Prolotherapy

Prolotherapy is an injection treatment. Proponents claim it relieves pain by jumpstarting your body’s natural healing abilities. It's not FDA approved, and most studies have found no scientifically-provable benefits.

Overview

A prolotherapy treatment is injected into a knee.
A prolotherapy treatment is injected into a knee.

What is prolotherapy?

Prolotherapy is an injection treatment used to relieve pain. Your healthcare provider will inject a small amount of an irritant into your body. Dextrose (sugar) solution is the most commonly injected irritant.

Proponents of prolotherapy claim it relieves pain by jumpstarting your body’s natural healing abilities. Prolotherapy is used to help people that have musculoskeletal conditions (issues with your bones, muscles, tendons, ligaments and soft tissues).

Prolotherapy is an alternative treatment, which means it’s not regulated by the U.S. Food and Drug Administration (FDA). Experts have found that it can benefit some people in certain situations, but it’s still not universally accepted because research has found inconclusive results. Some studies have found that prolotherapy does reduce people’s pain. Others find that any benefits are likely a placebo effect, meaning it helps people because they believe it will.

If you choose to use prolotherapy, make sure you receive it from a reputable clinic and provider. It’s important that you talk to your healthcare provider before adding any new treatments to your pain-management routine.

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Who needs prolotherapy?

Technically, nobody needs prolotherapy, but you can choose to use it. It’s not a standard treatment for any disease, condition or symptom. Even as it’s studied more, experts are still debating whether or not it’s an effective option to manage pain, and which conditions it benefits more than others (if any).

Why is prolotherapy used?

Prolotherapy is used to treat pain. It’s usually an elective treatment, meaning people choose to receive it rather than needing it because their healthcare provider prescribed it.

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What is does prolotherapy treat?

Prolotherapy is used to reduce pain caused by musculoskeletal conditions. Proponents believe it can reduce people’s pain for any number of diseases or disorders that affect your bones, muscles and connective tissues. Prolotherapy is used to help people with the following conditions:

It’s important to remember that prolotherapy doesn’t cure any of these conditions. It shouldn’t take the place of any treatments or medications your healthcare provider prescribes you.

How common is prolotherapy?

Prolotherapy isn’t very common. It’s a relatively new technique — it was developed and first used in the 1950s. Prolotherapy is becoming more widely used, but experts are still conducting studies on its efficacy (whether or not it works).

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Procedure Details

How does prolotherapy work?

Providers who believe prolotherapy is an effective treatment use it to jump-start your body’s natural healing responses.

They believe injecting dextrose (or other irritants) into your body causes cells in that area to kick into high gear and heal you in ways they weren’t before. Your body responds to the dextrose in prolotherapy injections as a threat or injury, which — in theory — triggers your immune and healing responses to rush to the area to “fix” the dextrose and, in the process, repair your damaged tissue.

Experts haven’t found scientifically significant proof that prolotherapy turns on your body’s healing responses. Even studies that find some people’s pain got better after treatment haven’t been able to prove how prolotherapy injections caused the improvement — or even if they did anything to help at all.

People also tend to have a strong placebo response to needles and injections. This means if you see a provider put a needle into your body, your brain is likely to associate that injection with a cure or getting better, which can make you feel better just by thinking you will be.

What should I do before starting prolotherapy?

Talk to your healthcare provider before starting prolotherapy. They’ll tell you if any medications you’re on or other pain-management techniques you’re using could cause complications during or after prolotherapy injections.

What happens during prolotherapy?

During a prolotherapy session, your provider will inject dextrose (or another) solution into your joints, tendons or ligaments — wherever you’re feeling pain. Your provider might use an imaging tool like an ultrasound to guide the injections.

You will need several injection sessions. Usually, people receive a total of three to six injections over the course of all their prolotherapy sessions. How many injections you’ll need — and how often — depends on where in your body you’re receiving treatment and what your provider recommends.

What happens after prolotherapy?

Most of the time, prolotherapy doesn’t require any special follow up. Talk to your provider about any changes you notice in your pain or symptoms, especially if your pain gets worse.

Risks / Benefits

What are the advantages of prolotherapy?

Proponents of prolotherapy say it has several advantages including:

  • Pain reduction: Some people who’ve used prolotherapy report a noticeable reduction in their pain after their injections.
  • Very few side effects: Prolotherapy is a relatively low-risk treatment that usually doesn’t have any serious side effects.
  • Can be used with other treatments: You should also be able to use prolotherapy in addition to other treatments and techniques to manage your pain, but make sure to talk to your provider before starting it.

What are the risks or complications of prolotherapy?

Fortunately, prolotherapy has no serious side effects. You might experience some pain at your injection site, and bruising is rare. There’s a very low risk the injections damage nerves, joints or other tissue near the injection site, but prolotherapy isn’t riskier than any other injection. Make sure you receive prolotherapy from a certified healthcare provider to minimize your chances of complications

The risks most associated with prolotherapy have more to do with its effectiveness rather than physical harm to your body. These risks include:

  • Overall usefulness: Experts haven’t proven the success rate of prolotherapy in a scientifically significant way, and it might not reduce your pain at all.
  • Temporary results: The reduction in your pain after prolotherapy — if you have any — might only be temporary. Many of the studies that find it benefits people don’t follow up with them beyond a few months, so there’s no way to know how long your improvement will last.
  • Cost: Most insurance plans will not cover prolotherapy injections, which means you’ll have to pay the full cost out of pocket. The cost can vary, but you might have to pay hundreds of dollars per prolotherapy session.

Recovery and Outlook

What is the recovery time after prolotherapy?

Prolotherapy sessions have little to no recovery time. You should be able to resume all your usual activities right away. You might be a sore at your injection site, but you should be able to resume all your normal activities with no interruptions.

Talk to your provider before resuming intense physical activities like strenuous workouts or playing sports after an injection.

Your provider will give you a schedule for any additional prolotherapy injections if you need them.

When to Call the Doctor

When should I see my healthcare provider?

Talk to your provider right away if you notice any of the following:

  • New or worsening pain.
  • Swelling.
  • Discoloration.
  • Rashes or hives.

A note from Cleveland Clinic

Prolotherapy has shown some effectiveness, but experts are still unsure if it’s a legitimate treatment for pain. It’s important to know what it can and can’t do for you. It might relieve your pain, and it might do nothing. It’s your choice to receive prolotherapy, and you should feel empowered to choose how you manage your symptoms. Make sure you talk to your healthcare provider before starting any new treatments. They’re an important teammate in your decision-making process and will help you find the best ways to feel better.

Medically Reviewed

Last reviewed by a Cleveland Clinic medical professional on 02/14/2022.

Learn more about our editorial process.

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