Prolotherapy, short for proliferative therapy, is an injection-based treatment. A small amount of an irritant, with pain medication, is used to jumpstart your body’s natural healing abilities.

The regenerative process:

1. Solution is injected into the area where there is damage or pain
2. The injection induces an inflammatory response
3. The body’s healing mechanisms are stimulated
4. Over time there is growth of healthy tissue

Prolotherapy is used to relieve pain and promote healing in joints, ligaments, and tendons. The response is not guaranteed or consistent. Because we are harnessing the body’s repair and immune system, we usually choose a singular joint, ligament, or as many as 4 trigger points per session.

Comparing Prolotherapy, PRP, and Corticosteroid Injections

Prolotherapy, platelet-rich plasma (PRP), and corticosteroid injections are all used to treat muscle, tendon, and joint problems — but they work in different ways and have different long-term results.

• Prolotherapy uses a mild irritant (often dextrose) to stimulate the body’s natural repair response and strengthen tissues.
• PRP uses your own platelets to deliver growth factors that reduce inflammation and promote true healing.
• Corticosteroids calm inflammation quickly but don’t promote tissue repair, so their effects are temporary.

All three can be used for acute and chronic soft tissue injuries, tendinopathies, and osteoarthritis, but research shows clear differences over time.

Rotator cuff tendinopathy:
Both prolotherapy and PRP outperform steroids for long-term pain relief and improved function — especially beyond 24 weeks and at long-term follow-up.

Tennis elbow and plantar fasciitis:
Prolotherapy often provides better long-term outcomes and fewer side effects than steroids, performing as well as extracorporeal shockwave therapy (ESWT) in many studies.

Chronic soft tissue injuries:
Prolotherapy shows results comparable to PRP and corticosteroids for pain and function, with strong safety and good tolerance.

Knee osteoarthritis:
Prolotherapy improves pain and function compared to exercise alone and may outperform both hyaluronic acid and steroid injections. PRP, however, shows the most consistent and durable improvement — outperforming all other injection types at six months or longer. Current guidelines rank PRP highest for sustained results.

Safety:
Adverse event rates are low and similar among prolotherapy, PRP, and corticosteroid injections.

Bottom line:
For most conditions, PRP or prolotherapy offer longer-lasting healing and better long-term outcomes than corticosteroids, which are best reserved for short-term symptom relief. Prolotherapy, while more affordable, appears to be less effective than PRP but still harness the body’s innate ability to heal.

Before treatment

• Our nurse will schedule you after creating a chart and performing a phone interview. She will talk you through the process.
• Eat as healthy as possible for the week before your treatment.
• Hydrate extremely well.
• Avoid anti-inflammatory medications (NSAIDs such as naproxen, mobic, ibuprofen etc) and smoking for 48 hours. (Clarify if you have any questions about your supplements or medications).
• Wear comfortable clothes which allow easy access to the injury site, if possible.
• Do not arrive late to the procedure.

The procedure and Treatment

• Vitals and exam
• Injection of the prolotherapy + anesthetic into the targeted area(s).
• Procedure takes <30 minutes.

Immediately after & early recovery

• Eat as healthy as possible for the week following the procedure. Limit alcohol and avoid smoking.
• You should feel better immediately. Though, we are initiating healing and work within the body, mild soreness, swelling, warmth or stiffness in the treatment area are uncommon but possible.
• Usually no downtime – but avoid strenuous activity for at least 1 day (or as I advise based on your individual case).

Weeks to months ahead

• Full benefit for tissue repair may take 3-6 months or more, particularly for tendon/ligament or more chronic injuries.
• Aftercare usually includes fascial release, lymph therapy, physical therapy, guided strengthening, and other individualized rehab protocol. I will help with referrals or recommendations, as needed.
• Avoid NSAIDs (which may interfere with healing) and other anti-inflammatories such as Alpha lipoic acid, Ginger, Turmeric, Boswellia, Pycnogenol, Omegas, Low Dose Naltrexone (LDN). Though hormone support is anti-inflammatory if dosed correctly we want you to continue this medication (pregnenolone, DHEA, estrogen, cortisol, testosterone, progesterone) per your provider.