Prolotherapy is short for “proliferation therapy,” Proliferation, of course, means “rapid production.” What Prolotherapy is said to rapidly produce is collagen and cartilage. Collagen is a naturally occurring protein in the body that is a necessary element for the formation of new connective tissue that holds the skeletal infrastructure together. These include, tendons, ligaments, muscle fascia and joint capsular tissue.

Prolotherapy is given as an injection of a mild irritant, often dextrose (a simple sugar), into a specific area of the body that is arthritic, worn down, or injured. When the irritant is injected into the knee or other area, it causes the body’s immune system to stimulate the inflammatory process. While it may seem counterintuitive to create more inflammation, it is in fact inflammation that is part of the body’s natural healing response.

This burst of increased inflammation attracts fibroblasts (immature cells present in connective tissue) and chondrocytes (cells that produce cartilage) and brings them to the area of degeneration or injury.

These cells rebuild the collagen (more specifically, what is called the “collagen matrix” of the tissue) and enable it to strengthen and restore the body part in many cases to pre-injury status.

There is a long history of medical studies on the effectiveness of Prolotherapy for chronic musculoskeletal pain.
A February 2023 paper (1) wrote: “Prolotherapy is beneficial in a variety of different musculoskeletal conditions, including, but not limited to, lateral epicondylosis, rotator cuff tendinopathy, plantar fasciitis, Achilles tendinopathy, osteoarthritis, low back pain, sacroiliac joint pain, and TMJ laxity.”

A September 2022 paper (2) wrote: “(Knee Pain) and disability were significantly improved with prolotherapy and platelet rich plasma injections (PRP) compared with exercise therapy. Although PRP is more effective than prolotherapy in the first month after treatment, prolotherapy may be preferred due to its low cost, long-term efficacy, and low complication rates. . . ”

A September 2022 paper reported (3) that ultrasound-guided dextrose prolotherapy and corticosteroid injections had similar positive outcomes in alleviating pain in carpal tunnel syndrome. The benefit of using Prolotherapy is that dextrose would have less side-effects than the triamcinolone (steroid).