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Prolotherapy: Treatment, Cost and Side Effects

Last Updated: Mar 25, 2024

What is Prolotherapy ?

Prolotherapy which is also referred as proliferation therapy is an injection-based treatment used in chronic musculoskeletal conditions. It is conisdered to be an alternative medicine practice. It is a procedure where a natural irritant or anesthetics is injected into the soft tissue of an injured joint, ligament or tendons to be repaired. The supporters of this treatment believe that it may provide significant relief for joint or back pain. It is very important to understand that the purpose of the treatment is to strengthen the weakened area or tissues and not to decrease the pain.

Prolotherapy is not a surgical treatment. Because of this it is also known as regenerative joint injection or non-surgical ligament. This treatment is mainly used by doctors to treat injured joints and ligaments. While it is most commonly used for the back, but it can also be used in the body parts like knees, hips, shoulder, other joints and ligaments. In patients with chronic conditions such as degenerative disc disease or arthritis, the prolotherapy treatment can be used. Though, this treatment is in practice since 1900 but its effectiveness is still questioned. But many of the medical practitioners believe it to be an effective alternative treatment.

Most commonly, hyperosmolar dextrose is the solution used. The injection is administered at joints or at tendons where they connect to bone. This therapy treatment is generally given every two to six weeks for several months in a sequence ranging from 3 to 7 treatments. Many patients receive treatment at less frequent intervals until treatments are rarely required, if at all. Hence this kind of treatment for the ligament or bone repairs and pain can be considered as an alternative treatment. Mostly beneficial for joint or back pain and also be beneficial for the arthritis patients to get relief from pain. Glycerin, lidocaine, phenol, sodium morrhuate are additional agents which are used commonly.

How is the treatment done?

Before starting the treatment doctors will assess a person with joint/ back pain to analyze whether he/she is the right candidate for the treatment because not every person will be suitable for this treatment. So to start with the assessment doctors will examine X-rays or other imaging results. By analyzing the report the doctor may conclude if the therapy is suitable for the location or the severity of injury and if doctor find it suitable then they may recommend you for the therapy.

On the day of the therapy the patient should have enough food. More often doctors recommend that the patient should have the protein rich meal before undergoing to prolotherapy. The therapy starts with the sterilization of the skin area where the syringe is to be injected. Either alcohol or sterilizing solution is used to rub the skin area. Then numbing cream is applied on the skin to avoid any discomfort while injecting the solution. In some patients if they are experiencing extreme pain or discomfort then additional sedation may be applied. Then doctor inject the irritant through long, thin needle to several body parts. The number of injections is depending upon the area or joint affected.

This procedure increases the number of fibroblasts, which synthesize collagen. The making of new collagen facilitates tissue repair, which allows for strengthen and restored joints and ultimately gives the patient more significant or permanent pain relief.

Who is eligible for the treatment?(When is the treatment done ?)

The eligibility for the treatment for the disease can be best diagnosed by the specialist doctor. It is therefore advised that the patient consults the doctor before undergoing any specific treatment. Doctors on examining the conditions shall decide the eligibility for the treatment. Before undergoing this treatment doctor first do a thorough analysis of the patient and check the suitability of the treatment for the patient. The eligibility includes some below point which can lead to prolotherapy.

  • Patient is having trouble of sleeping on his shoulder or uncomfortable of any movement of the shoulder because of the severe pain
  • Ligament tear or tendon sprains have been diagnosed
  • Any joint dis-location
  • Arthritis
  • Back-pain
  • If someone is having sever pain in joints
  • If any activity is uncomfortable due to joint pain
  • Sports injuries
  • Post-surgical back or neck pain So considering above points and the thorough examination of your pain doctor may advice you for the prolotherapy.

Who is not eligible for the treatment?

A person, who has minor symptoms and pain of joint and if it can be cured by medication then that person is not eligible for prolotherapy. If a person is taking anti-inflammatory medication then he should stop the medication for the prolotherapy or else he will not be eligible for the treatment. A person who hasn’t taken any proper consultation and thorough check-up cannot ahead for the treatment. Kids under age 15 years are not recommended to undergo this treatment.

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Are there any Side Effects?

Prolotherapy has some reported side-effects such as, fever and pain which can be treated with some antibiotics. The cases of any serious side-effects are very rare. Temporary swelling or pain can be experienced at the area where the therapy injection is injected.

The rare serious side-effects are risk of infection or nerve injury, sometimes collapsed lung when it is injected over the ribs or the chest. But these are very rare side effects and can be overcome through careful techniques.

What are the post-treatment guidelines?

Patients are advised to rest on that day after the treatment. Many people may go to their regular work immediately after the treatment but it is not advisable. Patients with smoking habits are advised to quit smoking for the best results of the treatment. Patient should avoid any inflammatory medicines during and for some days post treatment.

How long does it take to recover?

According to current research the patients undergoing prolotherapy witnessed high rate of success. However the research group was limited and the amount of research is considerable. The study included 90 participants but still the result of this small study has shown the success for prolotherapy. It is not a one-time treatment, it may continue as per the response from the patients but generally the injection series ranges from 3 to 7 seating which may take several months. There is no any particular care that one has to take post treatment but should take some rest on the day of the treatment is recommended.

What is the price of the treatment in India?

The price varies as per the medical organization or private consultant. Generally the charges are taken per seating or per injection. It also includes the consultation and diagnosis charges. General the collaborated charges start from ten thousand and may vary as per the treatment. It is also depend upon for which body part the treatment is carried out.

Are the results of the treatment permanent?

The results of the prolotherapy is said to be permanent. The pain, discomfort and stretched joint, ligament or tendon are directly addressed with the cause of instability and can be repaired with the prolotherapy. The therapy directly works on the root cause and repairs the weakened site and produce new fibrous tissues that results into permanent stabilization of the joint.

What are the alternatives to the treatment?

Alternatives are always there and same is in the case of prolotherapy. To get rid of the pain related to joint or ligament doctors also recommend knee brace to stabilize the knee joint and protect it from further injury. You can take anti-inflammatory painkillers. Take a regular exercise by consulting a physician. Avoid sudden movements. Other authorized treatments can be known from the medical experts.

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Content Details
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Written ByDr. Chirag Dalal MS - OrthopaedicsOrthopaedics
Reviewed By
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Reviewed ByDr. Bhupindera Jaswant SinghMD - Consultant PhysicianGeneral Physician
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