About Prolotherapy


A Medical Healing Technique for Joint Injury, Pain, and Dysfunction

Gary Clark, MD.

1. What is Prolotherapy

Prolotherapy is a curative treatment for chronic joint injury. The nonsurgical approach promotes the repair of injured ligaments and tendons by introducing a proliferative agent into the injured tissue, causing regeneration of the torn and stretched ligaments and tendons.

Prolotherapy is not a palliative, “Band-Aid” treatment that just simply masks musculoskeletal pain. Rather, it is a curative treatment that relieves pain and restores joint function with improved strength and range of motion.

Prolotherapy is appropriate for a wide range of musculoskeletal injuries and pain due to the ligament laxity (tearing and stretching) of general aging “wear and tear.” The physician can use Prolotherapy for the treatment of virtually any joint in the body, including:

  • Neck (e.g., whiplash injury)
  • Shoulder (e.g., dislocations and rotator cuff injuries)
  • Elbow (e.g., “golfer” and “tennis” elbow)
  • Wrist (e.g., fracture and sprain injuries)
  • Lower Back (e.g., occupational injuries)
  • Sacroiliac (e.g., sprain injuries)
  • Hip (e.g., anterior-posterior cruciate ligament injury)
  • Ankle and foot (e.g., fracture and sprain injuries)

2. What are Ligaments and Tendons?

Joint ligaments are dense, tough tissues that hold a joint together, causing the joint to function smoothly with stability. Muscle tendons are the dense, tough, tissues, that connect muscle to bones, causing the joint to move. Ligaments and tendons consist almost entirely of collagen.

Ligaments can sustain injury by accidental trauma (e.g., accidental falls, occupational injuries, sports injuries, and motor vehicle injuries), birth or delivery of babies, or by the long term war and tear of aging. Injured ligaments tend to be torn, stretched, and lax, causing the joint to be chronically painful and to move unsmoothly with instability and associated musculoskeletal pain. Muscle tendons can also sustain similar sprain injury, resulting in chronic pain and reduced range of joint motion.

3. How does Prolotherapy work?

Injured ligaments and tendons tend to heal incompletely because these tissues are poorly vascularized with inadequate blood supply and inadequate post-traumatic inflammation. Thus, the body lacks, the natural ability to build a large enough natural inflammatory response to cause the complete healing of these very dense, poorly vascularized connective tissues. Usually this incomplete healing of injured ligaments and tendons results in chronic joint pain and reduced joint function, i.e., reduced mobility and strength. These joint symptoms can last for years – indeed, for a lifetime – if not adequately treated.

Prolotherapy is a very simple office procedure, which creates an inflammatory response that causes healing of the injured ligament or tendon tissue. Prolotherapy-induced inflammation promotes the laying down of new collagen, which results in the restoration of brand new ligament and tendon tissues. This new collagen heals the tearing and stretching of torn tissues. Thus, Prolotherapy tightens lax ligaments and restores damaged tendons. Restoration of the injured ligament and tendon tissues relieves the chronic pain and restores joint mobility and function.

4. How is Prolotherapy performed?

The physician injects very small amounts of proliferative solution into the site of a ligament or tendon injury. The proliferative solution consists of dilute proportions of local anesthetic with varying amounts of specifically chosen additives, such as glucose and other inflammation producing agents.

5. Are there any significant adverse side effects to Prolotherapy?

The major side effect of Prolotherapy is post-injection discomfort immediately following the treatment. Since the treatment purposefully creates an inflammation reaction, it essentially is the same as recreating the injury. Thus, the patient may experience some discomfort of the treated area for the first 72 hours following injection. This discomfort is easily countered with appropriate analgesics.

1. Hauser, Ross A., Marion A Hauser, Prolo Your Pain Away.
Peachtree, CA: Frank W Cawood and Assoc. 2001

2. Ravin, Thomas H. et al, Principles of Prolotherapy. Denver 2008

Dr. Aaron Nickamin

Doctor of Acupunture & Oriental Medicine

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