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The human body, as complicated and fascinating it is, consists of numerous tissues, ligaments, tendons, veins, arteries that work together and support the functioning of the body. Due to an increase in physical activity and stressful everyday situations, sometimes the ligaments that join the different bones together weaken, which results in causing pain to the back, knees, hips, shoulders and other joints. There has been extensive research as to how any kind of joint pain should be treated but majority of those treatments are surgical. Patients, on the other hand, prefer treatments that do not include surgery due to recovery time and other factors. Therefore, a non-surgical method for treating joint pain and tissue stiffness has been brought to practice in the field of medicine and is known as Prolotherapy or Proliferation Therapy.



Prolotherapy is defined as a non-surgical treatment that helps in repairing ligaments that are damaged as a result of injured joints. It is also referred to as proliferation therapy or regenerative injection therapy.

The procedure of prolotherapy has been in practice since very long but the methodologies used to differ in old times. With an advance in the field of medical sciences, prolotherapy has also progressed and various treatments are now used for treating conditions related to joint pain and injury.

How Prolotherapy is Carried Out?

In prolotherapy, a solution containing natural substances combined with other elements is injected directly into the injury site or affected area of the body. It helps to strengthen and repair torn tissues and ligaments that cause joint pain in hips, knees, neck, back, shoulders and other joints.

The Duration of a Prolotherapy Treatment

In order to be effective, the prolotherapy treatment procedure usually requires several shots at the site of the injury. In a single session, 4 to 15 shots are expected whereas the number of sessions can vary from 3 to 6 months.

The duration of a prolotherapy treatment also depends on the specific condition or area of the body that is to be treated. In addition to that, the patient’s overall condition and the protocol of the physician are also contributing factors. However, the usual time duration remains the same, varying from 3 to 6 months, each session in between the interval of 3-6 weeks.


Although prolotherapy is a relatively new procedure of treating injured joints, the therapy now includes the following types:

Dextrose Prolotherapy – The original and foremost form of prolotherapy was introduced back in the 1930s. In this type of prolotherapy, natural substances such as concentrated dextrose or saline are injected into the body as irritants, tricking the body to begin healing.

The affected area is injected so that a temporary inflammation is caused at the site, stimulating ligaments and connective tissues to strengthen and repair.

Platelet Rich Plasma Prolotherapy (also known as PRP) – PRP is another method of injection that is designed to stimulate healing. In this type of prolotherapy, patient’s blood is drawn to first separate platelets, blood and plasma.

Secondly, various substances are added to increase the concentration of platelets in the blood. After the desired concentration is achieved, the substance is injected into the injury site as in dextrose prolotherapy, signaling the body to start healing.

Platelet Rich Plasma Prolotherapy is quite the same as dextrose prolotherapy in its methodology. However, the substances used in both therapies vary from each other, depending on the demand of the treatment.

Biocellular Prolotherapy – In this type of prolotherapy, rather than taking external stimulants, the practitioners extract repair cells from within the body (bone marrow or fat tissue) and injected into the injury site.

As for dextrose or PRP prolotherapy, the body has enough local repair cells and the treatments focus on healing only. Whereas, the Biocellular prolotherapy is required when body’s local repair cells have depleted and good repair cells are needed to carry out the healing process.


The procedure of prolotherapy is employed to treat conditions like back pain, neck pain, knee pain, ankle pain, wrist pain, hip pain, elbow pain, muscular tears, ligament, tendon or joint pain.

It also treats osteoarthritis, tendonitis, plantar fasciitis, golfers and tennis elbow, foot and toe pain. All in all, the issues related to joints and degenerative tissues, ligaments and tendons can efficiently be treated through different types of prolotherapy. 

Some other areas/problems that prolotherapy seeks to treat are degenerative disc disease, rotator cuff tears, hypermobility, osteitis pubis, temporomandibular joint syndrome (TMJ) and sacroiliac joint instability or dysfunction.

The nature and duration of every prolotherapy treatment depends on the condition and  area of the body that needs to be treated, and physicians respectively decide which prolotherapy treatment needs to be given according to the problem.


While a surgery would require anesthesia as well as relatively elongated recovery time, prolotherapy is beneficial when it comes to these concerns. A prolotherapy session does not require general anesthesia and the recovery period is also much shorter than that of surgery.

Apart from that, a prolotherapy treatment is less painful as it only causes slight inflammation to the area or site of the injury that is treated. Prolotherapy is regarded as safe and an all-natural treatment that relies on the body to repair itself and alleviate pain.

While surgical options, pain reliever and other medications only provide temporary relief, prolotherapy is a permanent treatment that is designed to repair joints, strengthen them and improved their overall stability, along with reducing the pain.


So far, prolotherapy as a treatment has not been researched extensively therefore, so many of the possible side effects have not been discovered yet. 

However, according to the existing research and experimentation in the domain, a prolotherapy treatment could cause infection at the site of an injection. Some other side effects include fever, swelling and pain due to the infection. 

Apart from the above-mentioned side effects in light of the research that has been conducted so far, prolotherapy is generally regarded as a safe treatment with high success rate.


Prolotherapy is regarded as a safe procedure of treating joint pain and injuries. However, just like any other injection procedure, it also carries the risk of infection. In order to minimize that risk, the first and foremost precaution that needs to be taken is to follow appropriate procedure of infection control.

To avoid any inconvenience or mis happening during the treatment, it is advised that each patient must be evaluated thoroughly. A patient’s medical history, an overall physical exam and X-ray or ultrasound exam as some of the prerequisites that need to be followed.

By doing so, the physician can ascertain the type of treatment that is to be provided according to the specific needs of the patient. Not only that, an early examination could help in eliminating the risks that are likely to be involved in case of patients with previous medical history or any disease that may hinder the treatment process.


The success of a prolotherapy treatment depends on various factors including:

  1. History of the condition under treatment
  2. Patient’s overall health
  3. Deficiencies in the body that may impede the healing process

These are some of the factors that the physicians keep in consideration while preparing to proceed with prolotherapy.

The overall success rates, according to the available research are up to 85% to 95% in most patients. However, it is important to mention here that the research conducted so far is not substantial, as the participants of the studies conducted were quite few in number.

One of the studies consisted of 13 participants, another tested 38 participants and one study used 90 participants, which is not a sufficient number to base any judgement upon.

Nevertheless, the results based on whatever little amount of research that has been carried out so far, show that prolotherapy is indeed an effective procedure of treating joint pain and injuries. 

The success of a treatment also depends on the skill of the physician and how an individual responds to the treatment. So far, the recorded results have turned out satisfactory. However, the need for more research into the treatment remains justified.


Prolotherapy is an expensive mode of treatment, which can cost from $250-$1000, depending on the clinic where it is treated as well as the part of the body that is treated. The expenses of medicines and other facilities may vary.

Health insurance does not usually cover prolotherapy and an individual has to pay for their own expenses, which makes it an option that is to be thoughtfully considered.


Prolotherapy is still under development as a therapy for treating conditions related to joint dysfunction anywhere in the body.

The therapy is regarded as safe and permanent according to the research that has been conducted so far, and physicians believe that this form of treatment will keep expanding and will evolve for the better.

However, prolotherapy is heavy on the pocket and not everyone can afford it, which makes it a far-fetched option for the majority. 


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