What Is Prolotherapy?

In a new study from July 2016, Ross Hauser, MD et al. published findings that summarized the benefits of Prolotherapy.

Prolotherapy is a “new” old treatments that has been utilized in clinical practices for over 80 years. Standardized and reviewed in clinical application by Dr. George Hackett in the 1950s, prolotherapy has been shown to be an effective treatment in patients who suffer from joint instability due to ligament damage and overuse and related musculoskeletal and osteoarthritis.

Prolotherapy’s popularity as a treatment for chronic pain has intensified over the past two decades among both physicians and patients as clinical and anecdotal observations has proved in many cases its reliance as a non-surgical option for joint and back pain.

Prolotherapy is a nonsurgical regenerative injection technique that introduces small amounts of an irritant solution to the site of painful and degenerated tendon insertions (entheses), joints, ligaments, and in adjacent joint spaces during several treatment sessions to promote growth of normal cells and tissues.

Irritant solutions most often contain dextrose (d-glucose), a natural form of glucose normally found in the body, but may also contain combinations of polidocanol, manganese, zinc, human growth hormone, pumice, ozone, glycerin, or phenol.

In severe cases, autologous cellular solutions may also be needed, such as platelet-rich plasma (PRP), bone marrow, or adipose tissue.

For the patient, the goal of prolotherapy in chronic musculoskeletal pain and instability is the stimulation of body’s natural healing and regenerative processes in the joint that will facilitate the repair and regrowth of connective tissue, ligaments, tendons for tensile strength, and cartilage and other joint stabilizing structures such as labral tissue.

Prolotherapy works by exactly the same process that the human body naturally uses to stimulate the body’s healing system, a process called inflammation. The technique involves the injection of a proliferant (a mild irritant solution) that causes an inflammatory response which “turns on” the healing process. The growth of new ligament and tendon tissue is then stimulated. The ligaments and tendons produced after Prolotherapy appear much the same as normal tissues, except that they are thicker, stronger, and contain fibers of varying thickness, testifying to the new and ongoing creation of tissue. The ligament and tendon tissue which forms as a result of Prolotherapy is thicker and stronger than normal tissue, up to 40% stronger in some cases!

Comprehensive Prolotherapy Research and Clinical Studies Published in the Journal of Prolotherapy


Knee Pain


Clinical Outcome of Bone Marrow Concentrate in Knee Osteoarthritis

This study evaluated the clinical effectiveness of bone marrow concentrate with autologous lipoaspirate as a treatment option for osteoarthritis of the knee.

A Retrospective Study on Dextrose Prolotherapy for Unresolved Knee Pain

In this study, the Hackett-Hemwall technique of dextrose Prolotherapy used on patients who had a duration of five years of unresolved knee pain was shown in this observational study to improve their quality of life. They reported less pain, stiffness, disability, depressed and anxious thoughts, medication and other pain therapy usage, as well as improved walking ability, range of motion, ability to work and activities of daily living.

Standard Clinical X-ray Studies Document Cartilage Regeneration in Five Degenerated Knees After Prolotherapy

Prolotherapy improved the pain and function in five knees with osteoarthritis. All five degenerated knees showed evidence of articular cartilage regeneration in their standard weight-bearing X-rays after Prolotherapy.


Hip Pain


A Retrospective Study on Hackett-Hemwall Dextrose Prolotherapy for Chronic Hip Pain at an Outpatient Charity Clinic in Rural Illinois

The Hackett-Hemwall technique of dextrose Prolotherapy used on patients who presented with over five years of unresolved hip pain were shown in this retrospective pilot study to improve their quality of life even 19 months subsequent from their last Prolotherapy session. The 61 patients with 94 hips treated reported significantly less pain, stiffness, crunching sensation, disability, depressed and anxious thoughts, medication and other pain therapy usage, as well as improved walking ability, range of motion, sleep, exercise ability, and activities of daily living.


Treatment of Trigeminal Neuralgia Utilizing Neural Prolotherapy: A Case Report

We report a case of trigeminal neuralgia successfully treated with neural prolotherapy. The patient is a 70-year-old man with a 15-year history of trigeminal neuralgia refractory to pharmacologic treatment. After one treatment of neural prolotherapy the patient reported 5 months of complete resolution of his symptoms.


Upper Cervical Instability of Traumatic Origin Treated with Dextrose Prolotherapy: A Case Report

A 47-year-old female with a history of trauma presented to our clinic in 2013 with headaches, chronic pain in the neck and upper limbs, and intermittent tingling in one arm. Pain was exacerbated by head movement.