Prolotherapy is a method of regrowing and strengthening ligaments and tendons by an injection technique which treats very common sources of chronic pain. Pain from auto accidents, athletic injuries and overuse injuries often arise from injury to the soft tissues in the body. These soft tissues, which include ligaments, muscles, tendons and joint capsules, are called connective tissues because they connect structures to bone, thereby supporting the skeleton. Prolotherapy causes these connections to be rebuilt and strengthened.

Prolotherapy, also called ligament reconstructive therapy, stimulated ligament repair, sclerotherpay, and non-surgical joint repair, can help or cure the following conditions:

  • Whiplash injury to the neck, upper back, shoulders and low back as a result of a car accident.
  • Headaches and TMJ pain often associated with car accidents.
  • Low back pain from lifting or work-related injuries.
  • Overuse injuries such as tennis elbow or shoulder tendonitis.
  • Muscle pain from fibromyalgia and other similar conditions.
  • Joint pain from arthritis.
  • Degenerative conditions of the spine.
  • Athletic injuries that have never healed.
  • Chronically weak and unstable shoulder, elbow, wrist, knee, and ankle joints from injury to supporting ligaments.

These soft tissue injuries can become chronically painful. These injured tendons and ligaments normally go through a repair and healing process taking from four to six weeks. As these tissues do not have a rich blood supply, they sometimes do not fully heal. Repeated injury only makes full recovery less likely. Anti-inflammatory drugs are often given to treat these injuries, but they may actually slow or stop this healing process.

Medications and other forms of passive treatment such as ultrasound, ice, heat, massage, acupuncture and manipulation may give minimal lasting benefits because the primary problem is not being addressed, namely the loose and injured ligaments. Stretching and strengthening exercises usually can provide some relief from chronic pain, but this is often only temporary. When these exercises have failed to increase the support sufficiently to diminish pain and improve function, a chronic pain cycle ensues. Prolotherapy will work on injuries regardless of their age. Very old injuries respond as readily to prolotherapy as more recent injuries, unless the problem has become more widespread over time as a result of repeated injury.

When rest and pain medications fail, other types of treatment become necessary.

Physical therapists often use muscle strengthening as the means to stabilize joints and reduce pain. However, it is primarily the ligaments that stabilize a joint. When they fail, strengthening muscles to do the ligaments’ job, though helpful, is not dealing with the cause of the problem.

Why not go to the cause of the problem, and strengthen the ligaments themselves? Most doctors are not aware that this can be done. Other types of treatment such as chiropractic care, massage therapy and acupuncture treatments may only give temporary relief.

Prolotherapy has been in use for since the 1930s and treatment results have often been amazing. As many as 85-90% of patients have received good to excellent results when assessing their pain relief and improved function. Just as importantly, pain medications can be greatly reduced or even eliminated. Prolotherapy often produces long-lasting relief, naturally. Most other types of treatment provide only temporary relief; prolotherapy can be an alternative to surgery in many cases. George Hackett M.D., a prolotherapy pioneer, proved that strengthening connective tissue relieves soft tissue pain. A research study in the respected medical journal, the Lancet, demonstrated the effectiveness of prolotherapy.

The healing that prolotherapy encourages seems to occur in stages over a six week period. Reevaluation of the injured site, after prolotherapy treatment, can confidently be made after 6 weeks.

Stage 1 (Inflammation): Increased blood flow, swelling and pain. Cells are called in to remove damaged tissue: this occurs during the first week.

Stage 2 (Fibroblastic Cells): The swelling and pain begin to subside with new blood vessels forming. Fibroblasts increase in number at the sites of injection and over the course of four to six weeks secrete a substance called collagen which is a very strong and relatively inelastic substance. The new collagen makes the ligaments thicker, denser and stronger, providing more support to the joints.

Stage 3 (Completed Healing): New blood vessels mature and tissue is stronger and pain subsides. Collagen density and diameter are increased. The strength of the injected ligaments can increase up to 40% above normal. Stability is increased as pain and muscle spasm decrease. The newly formed tissue continues to mature for one and one-half years.

So why don’t more people know about prolotherapy?

  1. Chronic pain is not well understood by most health care professionals and, therefore, is frustrating to treat. Thus the comment, “There is not much you can do about it… you just have to live with it”.
  2. Prolotherapy is not taught in medical schools, so doctors are unfamiliar with it.
  3. The technique of prolotherapy requires an in-depth knowledge of anatomy and the skill to place the injections accurately. It takes a great deal of study and training for a physician to become adept at the technique.
  4. The procedure takes up to one hour of clinic time, and most busy clinics cannot afford to take this amount of time for one patient.
  5. Many doctors and patients are looking for a “quick fix”, but prolotherapy results do not always occur overnight. Therefore the prolotherapy patient must be committed to the treatment because multiple sessions are often required.
  6. Pharmaceutical companies are not promoting it because there is no money in it for them. Prolotherapy solutions contain common and inexpensive substances. Drug companies cannot obtain exclusive manufacturing rights, so there is no investment potential and thus no profit to be made.
  7. Because there are very few doctors who perform prolotherapy, patients typically just accept the pain or have surgery. While surgery has its place, many patients and doctors are not aware that prolotherapy may relieve their pain and delay or prevent the surgery they thought they needed.
  8. Since prolotherapy is considered by most insurance companies to be “investigational” and “alternative” it is therefore not usually covered.

Prolotherapy is an effective treatment for a multitude of conditions. There is no other treatment that replaces prolotherapy for strengthening weakened ligaments and tendons. Healing occurs slowly but surely, and naturally. Multiple treatments are usually necessary to achieve maximum joint stability and long-lasting relief from pain. An Internet search should yield sites or associations which can direct you to doctors using prolotherapy in your area. One such site is GetProlo.


Prolotherapy can help with the following


Ehlers Danlos Syndrome

The following was posted on

“Amanda has Ehlers-Danlos Syndrome (EDS). This is a syndrome that can affect every joint and ligament in the body. People with EDS like Amanda’s are typically in a wheelchair by the early 20’s! Amanda had been a person in a wheelchair in the past, but she certainly was not when I first saw her. She had been receiving yearly Prolotherapy from Dr. Gustav Hemwall, and then started to see me when Dr. Hemwall retired. She received Prolotherapy to just about all of the joints of her body over a two day period. It really helped her. She was able to work part-time and have a much more enjoyable life that others with her condition.”



Prolotherapy is the treatment of choice for any weakened ligament or tendon and its associated pain. Prolotherapy successfully regrows tendons and ligaments and reduces or eliminates pain from tendonitis.


Heel Pain

Plantar fasciitis is one of the many ligament problems that respond well to prolotherapy treatments.



The scientific literature relevant to the use of prolotherapy for osteoarthritis, low back pain, and other musculoskeletal conditions was reviewed and critically analyzed to determine a clinical effect. Three randomized, controlled studies were found studying the use of dextrose/glycerine/phenol prolotherapy for chronic low back pain; however, they were inconclusive due to the lack of adequate controls, heterogeneity in patient diagnoses, and variations in solutions injected.

Two randomized, controlled studies were found that provide some evidence supporting the use of 10% dextrose prolotherapy for osteoarthritis. The sample size of the study (n = 13) involving osteoarthritic thumbs and fingers may have been too small to be strongly conclusive; however, it provides preliminary data to support future studies. Two studies involving osteoarthritic knees report an improvement in anterior cruciate ligament laxity; however, they did not have control groups for comparison. Only case reports were found supporting the pursuit of controlled clinical studies of prolotherapy for chronic neck pain. On the basis of the scarce body of literature critically reviewed to date, the clinical efficacy of prolotherapy in treating osteoarthritis, low back pain, and other musculoskeletal conditions remains inconclusive. [Am J Phys Med Rehabil. 2004 May;83(5):379-89.]

“For osteoarthritis of the peripheral joints, evidence showed that prolotherapy may have a role in the improvement of pain with joint movement and range limitation in osteoarthritic finger and knee joint.” [ Monday, 23 January 2012]



Prolotherapy, by strengthening the ligaments involved, provides definitive results in the relief of the chronic chest pain of costochondritis.



TMJ Problems

Prolotherapy regrows tendons and ligaments to strengthen and stabilize overly mobile joints such as the TMJ.




Joint Pain, General

Joint pain caused by or associated with ligament or tendon injury responds very well to Prolotherapy.


Carpal Tunnel Syndrome

If the diagnosis is incorrect, then surgery is less than likely to be successful.

“Unfortunately, many patients with elbow and hand pain have been misdiagnosed with Carpal Tunnel Syndrome. A typical Carpal Tunnel Syndrome patient will experience pain and numbness in the hand. Because most physicians do not know the referral pain patterns of ligaments, they do not realize that cervical vertebrae 4 and 5 and the annular ligament can refer pain to the thumb, index, and middle fingers. Ligament laxity can also cause numbness. Cervical and annular ligament laxity should always be evaluated prior to making a diagnosis of Carpal Tunnel Syndrome. Surgery for Carpal Tunnel Syndrome should not be done until an evaluation is performed by a physician who understands the referral problems of ligaments and is experienced in Prolotherapy.

Seldom do patients find relief from “Carpal Tunnel” complaints of pain in the hand and elbow with physical therapy and surgery because the diagnosis is wrong. The most common reason for pain in the elbow referring pain to the hand is weakness in the annular ligament, not from Carpal Tunnel Syndrome.

Several sessions of Prolotherapy will easily strengthen the annular ligament and relieve chronic elbow pain.” [Ross Hauser, MD]


Abdominal Hernia

Many people are subjected to hernia surgeries for groin pain, which has nothing to do with a hernia! Patients come to doctors who use prolotherapy after a hernia surgery failed to “cure” them of their groin pain. Remember, surgery generally does not cure injuries. To “cure” means that you are stimulating the body to repair the area. There is only one method to do this for a long-standing injury: Prolotherapy.

Most orthopedists do not routinely examine the pubic symphysis area because it means making the patients drop their drawers and palpating them in the groin area. The pubic symphysis is the front of the pelvis joint. It is connected together by a fibrocartilagenous disc, which is often injured. Injuries to this area are most often caused by slipping or falling, when the leg is suddenly pulled out from underneath. Swimmers who do the breast stroke are also vulnerable to injury in this area. Prolotherapy is extremely effective in strengthening the public symphysis and relieving chronic groin pain in this area. This is one of the most overlooked injuries and one of the most easily treated by Prolotherapy.



Prolotherapy treatments to strengthen the weakened ligaments can have potentially stabilizing and curative effects in scoliosis. If the scoliosis is progressing quickly, then bracing would be necessary in addition to Prolotherapy.


Low Back Pain / Problems

Low back pain is one of the easiest conditions to treat with prolotherapy. See Pain, Pain, Go Away, by William J. Faber, DO and Morton Walker, DPM – available in paperback.

Please see the link between Low Back Pain and Surgery. Avoiding surgery appears to be a very reasonable choice.


Vulvodynia / Vestibulitis

The iliolumbar ligament may be weakened and referring pain to the vulvar area. Prolotherapy can strengthen that ligament.


May do some good
Likely to help
Highly recommended



A single or series of injections that stimulates the body to regrow, tighten, and strengthen ligaments or tendons. It is unequaled for pain relief and restoration of normal function for any body joint where connective tissue is weak or has been damaged.


Usually Chronic illness: Illness extending over a long period of time.


Tempero-mandibular joint - hinge of the jaw.


(FMS): Originally named fibrositis, it is a mysteriously debilitating syndrome that attacks women more often than men. It is not physically damaging to the body in any way, but is characterized by the constant presence of widespread pain that often moves about the body. Fibromyalgia can be so severe that it is often incapacitating.


Inflammation of a joint, usually accompanied by pain, swelling, and stiffness, and resulting from infection, trauma, degenerative changes, metabolic disturbances, or other causes. It occurs in various forms, such as bacterial arthritis, osteoarthritis, or rheumatoid arthritis. Osteoarthritis, the most common form, is characterized by a gradual loss of cartilage and often an overgrowth of bone at the joints.


Reducing inflammation by acting on body mechanisms, without directly acting on the cause of inflammation, e.g., glucocorticoids, aspirin.


Any cell or corpuscle from which connective tissue is developed. Fibroblasts produce collagen and elastin.


The primary protein within white fibers of connective tissue and the organic substance found in tendons, ligaments, cartilage, skin, teeth and bone.


Involuntary contraction of one or more muscle groups.

Leave a Reply

This site uses Akismet to reduce spam. Learn how your comment data is processed.