Prolotherapy

Prolotherapy is a regenerative injection treatment used to support healing in injured ligaments and tendons. It has been practiced for decades and is considered one of the earliest forms of regenerative medicine. The treatment involves injecting a mild solution—most commonly dextrose (a medical-grade sugar)—into weakened soft tissue to stimulate the body’s natural repair response.

At Interventional Orthopedics of Washington, prolotherapy injections are performed using ultrasound or fluoroscopic guidance to ensure precise placement and safety.

Prolotherapy works by creating a controlled healing signal at damaged ligaments or tendons. The injected solution triggers a localized inflammatory response, which encourages the body to produce new collagen and strengthen the treated tissue. Over time, this process 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 contributes to pain or dysfunction. Conditions that may respond well include:

- Chronic neck or low back pain related to ligament instability

- Shoulder instability or rotator cuff strain

- Knee or ankle instability after repeated sprains

- Tennis elbow and other tendon injuries

- Plantar fasciitis

- Certain cases of osteoarthritis

A comprehensive exam and imaging help determine whether prolotherapy is appropriate.

Prolotherapy may be a good option for patients who:

- Have chronic joint or soft-tissue pain linked to ligament or tendon injury

- Experience instability rather than severe structural damage

- Want to avoid surgery or repeated steroid injections

- Have not improved with rest, physical therapy, or medication

Advanced imaging is often used to confirm candidacy and guide treatment planning.

Ligaments heal gradually, so prolotherapy is often delivered as a series of treatments, commonly 3–6 sessions spaced several weeks apart. The exact number depends on the severity of injury, the joint involved, and how the body responds over time.

When performed by trained providers using image guidance, prolotherapy is considered safe. The most common side effects are temporary soreness or stiffness at the injection site. Because the treatment uses non-toxic solutions and targets the body’s natural healing response, serious complications are uncommon.