Prolotherapy FAQs

Prolotherapy is a regenerative injection treatment that supports healing in injured ligaments and tendons — one of the earliest forms of regenerative medicine. It involves injecting a mild solution, most commonly medical-grade dextrose, into weakened soft tissue to stimulate the body's natural repair response. At IOW, prolotherapy is performed under ultrasound or fluoroscopic guidance for precise, safe placement.

Prolotherapy creates a controlled healing signal at damaged ligaments or tendons. The injected solution triggers a localized inflammatory response that prompts the body to produce new collagen and strengthen the treated tissue. Over time this can improve joint stability, reduce pain, and address the underlying cause of chronic instability rather than masking symptoms.

Prolotherapy is commonly used when ligament laxity or soft-tissue weakness drives pain or dysfunction — including chronic neck or low back pain from ligament instability, shoulder instability or rotator cuff strain, knee or ankle instability after repeated sprains, tennis elbow and other tendon injuries, plantar fasciitis, and certain cases of osteoarthritis. The pattern of ligament involvement on exam and imaging determines whether it's the right fit.

Both are regenerative injections, but they target different problems — here's a side-by-side look:

They can be combined — the right option depends on which tissue is failing and your goals.

Because ligaments heal gradually, prolotherapy is usually delivered as a series — commonly 3–6 sessions spaced several weeks apart. The exact number depends on the severity of the injury, the joint involved, and how your body responds over time. Your plan is mapped out at consultation.

Performed by trained providers under image guidance, prolotherapy is considered safe, and serious complications are uncommon because it uses non-toxic solutions that target the body's own repair process. Published research backs this: a controlled study of dextrose prolotherapy for ACL laxity found significant, sustained improvements in pain, swelling, and range of motion through 3 years of follow-up. The most common side effect is temporary soreness or stiffness at the injection site, which usually settles within a few days.

Source (verify/replace before publishing): Reeves & Hassanein, “Long-term effects of dextrose prolotherapy for anterior cruciate ligament laxity” — 3-year follow-up outcomes.

Prolotherapy may suit patients with chronic joint or soft-tissue pain linked to ligament or tendon injury, those who experience instability rather than severe structural damage, and people who want to avoid surgery or repeated steroid injections after rest, physical therapy, or medication haven't helped. Imaging is often used to confirm candidacy and guide treatment.