What is prolotherapy?

Prolotherapy (Proliferative Therapy) is a recognized orthopedic procedure that stimulates the body’s healing processes to strengthen and repair injured and painful joints and connective tissue. It is based on the fact that when ligaments or tendons (connective tissue) are stretched or torn, the joint they are holding destabilizes and can become painful. A major issue is that ligaments and tendons have poor blood supply, causing their healing time to be lengthy and possibly incomplete. Prolotherapy, with its unique ability to directly address the cause of the instability, can repair the weakened sites and produce new collagen tissue, resulting in permanent stabilization of the joint. Once the joint is stabilized, pain usually resolves. Prolotherapy injections contain natural substances that stimulate local and precise inflammation followed by a healing response, as well as local anesthetic agents to help with the pain of the injection. Traditional formulas include ingredients such as dextrose, saline, and procaine or lidocaine.

What is the process like?

First a patient goes through a thorough assessment- history of the issue, factors of health, orthopedic tests- to determine if they’re a good candidate for prolotherapy and exactly what and where the problem is. Once the location (or locations) for injection is determined, the patient is prepped and the area is sterilized. There may be some acupuncture and IMS done prior to injection to help release tight muscles and decrease the pain. Syringes of prolo solution are then prepped and the injections are performed. The first visit requires approximately 45 minutes and follow-up visits are 30 minutes.

What can it treat?

Prolotherapy is used for a variety of acute and chronic joint, tendon and ligament injuries. Some of the more common problems include:

  • Tennis and golfer elbow
  • Plantar fasciitis
  • Chronic ankle sprains (inversions and eversions)
  • Achilles tendonitis
  • Rotator cuff tears
  • Headaches
  • Runner and Jumper’s Knee
  • Shoulder dislocations and instability
  • Meniscal tears
  • Osteoarthritis
  • Chronic low back and neck pain

What is the difference between prolotherapy and PRP?

Prolotherapy and PRP can be used to treat the same issues, but PRP tends to require less injections and is often indicated when prolotherapy does not seem to be sufficient or its effects have plateaued. Certain patients that may have a more difficult time healing are likely better suited for PRP.

What are the risks and side effects?

The injection can be tender or painful (we are injecting into a damaged area after all) and there may be swelling, bruising and discomfort for 24-48 hours after the treatment. As with any medical procedure that punctures the skin, there is risk of infection, but the site is cleaned and sterilized before injection.

How many injections will I need?

Each person and condition is different but the majority of patients require 2-6 sets of injections at 4-6 week intervals. Patients may notice benefit after one treatment, and as the body does take time to heal, maximal benefit may not be noticed for 6-12 months.

How can I prepare for the injection? What can I do after?

The healthier you are before and after the treatment, the better the body will respond. This means trying to optimize diet, exercise, nutritional supplementation, sleep/rest and hydration while decreasing harmful activities like smoking, alcohol and stressful situations. During the intake we will discuss important factors of health and make an individualized plan for each patient.

It is also recommended to stop use of corticosteroids, blood thinners and anti-inflammatory medications (Ibuprofen, Aspirin, Advil) for one week before the procedure.