Regenexx Logo

Understanding Prolotherapy And Its Role In Pain Management

Medically Reviewed By:

Dr. Chaz Fausel, MD

Dr. Chaz Fausel is a Denver-based interventional orthopedics specialist and Regenexx educator, trained at Emory and the Centeno-Schultz Clinic.

Interventional orthobiologics is a field that may help support the body’s natural healing processes. This approach utilizes specialized techniques to address orthopedic conditions as an alternative to surgery or long-term medication use.

Prolotherapy is one such approach that is used to address chronic musculoskeletal discomfort. It may help support the body’s natural tissue repair processes in joints, tendons, and ligaments. For individuals who have not experienced sufficient improvement with conventional treatments, prolotherapy may provide an alternative to more invasive procedures.

What Is Proliferation Therapy?

Prolotherapy, sometimes called “proliferative therapy,” is an injection-based approach used to address chronic musculoskeletal conditions that may contribute to discomfort in muscles, tendons, ligaments, and joints. Physicians in the licensed Regenexx network may use this procedure using Regenexx lab processes to support the body’s natural tissue repair processes and strengthen treated areas.

Prolotherapy involves introducing a solution containing a mild irritant into the targeted area. This injection is intended to trigger a controlled inflammatory response, which may support the body’s natural healing mechanisms. This approach is used to help promote tissue repair and support the structural integrity of tendons, ligaments, and joints.

By facilitating this natural process, prolotherapy may aid in tissue repair and support improved function over time.

Inflammation As A Natural Part Of The Repair Process 

Inflammation plays a role in the body’s natural response to injury. When an injury occurs, inflammatory signals help direct blood flow to the affected area, carrying platelets and specialized proteins. These components may support the body’s natural healing mechanisms and contribute to tissue repair.

Common Solutions Used In Regenerative Injection Therapy

Prolotherapy solutions may contain sugar-based substances such as dextrose or glucose. Physicians in the licensed Regenexx network may use these solutions alone or in combination with glycerin or phenol. Sodium morrhuate, a purified derivative of cod liver oil, is used to help trigger an inflammatory response, which may support the body’s natural tissue repair processes.

To help maintain comfort during prolotherapy, physicians may include a local anesthetic such as lidocaine or procaine in the solution.

Learn More About Regenexx® Procedures
Request a digital booklet and more information to learn about alternatives to orthopedic surgery and the Regenexx patient experience.

Name(Required)
This field is hidden when viewing the form
This field is hidden when viewing the form
This field is hidden when viewing the form
This field is hidden when viewing the form
This field is hidden when viewing the form
This field is hidden when viewing the form
Ignore Duplicate Rules
We do not sell, or share your information to third party vendors. By submitting the form you agree that you've read and consent to our Privacy Policy.

Timeline And Expected Sessions

Following prolotherapy, patients may experience a gradual recovery process. Treatment typically involves multiple sessions, with the exact number depending on individual factors such as the condition being addressed. These sessions are generally scheduled two to three weeks apart over several months.

Recovery Considerations:

  • Rest and recovery: After each session, rest is recommended to allow the body to respond to the treatment. Patients may benefit from allowing time for the body to adapt.
  • Avoid strenuous activity: Patients should refrain from intense physical activity, as excessive strain may interfere with the body’s natural recovery process.
  • Gradual return to activity: As recovery progresses, a gradual return to activity may be recommended to help avoid overstraining the treated area.
  • Follow-up sessions: Follow-up appointments allow physicians to monitor progress and determine whether additional injections may be beneficial.

Managing Risks And Expectations After The Procedure

While prolotherapy is generally well tolerated, patients may experience some expected post-procedure effects. These are typically mild and temporary.

  • Nerve irritation: Though uncommon, some patients may experience tingling or numbness. This is typically temporary and may improve over time.
  • Temporary weakness: Some individuals may notice mild weakness if there is anesthetic in the injection. Function typically improves as recovery progresses.
  • Headache or dizziness: Mild headaches or dizziness may occur after treatment but often resolve with rest and hydration.

Tissue Repair Improvements With Proliferation Therapy

Prolotherapy is an injection-based approach that may support the body’s natural tissue repair processes. By initiating a localized inflammatory response at the injection site, this approach is intended to help facilitate the body’s natural healing mechanisms. This process may encourage cellular activity and the presence of platelets and other biological factors in the treated area.

As the body responds to the injections, prolotherapy may help support joint function and musculoskeletal health over time. Physicians in the licensed Regenexx network may consider prolotherapy as part of a personalized approach for individuals seeking a non-surgical option for managing musculoskeletal conditions.

Evidence-Based Benefits Of Prolotherapy In Pain Management

A systematic review and meta-analysis examined the use of dextrose prolotherapy for chronic musculoskeletal discomfort.

The study analyzed data from ten randomized controlled trials involving 750 participants and reported that prolotherapy was associated with reduced pain scores, compared to a combination of saline-only injections and exercise. In some cases, participants noted lower pain levels between six months and one year after treatment.

The study also observed that prolotherapy produced comparable outcomes to platelet-rich plasma (PRP) and steroid injections in certain cases. While these findings suggest that prolotherapy may serve as a non-surgical option for managing chronic musculoskeletal conditions, further long-term studies are needed to better understand its potential applications.

Conditions Prolotherapy Can Help Manage

Physicians in the licensed Regenexx network may consider prolotherapy for individuals with musculoskeletal conditions, particularly those with strained ligaments and joint instability. While responses vary, this injection-based approach offers a non-surgical option that may help support the body’s natural tissue repair processes and assist in maintaining function in certain cases.

Conditions where prolotherapy may be considered include:

  • Anterior Cruciate Ligament (ACL) Tears: An ACL tear is a partial or complete rupture of the anterior cruciate ligament in the knee, often caused by sudden twists or high-impact movements. It may lead to pain, swelling, instability, difficulty bearing weight, or changing direction. Read More About Anterior Cruciate Ligament (ACL) Tears.
  • Knee Osteoarthritis: Knee osteoarthritis occurs when the cartilage in the knee joint wears down over time, leading to pain, stiffness, swelling, and reduced mobility. Symptoms may worsen with activity, potentially affecting daily movements such as walking or climbing stairs. Read More About Knee Osteoarthritis.
  • Meniscus Tears: A meniscus tear is a common knee injury involving damage to the cartilage that cushions the joint. It may cause pain, swelling, stiffness, and a catching or locking sensation, often worsening with twisting movements or weight-bearing activities. Read More About Meniscus Tears.
  • Herniated Discs: A herniated disc occurs when the soft inner portion of a spinal disc pushes through its outer layer, potentially compressing nearby nerves. Depending on the affected area, this may cause pain, numbness, tingling, or weakness in the back, neck, or limbs. Read More About Herniated Discs.
  • Spinal Stenosis: Spinal stenosis is when the spinal canal narrows, putting pressure on the spinal cord or nerves. It may cause pain, numbness, tingling, or weakness in the back, legs, or arms, often worsening with prolonged standing or walking. Read More About Spinal Stenosis.
  • Bulging Discs: A bulging disc occurs when a spinal disc extends beyond its normal space without rupturing. Depending on the affected area, it may cause localized pain or nerve compression, leading to numbness, tingling, or weakness in the back, neck, or limbs. Read More About Bulging Discs.
  • Spondylolysis: Spondylolysis is a stress fracture or defect in the vertebra, most commonly in the lower back. It may cause localized pain, stiffness, and, in some cases, nerve irritation, often worsening with activity or prolonged standing. Read More About Spondylolysis.
  • Rotator Cuff Tears: A rotator cuff tear occurs when one or more tendons in the shoulder are partially or fully torn due to injury or degeneration. It may cause pain, weakness, and limited range of motion, often worsening with overhead movements or lifting. Read More About Rotator Cuff Tears.
  • Shoulder Labrum Tears: A shoulder labrum tear occurs when the cartilage ring surrounding the shoulder socket is damaged due to injury or repetitive strain. It may cause pain, instability, clicking sensations, and reduced range of motion, especially during overhead or rotational movements. Read More About Shoulder Labrum Tears.
  • Shoulder Osteoarthritis: Shoulder osteoarthritis occurs when the cartilage in the shoulder joint wears down over time, leading to pain, stiffness, swelling, and reduced range of motion. Symptoms may worsen with movement, potentially affecting daily activities and arm function. Read More About Shoulder Osteoarthritis.
  • Hip Osteoarthritis: Hip osteoarthritis occurs when the cartilage in the hip joint gradually wears down, leading to pain, stiffness, and reduced range of motion. Symptoms may worsen with movement or weight-bearing activities, potentially affecting mobility and daily function. Read More About Hip Osteoarthritis.
  • Hip Labrum Tear: A hip labrum tear occurs when the ring of fibrocartilage surrounding the hip socket is damaged due to injury or degeneration. It may cause hip pain, stiffness, clicking sensations, and instability, often worsening with movement or prolonged activity. Read More About Hip Labrum Tear.
  • Hip Tendon Tears: Hip tendon tears occur when the tendons around the hip joint partially or fully rupture due to injury or degeneration. This may cause pain, weakness, and reduced mobility, often worsening with movement or prolonged activity. Read More About Hip Tendon Tears.
  • TFCC tear: A TFCC (triangular fibrocartilage complex) tear is an injury to the cartilage and ligaments on the outer wrist, often caused by trauma or repetitive stress. It may lead to wrist pain, weakness, clicking sensations, and reduced grip strength, especially during rotation or weight-bearing activities. Read More About TFCC Tears.
  • Carpal Tunnel Syndrome: Carpal tunnel syndrome is caused by compression of the median nerve in the wrist, leading to numbness, tingling, weakness, or pain in the hand and fingers. Symptoms may worsen over time, affecting grip strength and fine motor skills. Read More About Carpal Tunnel Syndrome.
  • Thumb Arthritis: Thumb arthritis, or basal joint arthritis, occurs when the cartilage in the thumb’s base joint wears down, leading to pain, stiffness, and reduced grip strength. Symptoms may worsen with pinching or grasping movements, affecting daily activities. Read More About Thumb Arthritis.
  • Ankle Ligament Tears: Ankle ligament tears occur when the ligaments supporting the ankle are overstretched or torn due to trauma or excessive strain. This may cause pain, swelling, bruising, and instability, potentially affecting balance and mobility. Read More About Ankle Ligament Tears.
  • Ankle Tendon Tears: Ankle tendon tears occur when the tendons supporting the ankle partially or fully rupture due to injury or degeneration. This may cause pain, swelling, weakness, and instability, potentially affecting mobility and daily activities. Read More About Ankle Tendon Tears.
  • Ankle Osteoarthritis: Ankle osteoarthritis occurs when the cartilage in the ankle joint wears down over time, leading to pain, stiffness, swelling, and reduced mobility. Symptoms may worsen with weight-bearing activities, potentially affecting balance and daily movement. Read More About Ankle Osteoarthritis.
  • TMJ Syndrome: TMJ syndrome, or temporomandibular joint disorder, occurs when dysfunction in the jaw joint causes pain, stiffness, clicking, or difficulty chewing. Symptoms may also include headaches, ear pain, or jaw locking, often worsening with jaw movement or stress. Read More About TMJ Syndrome.
  • Non-Union Fractures: Non-union fractures occur when a broken bone fails to heal properly, often due to poor blood supply, instability, or infection. This may lead to persistent pain, swelling, and limited function, sometimes requiring additional treatment to promote healing. Read More About Non-Union Fractures.
  • Osteonecrosis (avascular necrosis): Osteonecrosis, also known as avascular necrosis, occurs when blood flow to a bone is reduced, leading to tissue death. This may cause pain, joint stiffness, and potential bone collapse, often affecting weight-bearing joints such as the hip, knee, or shoulder. Read More About Osteonecrosis (Avascular Necrosis).

The Regenexx Approach To Managing Musculoskeletal Pain

Physicians in the licensed Regenexx network utilize specialized techniques and expertise in interventional orthobiologics to tailor prolotherapy treatment plans. With a focus on non-surgical alternatives, these physicians may consider prolotherapy as part of a comprehensive approach to support the body’s natural tissue repair processes.

It aims to help support function and address discomfort by customizing treatment to individual needs. This approach offers individuals a non-surgical option for managing musculoskeletal conditions while reducing the need for invasive procedures or long-term medication use.

Start Your Journey To Approaching Musculoskeletal Pain Today

If you are managing chronic musculoskeletal discomfort, prolotherapy may be considered as a non-surgical option to help support function and address pain. Physicians in the licensed Regenexx network offer personalized treatment approaches designed to support the body’s natural healing processes.

Take the first step in exploring whether prolotherapy may be right for you. Learn more about this approach and how it may help support your musculoskeletal health. Reach out to a physician to discuss your treatment options.

Medically Reviewed By:

Dr. Chaz Fausel, MD

Dr. Chaz Fausel is a Denver-based interventional orthopedics specialist and Regenexx educator, trained at Emory and the Centeno-Schultz Clinic.
TO TOP