prolo knee

What is prolotherapy?

Prolotherapy (proliferative therapy), also called regenerative injection therapy (RIT), ligament reconstruction therapy, and fibro-osseous injection therapy, is a recognized orthopedic procedure that stimulates the body’s nature healing processes to strengthen joints weakened by traumatic or over-use injury.

Joints weaken when ligaments or tendon attachments are stretched, torn, or fragmented, become hypermobile and painful. Traditional approaches with surgery and anti-inflammatory drugs often fail to stabilized the joint and relieve this pain permanently. Prolotherapy, with its unique ability to directly address the cause of the instability, can repair the weakened sites and produce new fibrous tissues, resulting in permanent stabilization of the joint. Prolotherapy can also be used to treat varicose veins, spider veins, hemorrhoids, other vascular abnormalities and other similar conditions.

How does Prolotherapy work?

With a precise injection of a mild irritant solution directly on the site of the torn or stretched ligament or tendon, prolotherapy creates a mild, controlled injury that stimulates the body’s natural healing mechanisms to lay down new tissue on the weakened area. The mild inflammatory response that is created by the injection encourages growth of new ligament or tendon fibers, resulting in a tightening of the weakened structure. Additional treatments repeat this process, allowing a gradual buildup of tissue to restore the original strength to the area. Injection of varicose veins and other similar abnormalities creates a mild inflammatory response causing them to contract so that they become smaller or even vanish.

What does Prolotherapy Treat?

This form of therapy can be used to treat dislocation of the joints, knee pain, shoulder pain, elbow pain, ankle pain, Temporal Mandibular Joint dysfunction, Carpal Tunnel Syndrome, and disc problems at any level of the spine. The therapy affects only the area treated and does not cause any problem in any other area. Spider veins, abnormal or bulging veins and other similar conditions can be treated on the legs, feet, hands, arms, breast, face, and most other areas.

Is there pain with the treatments?

Any pain involving an injection will vary according to the structure to be treated, the choice of solution, and the skill of the physician administering the injection. The treatment may result in mild swelling and stiffness. The mild discomfort passes fairly rapidly and can be reduced with pain relievers such as Tylenol. Anti-inflammatory drugs, such as aspirin and ibuprofen, should not be used for pain relief because their action suppresses the desired inflammatory process produced by the injection.

How often are the treatments given?

The treatments should be administered every one, two, or three weeks, as determined by the treating physician.
Start with 1-2/week, then can go to 1 per month to give your body some time to catch up. Vein treatments are usually scheduled four or more weeks apart.

What is the success rate of Prolotherapy?

The anticipated rate of success depends on a number of variables, including the patient’s history and ability to heal, and the type of solution used. In patients with low back pain with hypermobility, 85% to 95% (for pain management, unknown with rebuilding) of patients treated experience remission of pain with this form of therapy. In comparison, the Journal of Bone and Joint Therapy reports on a 52% improvement in patients treated surgically for disc involvement. Varicose veins can usually be 90% to 100% eliminated. Spider veins can usually be improved 70% to 90%.


  • According to the NIH, absolute contraindications to prolotherapy are few and include acute infections such ascellulitis, local abscess or septic arthritis. Relative contraindications include acute gouty arthritis, uncontrolled diabetes and acute fracture. (Prolotherapy in Primary Care, 2010)
  • Allergies to local anesthetics: Lidocaine, Procaine, Marcaine
  • Caution if you have a fear of needles

Side Effects:

  • Pain flares may occur at site of injection for up to 72 hours, but is self-limiting
  • Do not take anti-inflammatories at this time, let the healing cascade occur.
  • Regular activity may resume after pain flares dissipate.

Other Injection Therapies to Consider:

* Please ask the Naturopathic doctors for more information on these.

  • Trigger point
  • Dry needle
  • Neural therapy
  • Neural prolo
  • Prolozone
  • PRP

For more information and clinical research on prolotherapy and other injection therapies please visit:

Advanced Therapy for Management of Pain Syndromes. AOAPRM, 2013. American Osteopathic Association of Prolotherapy Regenerative Medicine.

Prolotherapy in Primary Care, 2010. David Rabago MD, Andrew Slattengren DO, Aleksandra Zgierska, MD, PhD. National Institute for Health.