed37NlQ.jpg</image:loc>
      <image:title>Acne</image:title>
    </image:image>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/5bf19d322714e5493ab412ef/7c571f0e-6b49-4c37-8305-27ecc08478f0/Copy+of+Wellness+Wednesday-2.jpg</image:loc>
      <image:title>Acne - Make it stand out</image:title>
      <image:caption>Whatever it is, the way you tell your story online can make all the difference.</image:caption>
    </image:image>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/5bf19d322714e5493ab412ef/35470eac-76ea-408a-930a-1497c6b9acd8/99.png</image:loc>
      <image:title>Acne - Make it stand out</image:title>
      <image:caption>Whatever it is, the way you tell your story online can make all the difference.</image:caption>
    </image:image>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/5bf19d322714e5493ab412ef/0e6cc3b6-a44a-4f12-9b5c-16979e9a0de8/Screen+Shot+2021-12-29+at+2.49.03+PM.png</image:loc>
      <image:title>Acne - Make it stand out</image:title>
      <image:caption>Whatever it is, the way you tell your story online can make all the difference.</image:caption>
    </image:image>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/5bf19d322714e5493ab412ef/ec63b6a5-8343-4c92-8ab0-5f4efb685ef6/Screen+Shot+2022-01-01+at+1.11.39+PM.png</image:loc>
      <image:title>Acne - Make it stand out</image:title>
      <image:caption>Whatever it is, the way you tell your story online can make all the difference.</image:caption>
    </image:image>
  </url>
  <url>
    <loc>https://www.arynnd.com/prolotherapy</loc>
    <changefreq>daily</changefreq>
    <priority>0.75</priority>
    <lastmod>2026-05-19</lastmod>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/5bf19d322714e5493ab412ef/1b25338b-be5e-4709-937b-f6223d1fa47e/IMG_1300.jpg</image:loc>
      <image:title>Prolotherapy</image:title>
    </image:image>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/5bf19d322714e5493ab412ef/1641594319207-70V6LBFUC2ORPWLA9RTU/gettyimages-591994058-612x612.jpg</image:loc>
      <image:title>Prolotherapy - Make it stand out</image:title>
      <image:caption>ROTATOR CUFF PAIN Treatment: Dextrose vs saline (control) Frequency: Monthly x 3 Participants: 73 participants Mean age 51.3±14.2 Male (63%):Female (37%) This double-blind RCT examined the efficacy of dextrose prolotherapy for painful rotator cuff tendinopathy of 7.6±9.6 years duration. The researchers hypothesized that dextrose injections would be superior in decreasing shoulder pain and reversing degenerative changes. Seventy-three study participants with previous ultrasound-confirmed supra-spinatus tear and a mean age of 51.3±14.2 were randomized to three monthly injections of either dextrose or saline. At 9 month follow up, differences in pain were measured using the Visual Analog Scale (VAS), the Ultrasound Shoulder Pathology Rating Scale (USPRS), and a numerically-scaled patient satisfaction score. In comparison to saline, dextrose prolotherapy significantly reduced shoulder pain and demonstrated patient satisfaction with the outcome. While regenerative pathological healing effects were demonstrated by ultrasound measurements, they were not significant enough to be attributed to dextrose prolotherapy. Bertrand, H., Reeves, K. D., Bennett, C. J., Bicknell, S., &amp; Cheng, A. (2016). Dextrose prolotherapy versus control injections in painful rotator cuff tendinopathy. Archives of Physical Medicine and Rehabilitation, 97(1), 17-25. doi:10.1016/j.apmr.2015.08.412</image:caption>
    </image:image>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/5bf19d322714e5493ab412ef/1641594930517-K5X5BYT3J98TWFPFKEMR/gettyimages-1199688893-612x612.jpg</image:loc>
      <image:title>Prolotherapy - Make it stand out</image:title>
      <image:caption>TENNIS ELBOW Treatment: Dextrose vs dextrose-morrhulate sodium vs  ‘wait-and-see’ Frequency: Single session Participants: 26 participants Ages 18-65 Male (65%):Female (35%) This three-arm, single-blind, randomized controlled trial compared dextrose or dextrose-morrhuate sodium prolotherapy with watchful waiting/lifestyle counseling in patients with chronic and painful lateral epicondylosis (CLE). It was hypothesized that prolotherapy would offer improved elbow-related quality of life. Twenty-six participants between the ages of 18 and 65 were randomized to no therapy (wait-and-see) or blinded to either dextrose or dextrose-morrhulate sodium injections.Using the Patient-Rated Tennis Elbow Evaluation and a grip strength rating scale, outcome measurements for functionality and pain, respectively, were taken at 4, 8, and 16 weeks for all groups and again at 32 weeks for the two prolotherapy groups. While the results demonstrated less grip strength pain in the dextrose group than the dextrose-morrhulate sodium group, in comparison with the wait-and-see control group, both types of prolotherapy resulted in statistically significant improvement of elbow pain and functionality. Rabago, D., Lee, K. S., Ryan, M., Chourasia, A. O., Sesto, M. E., Zgierska, A., et al. (2013). Hypertonic dextrose and morrhuate sodium injections (prolotherapy) for lateral epicondylosis (tennis elbow): Results of a single-blind, pilot-level, randomized controlled trial. American Journal of Physical Medicine &amp; Rehabilitation, 92(7), 587-596. Doi:10.1097/PHM.0b013e31827d695f</image:caption>
    </image:image>
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      <image:loc>https://images.squarespace-cdn.com/content/v1/5bf19d322714e5493ab412ef/1641595994922-MHZNY64ML6T3A2E8DC7I/gettyimages-614441738-612x612.jpg</image:loc>
      <image:title>Prolotherapy - Make it stand out</image:title>
      <image:caption>KNEE OSTEOARTHRITIS Treatment: Dextrose 12.5% vs ozone-oxygen Frequency: Every 7-10 days x 3 sessions Participants: 80 participants Ages 40-75 Male (39%):Female (61%) This double-blind RCT compared the efficacy of dextrose prolotherapy injections with prolozone injections for mild to moderate knee osteoarthritis confirmed by clinical examination and radiography. The researchers hypothesized that both therapies would be effective in decreasing knee pain and stiffness while improving overall functionality. The study participants included 80 adults age 40 to 75 years were randomized to either dextrose or ozone-oxygen injections three times at seven to 10 day intervals. The Western Ontario McMaster University Osteoarthritis Index (WOMAC) and Visual Analog Scale (VAS) outcome scores were used to measure knee functionality and pain, respectively, at 26 and 52 weeks. Pain control and functional ability improved significantly and comparatively with both therapies. Hashemi, M., Jalili, P., Mennati, S., Koosha, A., Rohanifar, R., Madadi, F., et al. (2015). The effects of prolotherapy with hypertonic dextrose versus prolozone (intraarticular ozone) in patients with knee osteoarthritis. Anesthesiology and Pain Medicine, 5(5), e27585</image:caption>
    </image:image>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/5bf19d322714e5493ab412ef/1641594461507-B0J6QCTLBA2AWRSYSWOQ/gettyimages-855364840-612x612.jpg</image:loc>
      <image:title>Prolotherapy - Make it stand out</image:title>
      <image:caption>SACROILIAC JOINT PAIN Treatment: Dextrose (25% intra-articular) vs steroid Frequency: Bi-weekly x 3 sessions Participants: 48 participants Mean age 60.15±14.1 Male (29%):Female (71%) This prospective two-arm RCT compared dextrose prolotherapy with corticosteroid local injection to determine if pain control could be improved in the presence of sacroiliac pain. It was hypothesized that dextrose therapy would be superior to cortisone injection. Forty-eight participants with a mean age of 60.15±14.1 years were equally randomized to three bi-weekly injections of either dextrose or triamcinolone. Outcome measurements were assessed using the Numeric Rating Scale (NRS) where a score of 0 is no pain and 10 is maximum pain. Follow up at two weeks demonstrated significant and comparable results in both the dextrose and steroid group. However, at fifteen weeks statistically significant improvement in pain occurred with the prolotherapy group in comparison to the steroid group. Kim, W. M., Lee, H. G., Jeong, C. W., Kim, C. M., &amp; Yoon, M. H. (2010). A randomized controlled trial of intra-articular prolotherapy versus steroid injection for sacroiliac joint pain. Journal of Alternative and Complementary Medicine (New York, N.Y.), 16(12), 1285-1290. Doi:10.1089/acm.2010.0031</image:caption>
    </image:image>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/5bf19d322714e5493ab412ef/1641595094150-BD59B8DBEG6BL4I0MT3H/gettyimages-637860856-612x612.jpg</image:loc>
      <image:title>Prolotherapy - Make it stand out</image:title>
      <image:caption>THUMB OSTEOARTHRITIS Treatment: Dextrose 20% vs corticosteroid Frequency: Monthly x 3 sessions Participants: 60 participants Mean age 63.6±9.7 Male (27%):Female (73%) This RCT compared dextrose prolotherapy with corticosteroid local injection to determine if pain control and functional ability could be improved in the presence of radiographical confirmed carpometacarpal joint osteoarthritis. It was hypothesized that dextrose therapy would be superior to cortisone injection. Sixty participants with a mean age of 63.6±9.7 years were equally randomized to three monthly injections of dextrose or two monthly saline placebo injections followed by a single injection of methyl-prednisone acetate. Participants and assessors were blinded, and follow up was performed at 1, 2, and 6 months. Pain levels were measured using the Fisher’s pressure algometer in conjunction with the Visual Analog Scale (VAS) while hand function was assessed using the Health Assessment Questionnaire Disability Index (HAQ-DI) during three specific activities of eating, gripping, and dressing. Follow up demonstrated comparable results at 2 months and better results with dextrose therapy at 6 months. Jahangiri, A., Moghaddam, F. R., &amp; Najafi, S. (2014). Hypertonic dextrose versus corticosteroid local injection for the treatment of osteoarthritis in the first carpometacarpal joint: A double-blind randomized clinical trial. Journal of Orthopaedic Science, 19(5), 737-743. Doi:10.1007/s00776-014-0587-2</image:caption>
    </image:image>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/5bf19d322714e5493ab412ef/1641598036924-6AXIB3T0C6FZWHNJE8MN/gettyimages-1160585908-612x612.jpg</image:loc>
      <image:title>Prolotherapy - Make it stand out</image:title>
      <image:caption>KNEE OSTEOARTHRITIS Treatment: Dextrose (15% extra-articular, 25% intra-articular) vs physiotherapy Frequency: Monthly x  3-5 sessions Participants: 104 participants Mean age 50.98±10.5 years Male (25%):Female (75%) This two-arm RCT compared the efficacy of dextrose prolotherapy (Group 1) with physiotherapy (Group 2) for symptomatic radiographically-proven knee osteoarthritis of greater than six months duration. The researchers hypothesized that dextrose therapy would provide superior results in improving pain, functionality, and radiological grading. The study participants were age, gender, disease duration, and BMI matched, and included 104 adults between the ages of 38 and 73 years randomized 4:1 in favour of dextrose prolotherapy. Group 1 (dextrose therapy) participants received extra-articular and intra-articular dextrose injections monthly for 3 to 5 sessions while Group II (physiotherapy) were enrolled in at-home exercise intervention. Outcome measures were performed at baseline and 12 months using radiography, musculoskeletal ultrasound, and the Western Ontario McMaster University Osteoarthritis Index (WOMAC) by Visual Analog Scale (VAS). At 2 and 5 months, WOMAC/VAS scores were measured. Dextrose prolotherapy was significantly better than physiotherapy in respect to pain control, function, and regeneration. Soliman, D. M. I., Sherif, N. M., Omar, O. H., &amp; El Zohiery, A., K. (2016). Healing effects of prolotherapy in treatment of knee osteoarthritis healing effects of prolotherapy in treatment of knee osteoarthritis. Egyptian Rheumatology and Rehabilitation, 43(2), 47-52. doi:10.4103/1110-161X.181858</image:caption>
    </image:image>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/5bf19d322714e5493ab412ef/1641598003943-0BT3946P3TVWP9CMCGBD/gettyimages-1160585908-612x612.jpg</image:loc>
      <image:title>Prolotherapy - Make it stand out</image:title>
      <image:caption>KNEE OSTEOARTHRITSIS Treatment: Dextrose 25% intra-articular vs erythropoieten 4000 IU intra-articular vs pulse radiofrequency articular Frequency: Single injection Participants: 70 participants Mean age 59.9±8.08 Male (43%):Female (57%) In this double-blinded, three-arm RCT, erythropoietin, dextrose, and pulsed radiofrequency were compared to determine their effects on pain control and knee functionality in the presence of knee osteoarthritis. It was hypothesized that intra-articular injection of erythropoietin or dextrose would be more effective than pulsed radiofrequency. Seventy participants, age 40 to 70, were randomized to receive a single intra-articular injection of either erythropoietin or dextrose, or pulsed radiofrequency in the articular area of the knee. Pain levels were measured in weeks 2, 4, and 12 using the Visual Analog Scale (VAS) for pain and knee range of motion was assessed using a geometric method to assess. The results demonstrated that erythropoietin prolotherapy, when compared with dextrose injections and pulsed radiofrequency was more effective in both pain control and functional improvement. Rahimzadeh, P., Imani, F., Faiz, S. H. R., Entezary, S. R., Nasiri, A. A., &amp; Ziaeefard, M. (2014). Investigation the efficacy of intra-articular prolotherapy with erythropoietin and dextrose and intra-articular pulsed radiofrequency on pain level reduction and range of motion improvement in primary osteoarthritis of knee. Journal of Research in Medical Sciences: The Official Journal of Isfahan University of Medical Sciences, 19(8), 696-702.</image:caption>
    </image:image>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/5bf19d322714e5493ab412ef/1641597525081-4O2EM9UG81UQ6AD7D4FT/gettyimages-1160585908-612x612.jpg</image:loc>
      <image:title>Prolotherapy - Make it stand out</image:title>
      <image:caption>KNEE OSTEOARTHRITIS Treatment: Dextrose 15% extra-articular, 25% intra-articular vs saline vs exercise Frequency: Every 4 weeks x 3-5 sessions Participants: 90 participants Ages 40-60 Male (33%):Female (67%) This 3-arm blinded RCT examined the efficacy of dextrose prolotherapy injections for moderate to severe knee osteoarthritis of greater than three months duration. The researchers hypothesized that dextrose injections would be superior in decreasing knee pain and stiffness while improving overall functionality. The study participants included 90 adults with a mean age of 56.7 years, randomized to either at-home exercise or blinded-to-participant injection of dextrose or saline every 4 weeks for 3 to 5 sessions. The Western Ontario McMaster University Osteoarthritis Index (WOMAC) and Knee Pain Scale (KPS) outcome scores were used to measure knee functionality and pain, respectively, at 26 and 52 weeks. When adjusted for gender, age, and BMI, Dextrose prolotherapy produced a significantly better knee-related quality of life than either saline or exercise.  Rabago, D., Patterson, J. J., Mundt, M., Kijowski, R., Grettie, J., Segal, N. A., &amp; Zgierska, A. (2013). Dextrose prolotherapy for knee osteoarthritis: A randomized controlled trial. Annals of Family Medicine, 11(3), 229.</image:caption>
    </image:image>
    <image:image>
      <image:loc>https://images.squarespace-cdn.com/content/v1/5bf19d322714e5493ab412ef/1641597571664-5Q6XJIUME6CQONALQK41/gettyimages-518857300-612x612.jpg</image:loc>
      <image:title>Prolotherapy - Make it stand out</image:title>
      <image:caption>ROTATOR CUFF LESION Treatment: Dextrose - 25% subacromial bursa - 15% infraspinatus - 15% supraspinatus - 15% subscapularis - 15% coracoid process vs Exercise Frequency: 2-6 injection sessions Participants: 120 participants Ages 30-60 Male (40%):Female (60%) This double-blind RCT examined the efficacy of dextrose prolotherapy in comparison to physical therapy for painful rotator cuff MRI-confirmed lesions of greater than six months duration. The researchers hypothesized that dextrose injections would be superior in decreasing shoulder pain while increasing functionality and patient satisfaction with treatment. One hundred twenty participants, age 30 to 60, were randomized equally to ultrasound-guided multiple injection site sessions (2 to 6) of dextrose or three weekly supervised sessions of physical therapy (control) for 12 weeks. At-home exercises were provided to both groups. At baseline and follow up at 3, 6, and 12 weeks, pain, function, and patient satisfaction were measured using the Visual Analog Scale (VAS), the Shoulder Pain and Disability Index (SPADI), and the Western Ontario Rotary Cuff (WORC) Index. In comparison to exercise, pain, disability, and functional scores were significantly improved with dextrose prolotherapy. Seven, M. M., Ersen, O., Akpancar, S., Ozkan, H., Turkkan, S., Yıldız, Y., &amp; Koca, K. (2017). Effectiveness of prolotherapy in the treatment of chronic rotator cuff lesions. Orthopaedics &amp; Traumatology: Surgery &amp; Research, 1-20. doi:10.1016/j.otsr.2017.01.003</image:caption>
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