About Prolotherapy
Prolotherapy works by creating a brief, controlled irritation where tissue is weak or painful. That irritation draws in the body's normal healing response, which may strengthen and calm the tissue over time. The most common solution is dextrose, a simple sugar, often mixed with a numbing medicine.
We use prolotherapy for chronic ligament pain, such as around the sacroiliac joint, knee, or ankle, and for some tendon and joint problems. It is sometimes a good first step before PRP, or an option when a person prefers a simpler injection. The evidence is mixed and strongest for certain conditions, which we discuss openly.
Dr. Gruner and Dr. Chen place prolotherapy injections under ultrasound so the solution reaches the ligament or tendon attachment that is actually painful. Treatment is paired with rehab to build strength and control around the area.
What happens during treatment
- 1.
Your physician examines you and uses ultrasound to locate the specific ligaments or tendon attachments causing pain.
- 2.
The skin is cleaned, and the solution is prepared, usually dextrose with a local anesthetic.
- 3.
Under ultrasound guidance, your physician places small amounts of the solution at the targeted areas.
- 4.
You go home the same day, and injections are typically repeated every few weeks for a short series.
Who may be a good candidate
- People with chronic ligament or tendon pain that has not improved with rehab.
- People with a sense of looseness or instability around a joint, such as the ankle or sacroiliac joint, without a complete ligament tear.
- Patients who want a simpler injection option before considering PRP.
- People who can commit to a series of visits and a rehab program.
Recovery
Soreness and stiffness for a few days after each session are common and expected. Most people return to normal daily activity right away and continue rehab with a short break from hard training. Improvement, when it occurs, tends to be gradual across the series of injections.
Risks and limits
Post-injection soreness is the most common side effect. Less common risks include infection, bleeding or bruising, and nerve irritation, and rarely a flare of pain that lasts longer than expected. We may ask you to avoid anti-inflammatory medicines around each session. Prolotherapy does not repair a complete ligament or tendon tear, and the research supporting it is limited for some uses. It is not appropriate with an active infection in the area.
What to expect at your visit
- 1.
We listen first
Your visit opens with a real conversation: how the problem started, what you have already tried, and the activity you want back.
- 2.
Exam and in-office ultrasound
A hands-on exam, then ultrasound at the exam table, often while you move, so your physician can see the tendon, joint, or nerve involved.
- 3.
A clear diagnosis and plan
You leave knowing what is wrong and what your options are, from strength-based rehab to procedures, and why we recommend each one.
- 4.
Treatment and follow-through
Most procedures happen here in the office. We coordinate with your physical therapist and check progress against the goals you set.
Questions about Prolotherapy
- What is in a prolotherapy injection?
- The most common solution is dextrose, a simple sugar, mixed with a local numbing medicine. It does not contain steroid. The sugar solution causes a mild, brief irritation that prompts a healing response.
- How many prolotherapy sessions will I need?
- Prolotherapy is usually given as a short series, often several sessions a few weeks apart. The number depends on the area treated and how you respond. We reassess along the way instead of committing to a fixed number.
- Is prolotherapy the same as PRP?
- No. Prolotherapy uses a dextrose solution to create a mild irritation, while PRP uses a concentrate of your own platelets. Both aim to prompt the body's repair response, and your physician can explain which fits your condition better.