Prolotherapy, also known as Regenerative Injection Technique (RIT), is a treatment that we offer where we administer dextrose (typically combined with lidocaine and saline) into your joints, ligaments and tendons at the sites of injury to stimulate collagen and connective tissue repair. This process promotes your body’s own ability to heal chronic injuries by initiating a controlled and localized inflammatory response.
After an injury is sustained, connective tissues such as cartilage, ligaments and tendons generally heal poorly due to their low blood supply. As a result, the patient is usually left with chronic pain, ligament laxity or joint instability due to incomplete healing.
Prolotherapy connects the dots by helping to complete your body’s healing process.
It is ideal for any musculoskeletal pain from injury or overuse, a subacute or chronic sports injury, or for a joint or connective tissue that has healed poorly after an accident or surgery.
Prolotherapy offers a permanent fix, and as a result, is an excellent alternative to surgery for ligament repair or joint replacement. At High Five, we are passionate about prolotherapy because it has minimal (if any) down time, and will help you get back on your feet doing the things you love.
A proper diagnosis is required by a qualified physician to determine whether prolotherapy is right for you.
Start this conversation by booking a Sports Medicine Initial Consultation.
Most patients require 3-6 treatments and treatments are usually administered every 2-6 weeks.
Some common conditions that are treated are:
- Acromioclavicular (AC) tear
- Adhesive capsulitis (frozen shoulder)
- Recurrent shoulder separation or dislocation
- Golfer’s and tennis elbow
- Temporomandibular joint (TMJ) pain and instability
- Low back/lumbar, hip and sacroiliac (SI) pain and instability
- ACL, PCL, MCL and LCL laxity or tear in the knee
- Medial meninscus tear, bucket handle tear in the knee
- Ankle sprain/ligament instability
- Plantar fasciitis
- Fallen arches
- Achilles tendon tear
- Pubic symphysis pain
- Hamstring or groin tear
Many teenagers and young adults suffer from sports-related injuries. If left untreated, not only can these injuries interfere with their athletic performance, they can also lead to chronic joint instability and early development of osteoarthritis.
Conditions in teens that are commonly treated with prolotherapy include:
- ACL tears
- MCL tears
- Medial meniscus tears
- Osgood Schlatter’s disease
- Fallen foot arches
- Achilles tendonitis or Achilles tendon tears
- Patellar tendinitis/Jumper’s Knee
- Rotator cuff tears
- AC (acromioclavicular) separation
A proper diagnosis is required by a qualified physician to determine whether prolotherapy is right for your teen.
Start this conversation by booking a Sports Medicine Initial Consultation.
Is Prolotherapy Right For You?
You may experience popping, grinding, aching or clicking within the joint, or a joint that catches or gives out. If your have swelling or fluid effusion around the joint, this may be a sign of instability leading to friction and chronic inflammation of the tissues. This instability can be treated with prolotherapy injections.
Some people who experience temporary relief from massage or chiropractic adjustments, yet it doesn’t last, or the adjustment doesn’t seem to hold, will benefit from prolotherapy treatment.
An easy way to assess whether your pain could be relieved by prolotherapy is if you experience cocktail party/theatre syndrome. This type of condition is described as a worsening of joint pain if you have been standing still for a long time (such as while mingling at a cocktail party). If you sit down, the pain lessens – however if you stay seated for too long (such as at a theatre), you become uncomfortable again and experience a worsening of the pain or aching.
The reason for this is that when you are standing, the muscles surrounding the unstable joints in your back or leg become tense in order to stabilize the joint by taking over the work for the weak ligaments. When you are seated, your muscles relax and the weak ligaments have to do the job of stabilizing the joint.
You may find that your aching is worse first thing in the morning, but improves with walking, movement and light exercise. Throughout the day, you may find that you are constantly changing your position to avoid pain. If however you exercise too hard, this will also precipitate pain, aching or throbbing in the joint, and tension in the surrounding tissues as your muscles tense up to guard the weak joints.
If you find that wearing a brace, tensor bandage, or supportive shoe helps your condition, this may also be a sign of joint instability that can be permanently treated with prolotherapy. The brace adds temporary extra support to a weak joint, while prolotherapy can initiate your body to heal the damaged tissues providing lasting stability.
Joints that have been injected with cortisone or treated surgically without positive and lasting results can also be treated with prolotherapy.
Frequently Asked Questions
Does prolotherapy hurt?
Because prolotherapy involves injections, it can be painful. Before the treatment begins, the area is frozen with superficial injections of anesthetic (lidocaine) to minimize the discomfort of the prolotherapy injections. Lidocaine is also included in the prolotherapy solution, so that a small amount of anesthetic is introduced to every tender spot that is injected. The freezing lasts approximately one-hour.
What if you have an allergy to one of the components in the prolotherapy solution?
Dextrose, a common ingredient used for prolotherapy is often derived from corn. Dextrose should not be used in patients with a corn allergy. Although allergic reaction to dextrose is rare, it is best to avoid use of dextrose in these cases. An alternative to dextrose is sodium morrhuate, however sodium morrhuate is derived from cod liver oil and cannot be used in patients with allergy to fish.
How long do the effects of prolotherapy last?
Prolotherapy is intended to be a lasting treatment in which the cartilage, ligaments and tendons are repaired permanently. If the joint is re-injured after it has been treated successfully with prolotherapy, further treatments may be required. Studies have shown increased proliferation of connective tissue within and surrounding the joint for up to three-months after the treatment, and once this healthy tissue is laid down, the effects are lasting.
Do I need to do special exercises for prolotherapy to work?
Exercises to strengthen the muscles around the joint may be helpful when recovering from an injury. Sometimes exercises, stretches or adjunctive treatments are recommended depending on the case, however these are not necessary for prolotherapy to work.
Are exercises and stretches necessary to maintain results from prolotherapy and lasting joint health?
Movement, strengthening and light stretching are all necessary for joint health. Exercise increases synovial fluid within the joint, keeping joint surfaces smooth and well-lubricated. Walking, swimming, jogging, yoga and qigong are activities that will keep joints functioning optimally late into life. Stay within your comfort zone to avoid injury, and don’t over-stretch as a strained ligament will not return to its original length without treatment.
Should I avoid any medications if I wish to be treated with prolotherapy?
Avoid all COX inhibitors / NSAIDs (non-steroidal anti-inflammatory drugs) as these drugs will interfere with the healing of connective tissue and may reduce the positive effects from the prolotherapy. Some common examples of such drugs are: Aspirin, ibuprofen, naproxen, celecoxib (Celebrex), and diclofenac (Arthrotec). Please also be aware that some drugs such as Midol contain NSAIDs. If you are experiencing pain, you may use Tylenol/acetaminophen.
How much down-time is there after each treatment?
Unlike a surgery, there is virtually no down-time after prolotherapy. You will likely experience some tenderness after the injections, which may last for 1-7 days on average. It is recommended that you keep to light exercise only for the first three days after a treatment.