Prolotherapy, also known as Regenerative Injection Therapy,
is an injection technique used to treat chronic pain related to damage
to underlying ligament and/or tendon structures. It involves injecting
a small amount of a mixture of Novocain and dextrose (sugar), or other
similar solution, directly at the site of damage. The sugar stimulates
the body’s natural healing and repair processes.
behind prolotherapy dates as far back as the ancient Greeks, when
Hippocrates would treat athletes with unstable shoulders. He described
touching the tip of a slender hot metal rod to the damaged ligaments.
This "cauterized" the ligaments, causing them to tighten up. (It is
interesting to note that orthopedic surgeons have used a similar
technique surgically, involving lasers or heat probes, to tighten loose
shoulder ligaments.) Modern use of prolotherapy traces its roots to the
early 20th century when a surgeon from Ohio, George Hackett MD, started
treating patients with chronic low back pain by injecting the ligaments
around the low back. He demonstrated an 80-90% success rate.
sugar solution is an irritant (like getting lemon juice in a cut on
your finger), and it creates a local inflammatory reaction. This
reaction then stimulates or "jump starts" the body’s own natural repair
For more information, you may view and download our comprehensive Prolotherapy handout, Regenerative Injection Therapy.
pain from chronic ligament and tendon damage can be confusing, because
damaged structures can refer pain to other locations that do not seem
connected to the site of injury. Sprained ligaments in the neck, for
example, can refer symptoms down the arm and can even cause vague and
varied symptoms around the face. Damage to the sacroiliac ligaments of
the low back can cause pain patterns that look identical to herniated
Today, prolotherapy is used successfully to treat many different painful conditions, including:
- Joint instability, including the knee, shoulder, wrist, ankle, hip and other joints
- Chronic sports injuries
- Certain types of arthritis
- Chronic or recurrent tendinitis, such as Tennis elbow, partial rotator cuff tears, Achilles tendinitis or patellar tendinitis.
- Chronic or recurrent sprains & strains of the ligaments and tendons
- Whiplash injuries
- Chronic back pain
is designed to be a permanent fix, not simply a temporary procedure.
Approximately 80-90% of patients appropriately treated with
prolotherapy will experience benefit; some get 40-50% improvement,
while others may get 90-100% improvement. There is no way, however, to
predict how well someone will respond.
treatment usually takes between 3 and 6 treatments. Treatments are
given approximately once a month. If no signs of improvement are seen
after 3 treatments, treatment is usually discontinued. If there is
marked improvement after only 1-2 treatments, then no further
treatments may be necessary. There is no limit to the number of
treatments that may be given, as long as improvement continues to be
seen. There is also no increase in risk factors with subsequent
The effectiveness of prolotherapy treatment may
be enhanced by improving nutrition (including taking supplements such
glucosamine and MSM) and optimizing hormone balance.
is extremely safe, and while there are risks to any injection
procedure, the risks are minimal. At Valley Sports Physicians we have
never had any long-term adverse effects from prolotherapy treatments.
physicians at Valley Sports Physicians & Orthopedic Medicine have a
long and successful history of using prolotherapy. In fact, they often
give lectures and teach workshops to other physicians on prolotherapy, and Dr. Tortland is one of the first physicians in the country actually certified in Prolotherapy.
Please be aware that prolotherapy is NOT covered by most insurance plans.