Prolotherapy (polo = proliferative) has been around officially since the 1950s, with variants of the technique pre-dating that.  With the primary component of the solution injected being dextrose (a form of sugar), the therapy was not a subject of extensive drug trials and lost favor to more eloquent or extensively studied drug approaches.  

In part due to its undeniable effectiveness, along with its high level of safety as an injected therapy, more recent research has helped proven its effectiveness, including Level I studies (the top tier and most conclusive from a research standpoint).  A landmark study proved undeniable effectiveness for knee arthritis, with several other smaller studies proving its use in other conditions, particularly those involving ligament damage or laxity.  Physicians that are well trained in prolotherapy can effectively treat most chronic joint conditions where ligament damage is present.   Prolotherapy can stimulate an immune response similar to PRP, but recent research also show dextrose has an effect on nerve pain, which interestingly also is directly involved with ligamentous injury. 


Conditions Treated

  • Arthritis

  • Chronic sprains, strains, tendonosis (Tennis elbow, plantar fasciitis, patellar tendonitis, achilles tendonitis, etc)

  • Rotator cuff injuries

  • Chronic shoulder subluxation

  • Ligament laxity and joint instability, including Ehlers-Danlos spectrum

  • Oshgood-Schlatters

  • Chronic pain from motor vehicle accidents, whiplash

  • Spine related pain (cervical, thoracic, lumbar, sacroiliac)

  • Chronic headaches

  • Rib, costovertebral pain

  • Read More


"You'll recall the last shoulder prolo treatment you gave me included breaking up that calcium deposit. Whether it worked or not I don't know but after about a week or so I started to have better mobility in the shoulder. I am back at a gym about five days a week doing core body exercises (and not abusing my shoulders or elbows.) The regular exercise has no doubt also helped.  Anyway, I'm now flying on my own and not thinking very much about my shoulders or elbows! Yippee!  THANKS A MILLION for your kindness and great prolo treatments and saving me from the scalpel!"

- D.P.  (tennis elbow, shoulder calcific tendinosis)



Q: I’ve heard prolotherapy involves multiple injections.  Is this true? +
A: In general, yes.  Often prolotherapy is used for joint injuries which involves ligament damage or laxity (weakness).  Since there are many ligaments around a joint, including the joint capsule itself, most if not all of the ligaments are treated to help get maximal stability.  When a joint is injured (sprain, rolled ankle, etc) it is virtually impossible to injure just a single ligament because of the stretch that occurs through the entire joint.
Q: Does the treatment hurt? +
A: A local anesthetic is used at the injection site to reduce needle/injection discomfort; this part is generally well tolerated. Prolo is meant to stimulate an immune response, which starts with inflammation (and is the reason for pain during any injury). Since prolo helps stimulate this response, there can be ranging degrees of increased soreness following treatment, on average for 2-3 days.
Q: Can I take pain medications following treatment? +
A: Tylenol is allowed for pain relief. Low dose opioid medications are occasionally prescribed for certain injections (typically only needed for 2-3 days following treatment). Anti-inflammatory (NSAIDs) and steroid medications are not allowed (rare exceptions) as these interfere with a normal inflammatory and healing response.
Q: How quickly does it work? When will I see results? +
A: This depends on the type of injury, location, and length of time since onset. As a general rule, it takes 2-3 months for the initial stages of regeneration and repair to occur. At this point patients typically see and feel results. Repair processes can continue for many months after injections. For osteoarthritis, pain reduction can actually occur much more quickly, within a couple weeks. Also, dextrose can help with certain types of nerve irritaion; injections may help reduce this type of pain much quicker.
Q: Do I have to avoid sports or my favorite activities? If so, for how long? +
A: Again, this varies depending on the condition. Prolo is usually better tolerated with quicker recovery than PRP, but time is still needed for healing. Typically major exercise is avoided for the first week after treatment, with return to normal activity levels over the 2nd week. Exceptions to this are discussed following the initial visit.
Q: What is actually in the injections? +
A: Baseline prolotherapy solutions include dextrose (a sugar), a small amount of anesthetic (usually lidocaine or procaine), and saline. Vitamin B12, testosterone, or other natural substances may be added depending on the condition or strength of response needed. Aside from the anesthetic, there are no other pharamceutical medications used.
Q: Does dextrose prolotherapy cause scarring? +
A: No. Prolotherapy with dextrose stimulates a regenerative response, with collagen production and strengthening/tightening of ligaments. This does not cause scarring. This should not be confused with sclerotherapy, another term often confused with prolo. Sclerotherapy involves injecting substances into damamged blood vessels, typically smaller veins, to irritate and destroy them.
Q: What are the contra-indications for Prolotherapy? +
A: Prolotherapy is generally very safe and well tolerated with most medications or other medical conditions. A full medical history is always reviewed prior to initiating treatment. Patients on immunosuppressive medications, active cancer, or infection around the site to be treated are contraindications to treatment.
Q: How does prolotherapy work? +
A: Prolotherapy works by causing a mild inflammatory response at the site of injury, with an injected substance, typically dextrose.  The inflammation results in a new healing response which helps to repair damaged tissues, such as ligaments and tendons. 

Click on the image below to watch a brief educational video. You can also read more about prolotherapy and links to studies in our RESOURCES section.



Schedule an appointment online with Dr. Minarik or Dr. Herman.


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Visit our Resources section for related articles and links to studies.