Prolotherapy is an injection technique sometimes offered for certain persistent musculoskeletal pain problems. It most often uses a dextrose solution injected into or around selected tissues. Its exact mechanism is not established, and results cannot be predicted for each person. This page provides general information; it cannot determine whether the treatment is right for you.
What is prolotherapy?
The term generally refers to injections of an irritating solution, most often dextrose, into a painful area. The technique and targeted structures depend on the problem being assessed. A proposed explanation is that local irritation may stimulate a repair response, but this does not prove that an injection regenerates a tendon, ligament, or cartilage. The goal discussed in clinical practice is usually to try to improve symptoms and function, with no guaranteed result.
How does it differ from PRP or cortisone?
- Prolotherapy: most often uses a dextrose solution. It does not contain concentrated platelets.
- PRP: is prepared from a blood sample from the person, then processed to concentrate platelets. Its composition and evidence for effectiveness vary by preparation and condition.
- Cortisone: is a corticosteroid used to reduce inflammation and sometimes short-term symptoms in certain situations. Its indication, benefits, and risks depend on the site and diagnosis.
These injections are not interchangeable. Choosing a treatment, or deciding against an injection, depends on the assessment and the person's goals.
When might it be discussed?
A physician may discuss prolotherapy for some persistent musculoskeletal problems, such as certain pain associated with knee osteoarthritis or tendinopathy. This follows an assessment of the likely cause of pain and consideration of initial care, such as temporary activity modification, exercise or physiotherapy, and appropriate symptom relief options. An injection does not replace assessment of a significant recent injury or care needed for another cause of pain.
Suitability depends on factors such as the diagnosis, treatment site, care already tried, other health conditions, medications, individual risks, and the person's preferences. Some situations or medications may make an injection unsuitable. A consultation reviews these factors; it does not mean an injection will be recommended.
What does the evidence show?
Studies examine different conditions, solutions, techniques, and outcome measures. For knee osteoarthritis and some tendinopathies, some studies report improvements in symptoms or function, but results are inconsistent and certainty remains limited for many indications. Evidence does not show a reliable benefit for all pain problems or tissue regeneration. Comparisons between studies are difficult, and recommendations may differ by condition.
Improvement after an injection does not always show that the injected solution caused it: natural change over time, exercise, other care, and expectations may also contribute. Long-term effects are less certain than short-term effects. No treatment can promise healing or lasting pain relief.
What are the alternatives?
Options depend on the cause of pain and may include education about the problem, a suitable progression of activity and loading, exercise or physiotherapy, and medication when appropriate. Depending on the diagnosis, a physician may also discuss other injections, specialist assessment, or surgery. PRP and cortisone also have indications, limits, and risks that need individual review. Choosing non-injection care or no injection is reasonable.
What happens during an injection?
Before the procedure, the clinician confirms the problem being treated, explains the options and risks, reviews allergies and medications, and obtains your consent. The skin is cleaned and one or more injections are given at the selected site; ultrasound guidance may be used depending on the area and situation. An injection may cause pain or pressure. The technique, number of sites, and number of sessions, if any, vary; there is no universal schedule.
Tenderness, stiffness, or a temporary increase in pain may occur after treatment. The clinician will give instructions tailored to you about activity, local care, and a gradual return to effort. Recovery and symptom changes vary from person to person.
What are the risks?
Possible effects include temporary pain or swelling, bruising, bleeding, a vasovagal episode, or a local reaction. As with any injection, there is a risk of infection; injury to a nerve, blood vessel, or nearby structure is rare but possible depending on the site and technique. Other risks may depend on the product used and your health. Ask which warning signs should prompt medical attention. After an injection, fever, spreading redness, rapidly worsening pain, or new weakness or loss of sensation warrants prompt assessment.
Where can you get an assessment?
Prolotherapy is available at the Saint-Sauveur and Laval clinics, subject to assessment and an appropriate indication. See the sports medicine services page for more information about assessment options.
This page provides general information and does not replace a medical consultation, diagnosis, or personalized advice. The appropriateness of an injection, its possible benefits, risks, and alternatives should be discussed with a qualified healthcare professional familiar with your situation.