Prolotherapy

Prolotherapy is a series of injections used to relieve pain. A healthcare provider injects a small amount of an irritant into your body. Dextrose (sugar) solution is the most commonly injected irritant.

It’s usually an elective treatment. That means people choose to use it rather than needing it because their healthcare provider prescribed it.

Proponents believe prolotherapy can reduce pain caused by musculoskeletal conditions. These are issues that affect your bones, muscles and connective tissues. Prolotherapy is used to help manage:

• Arthritis
• Fibromyalgia
• Degenerative disk disease
• Tendinopathy
• Lower back pain

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.

Experts are still studying prolotherapy to find out if it’s an effective option to manage pain or treat any conditions. It might benefit some people in certain situations. But research has found inconclusive results. Some studies have found that prolotherapy can reduce pain. Others have found that any benefits are likely a placebo effect. That means it helps people because they think it will.

For now, prolotherapy isn’t a standard treatment for any disease, condition or symptom. It’s an alternative treatment. That means it’s not regulated by the U.S. Food and Drug Administration (FDA). If you choose to use it, make sure you receive it from a reputable clinic and provider.

Benefits/risks

Proponents of prolotherapy say it has several advantages, including:

• Pain reduction
• Very few side effects
• Can be used with other treatments

Talk to your healthcare provider before starting prolotherapy. They’ll tell you if any medications you take or other pain-management techniques you’re using could increase your risk of complications.

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

Prolotherapy’s biggest risks have more to do with whether or not it works, including:

• It may not help: Experts haven’t proven prolotherapy’s success rate in a scientifically significant way.
• Temporary results: Pain reduction after prolotherapy might only be temporary. Many studies that find it’s helpful don’t follow up with people after a few months. So, there’s no way to know how long improvement will last.
• Cost: Most insurance plans don’t cover prolotherapy treatments. You may have to pay the full cost out of pocket. You might have to pay hundreds of dollars per session.

How does prolotherapy work?

Providers who believe prolotherapy is effective 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. In theory, this triggers your immune system and natural healing response to rush to the area to “fix” the dextrose. The thinking here is that the injection therapy can “trick” your body into repairing damaged tissue that it wasn’t before.

But experts haven’t found scientifically significant proof that prolotherapy activates 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 tend to have a strong placebo response to needles and injections. If you see a provider put a needle into your body, your brain might picture a cure or getting better. This might make you feel better even if nothing in your body has changed.

What happens during prolotherapy?

A healthcare provider will inject the irritant solution near where you feel pain. It might be in a joint, tendon or ligament. Your provider might use an imaging tool like an ultrasound to guide the injections.

Usually, people get three to six injections over a few sessions. Your provider will tell you how many shots you’ll they recommend.

What is the recovery time after prolotherapy?

There’s little or no recovery time after an injection. You might be sore at the injection site, but you should be able to do all of your normal activities right away.

Talk to your healthcare 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 treatments if you need them.

When should I call my healthcare provider?

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

• New or worsening pain
• Swelling
• Skin discoloration or bruising
• Rashes or hives