Prolotherapy

Is there any published research on prolotherapy in peer-reviewed medical journals?

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Absolutely. In fact, research on prolotherapy continues to be published despite this treatment being over half a century old. According to a paper published in October 2022 by the journal, Orthopedic Reviews, "Prolotherapy has been shown to be a safe option for improving pain, function, and quality of life as effectively as other treatment options." A study published in the Journal of Alternative and Complementary Medicine in April 2022 concluded that "dextrose prolotherapy may result in safe, significant, sustained improvement of knee pain, function, and stiffness scores".

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What are the alternatives to prolotherapy?

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Depending on the condition(s) being treated, more traditional medical alternatives to prolotherapy may include:

•  Non-steroidal anti-inflammatory medications (NSAIDs) such as ibuprofen, meloxicam, naproxen, or aspirin.

• Steroid injections

• Surgery

• Opioid medications such as hydrocodone, oxycodone.

• Muscle relaxants such as flexiril or tizanidine.

• Physical therapy

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Prolotherapy is just one of many alternative treatments we offer in an effort to relieve your pain without risky medications or surgery. If you're terrified of needles and injections aren't for you, consider osteopathic manipulation (also know as "OMT") to treat your pain or discomfort. OMT is a treatment modality where medications and needles aren't necessary. Learn more about OMT.

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How much does prolotherapy cost?

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The average cost of prolotherapy in the U.S. is around $250 - $1000 for each treatment. We offer prolotherapy injections for only $149 per treatment. Why do we charge so little? Because our goal is to provide you with the best care possible at a reasonable price. 

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The number of treatments will vary depending on the area to be treated and the severity. 

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Can prolotherapy be done at the same time with PRP/PRF injections?

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Yes! One of the awesome benefits of prolotherapy is its versatility. Platelet rich plasma and platelet rich fibrin can provide additional benefit when getting prolotherapy injections.

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How many injections are needed for a complete treatment?

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On average, prolotherapy injections are done once a month for 4 to 6 months. The number of prolotherapy injections depends on the area being treated as well as the severity of your condition. Some patients require few treatments while others may require more. Each individual responds differently, however 4-6 injections total is the average.

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Prolotherapy Injections for Knee Pain

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A randomized controlled trial on prolotherapy for knee pain was published in the Annals of Family Medicine in 2013.  The researchers studied the effectiveness of dextrose prolotherapy injections in the treatment of knee pain from osteoarthritis. The study compared prolotherapy injections with normal saline injections (the control group). Prolotherapy injections were found to improve knee pain, knee stiffness, and function compared to the control group. The study used the WOMAC score as its criteria, which is considered the standard by which clinically meaningful results for knee pain are measured.

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A retrospective study published in Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders in 2014 studied the use of prolotherapy injections to treat knee pain from chondromalacia patella (arthritis of the knee cap). The researchers concluded that prolotherapy injections should be considered the "first-line conservative therapy" for chondromalacia pattela. The patients receiving prolotherapy injections reported  improvement in stiffness, range of motion, knee pain, and activities of daily living. In this study, only 3 out of the 16 patients later had knee surgery. The remaining 13 of the 16 patients were able to avoid having knee surgery - that's more than 80%!

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A systematic review published in the British Medical Bulletin in 2017 determined that there was evidence that prolotherapy is safe and can significantly improve knee pain and other symptoms of knee osteoarthritis. They found that patient satisfaction for prolotherapy was around 82%!

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One of the benefits of prolotherapy is the mild ingredients that are used - dextrose, saline, and lidocaine. These ingredients have fewer side effects, if any, when compared to steroid injections like cortisone. 

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Prolotherapy Injections for Carpal Tunnel Syndrome

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Pain Management, in 2022, published the results of a randomized, controlled clinical trial comparing the effectiveness of prolotherapy injections with corticosteroid injections in the treatment of carpal tunnel syndrome. The study showed similar efficacy between the two treatments in regards to improvement of pain and other parameters. Essentially, the study determined that prolotherapy is just as effective as steroid injections for the treatment of carpal tunnel syndrome.

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A different randomized double-blinded clinical trial published in the Annals of Neurology in 2018 also compared corticosteroid injections with prolotherapy injections for the treatment of carpal tunnel syndrome. This study concluded that prolotherapy injections are actually superior to corticosteroid injections when used to treat carpal tunnel syndrome.

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There are several other studies on using prolotherapy injections to treat carpal tunnel syndrome. As with prolotherapy injections for knee pain, prolotherapy avoids the negative side effects that are caused by the injection of corticosteroids. 

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Prolotherapy Injections for Shoulder Pain

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A study published by the Orthopedic Journal of Sports Medicine in 2022 compared the use of prolotherapy injections to corticosteroid injections for shoulder pain caused by supraspinatus injury. The study found that steroids actually did more to improve the pain at 6 and 12 weeks, but actually produced more damage to the muscle as seen on ultrasound. It would have been interesting to see what the results would have been if the researchers administered more than one prolotherapy injection for these patients.

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A study published in Journal of Sport Rehabilitation in 2022 compared the use of prolotherapy with corticosteroid injections for shoulder pain caused by supraspinatus tear. This study revealed that the benefits of corticosteroid injections for the shoulder were better in the sort term, but the benefits went away with time. In contrast, the patients treated with prolotherapy injections had a longer lasting benefit. 

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Overall, the studies on prolotherapy injections for shoulder pain appear to focus primarily on rotator cuff injuries. However, the results indicate that steroids provide a short-lasting, temporary benefit while prolotherapy actually provides a gradual lasting improvement over time.

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