Prolotherapy is a nonsurgical technique that uses injections to treat injured connective tissues. Connective tissues include tendons, ligaments, and cartilage. Prolotherapy is also known as proliferation therapy or regenerative injection therapy.
Studies have shown that prolotherapy may allow some patients may push back the need for surgery or avoid surgery on injured tissues altogether. Athletes and active patients may choose prolotherapy because it normally doesn’t require long breaks in activity.
During prolotherapy, a doctor uses a needle to inject a solution into the patient’s damaged tissue. The injection is intended to trigger a mild inflammatory response. The goal is for this inflammation is to encourage the body’s natural healing response to reduce pain.
The doctor marks the area for injection and sterilizes the region. In some cases, they may apply a numbing spray to reduce pain at the injection site. Your doctor also may use ultrasound to view the affected area. Once they identify the area, they inject the solution into and around the damaged tissue.
Prolotherapy injections are typically composed of an “irritant” solution that contains dextrose (a simple sugar), saline, and a numbing medicine such as lidocaine. Patients receive monthly injections for 4 to 6 months, depending on the severity of the condition. They normally perform physical therapy exercises along with the injections, which has been shown to improve outcomes.
Ask your health care provider if you may be a candidate for prolotherapy. Call Mass General Brigham Sports Medicine to learn more.
You may be a candidate for prolotherapy if you have one of these conditions:
Prolotherapy should be used with caution in certain patients, including:
Prolotherapy isn’t recommended for people who:
All medical procedures are associated with some level of risk. For example, patients may have side effects that occur with any needle injection. These include mild bleeding and temporary discomfort or pain flare lasting up to 7 days. There is also a risk of infection. We greatly reduce this risk by using sterile techniques.
Serious complications are rare but can include:
Most patients have an outpatient procedure done in a clinic. Before your procedure, tell your doctor if you have:
Depending on your medical history, you may need to stop or adjust some of your medications prior to the procedure. To have the desired inflammatory response, you should stop taking non-steroidal anti-inflammatory drugs (NSAIDS) 7 days prior to treatment. NSAIDs relieve fever and pain. They also reduce swelling from arthritis or a muscle sprain or strain. NSAIDs include aspirin, ibuprofen (Advil and Motrin), and naproxen (Aleve and Naprosyn).
Expect discomfort for 5 to 7 days after prolotherapy injections due to the inflammatory response. This may feel like a pain flare-up but it’s actually a good sign that your body is responding well to the treatment. You can expect temporary and local bruising, swelling, and tenderness at the injection site.
Here are some tips for your recovery: