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Prolotherapy FAQs

Prolotherapy: An Explanation

Prolotherapy, a form of regenerative orthopedics, is a nonsurgical pain treatment that stimulates the body’s natural healing response to repair injured or weakened joints, ligaments and tendons.  The weakened areas are injected with a solution, a “proliferant”, that initiates growth of healthy tissue to restore function, mobility and eliminate pain.  Prolotherapy has been practiced in the US since the 1930’s and endorsed by US former Surgeon General C. Everett Koop.  It is a very effective treatment for musculoskeletal injuries including arthritis, tendinitis, bursitis, joint instability and more.

Can Prolotherapy help my pain?

Many types of chronic pain are caused by damaged ligaments, tendons, muscles and joints.  Prolotherapy often results in healing of these structures with permanent pain relief.

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What is the solution that is injected?

The most commonly used proliferant is a mixture of dextrose (sugar derived from corn) and lidocaine with normal saline.  It is safe and effective for most patients.  

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How does prolotherapy work?

Injecting a proliferant into the injured area signals the body’s natural repair mechanisms to start the healing cascade.  This initiates repair and growth of new healthy ligament and tendon fibers.  Subsequent treatments repeat this proliferative process, allowing a gradual building of structures to restore strength and function and eliminate pain.

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Is the prolotherapy treatment painful?

Most patients tolerate the procedure well with a pretreatment of local anesthesia (lidocaine).  Some people forgo it.  The treatment is experienced differently among patients.  Some may experience discomfort.  We recommend pretreating with Tylenol.

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How often do I need these treatments?

This, too, is different for each individual. Some people may feel their pain resolved after just one treatment.   Many require multiple treatments with an average of 3-6 treatments separated by 2-6 weeks depending on your condition and the response to the treatment.

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How will I feel after prolotherapy treatment?

You can expect to have increased discomfort for three to five days because your body is responding to the proliferant.  It may cause you to feel stiff and sore, like you had the sprain or arthritis flare-up all over again.  This is a good sign that you are getting a proper response.  You can expect some bruising, local swelling and tenderness at the injection site.

When can I go back to work and play sports?

Some patients prefer to rest after treatment while others carry-on with their work and other activities.  Certainly avoid strenuous work and sports for two or three weeks after injection to give the repaired tissue a chance to mature.  Your body heals best when not struggling with continued microtrauma and reinjury.  The growth cycle is complete in six weeks.

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Is prolotherapy safe?

It is safe when administered by a properly trained prolotherapist.  The risks are similar to other joint injections. Rare side effects include infection and nerve damage.  Dr. Winiecki is a trained member of the International Association for Regenerative Therapy, IART. 

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How effective is prolotherapy?

Prolotherapy is very effective.  There is extensive research to support the use of prolotherapy for multiple musculoskeletal conditions.  The rate of success depends on multiple factors including the patient’s other medical conditions, age, nutrition, and their ability to rest.  

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How is prolotherapy different from steroid injections?

Steroids produce pain relief by inhibiting the body’s natural healing inflammatory mechanism.  Swelling is reduced, the pain goes away but healing is suppressed!  In the long run, steroids cause tissue breakdown, joint instability, pain and multiple adverse effects.   Prolotherapy safely does just the opposite by promoting healing.

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When would you use prolotherapy versus platelet rich plasma (PRP) or stem cells?

The goal of regenerative injections such as prolotherapy, PRP or stem cell treatment, is to stimulate the healing cascade.  In general, if a patient gets the desired 2-3 days of inflammation (stiffness, soreness, local pain) after prolotherapy, they do not need a stronger proliferant like PRP or stem cells.  Prolotherapy is much more cost effective and less invasive (does not require processing blood or cellular tissue).  

Why should you consider Prolotherapy?

Prolotherapy stimulates your body to heal on its own with the injection of a simple sugar, dextrose.  It repairs the damaged structures that cause the pain rather than just masking it.  Prolotherapy is less invasive than surgery with a shorter recovery time.  In some cases, prolotherapy is more effective than surgery.

Will my insurance cover for prolotherapy?

No.

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Is prolotherapy evidence based medicine?

Absolutely yes!  Over the past decade there have been increasing numbers of Level I randomized controlled trials showing support for the use of prolotherapy for multiple conditions including osteoarthritis of the knee, rotator cuff injury, lateral epicondylitis (tennis elbow), osteoarthritis of the hands/fingers, plantar fasciitis, Achilles tendinopathy, Osgood Schlatter disease and many more.  Recent meta-analyses show efficacy and safety.