What is Prolotherapy?

Prolotherapy is an in-office injection treatment that research and medical studies have shown to be an effective, trustworthy, reliable alternative to surgical and non-effective conservative care treatments. In our opinion, based on extensive research and clinical results, Prolotherapy is superior to many other treatments in relieving the problems of chronic joint and spine pain and, most importantly, in getting people back to a happy and active lifestyle.


Prolotherapy is a regenerative injection treatment used to treat joint and spine pain by repairing damaged and weakened ligaments and tendons.

  • Prolotherapy is considered a viable alternative to surgery, pain medications, and cortisone and other steroidal injections.
  • The Prolotherapy procedure is considered a safe, affordable option that allows the patient to keep working and/or training during treatment.
Does Prolotherapy Work?

A December 2020 study in the journal Anesthesia and Pain Medicine made these observations on prolotherapy treatment:

  • The researchers principle findings revealed that dextrose prolotherapy has a clear and positive effect on chronic musculoskeletal pain ranging from 6 months to 1 year.
  • In comparison with saline injection or exercise, treatment with prolotherapy showed a moderately superior therapeutic effect. In particular, prolotherapy was found to be more effective than exercise from one month after treatment.
  • Prolotherapy was also found to have a similar effect to steroids or PRP (Platelet Rich Plasma injections) one month after treatment.
  • In a comparison of the effects of corticosteroid injection and prolotherapy in patients with first carpometacarpal (thumb) osteoarthritis, one study reported that the corticosteroid injection group had better results of pain score at 1 month. However, after 2 months, prolotherapy had a more favorable outcome than corticosteroid injection. Another concern of corticosteroids is adverse effects, in contrast, prolotherapy has no serious side effects and is effective, safe, and sustainable.
  • In conclusion, dextrose-based prolotherapy has been shown to have a positive and significantly beneficial effect for patients with chronic musculoskeletal pain, ranging from 6 months to 1 year. There is evidence that dextrose-based prolotherapy has a better therapeutic effect than exercise, and that it has a similar effect compared to PRP and steroid injection.

Bae G, Kim S, Lee S, Lee WY, Lim Y. Prolotherapy for the patients with chronic musculoskeletal pain: systematic review and meta-analysis. Anesthesia and Pain Medicine. 2020 Dec 16. [Google Scholar]

Prolotherapy Treatment Goals
What are our goals for the use of prolotherapy for our patients?
  1. Function Is your ability to function in activities of daily living improved? Are you able to perform previously painful activities without pain? Are you able to do things that they could not do prior to Prolotherapy? We typically advise continuing to receive Prolotherapy injections in combination with OMT until able to stably perform that certain function pain and cracking-free. For example, you can now climb two flights of stairs without knee pain after Prolotherapy, whereas prior to the Prolotherapy this would cause excruciating pain, then we know that Prolotherapy is helping improve function.
  2. Strength Ligament and tendon injury may cause muscle strength to decline. When a person receives Prolotherapy, one of the noticeable effects of the treatment is that strength improves in the injected areas.
  3. Pain Pain is one of the most common reasons patients receive Prolotherapy. Thus, a noticeable decrease in pain shows the benefit of successful Prolotherapy.
  4. Stiffness Patients commonly experience stiffness upon morning rising or after performing a certain activity. A great sign that Prolotherapy is working is that stiffness has subsided. Once Prolotherapy helps stabilize the area involved, the muscles no longer have to provide this stability so they relax. Once they relax, the stiffness subsides.
  5. Physical Examination We can also assess whether the Prolotherapy is working by simple physical examination. We can also listen for crepitation or crunching in the joints which can often be audibly heard by moving the joint. The joint that doesn’t crunch is also improving. X-rays and MRIs are poor indicators that Prolotherapy is working, the reason being that most ligaments do not show up well on these tests. We do not rely on MRI changes, but solely on how you are feeling and functioning as well as what our hands tell us!