Prolo / Dextrose Injection / Regenerative Injection Therapy
Prolotherapy involves injecting a mildly irritant solution (typically dextrose/glucose in varying concentrations) into and around damaged ligaments, tendons, or joints to trigger a controlled inflammatory response that stimulates the body's natural repair mechanisms, ultimately strengthening and tightening the injected tissue.
How it works
The dextrose solution creates a mild, localised inflammatory reaction by triggering osmotic disruption of local cells and activating inflammatory mediators (prostaglandins, cytokines). This initiates the healing cascade: fibroblast proliferation → collagen synthesis → tissue remodelling. The process mimics and amplifies the natural repair response, strengthening weakened or chronically injured connective tissue. Unlike steroid injections (which suppress inflammation), prolotherapy uses inflammation purposefully to drive healing.
Reported benefits
- Chronic joint pain (knee, hip, shoulder, ankle)
- Ligament laxity and instability
- Chronic tendinopathy (tendon pain)
- Lower back pain from SI joint or ligament instability
- Sports injuries that haven't healed conservatively
- Hypermobility syndrome symptoms
- Ankle instability
Regulatory status
Approved for: Musculoskeletal pain management under physician supervision
More widely accepted as a legitimate musculoskeletal treatment in Germany, Netherlands, and Nordic countries. Dextrose is an approved pharmaceutical solution; its use for prolotherapy is off-label. Included in some European pain medicine guidelines as an alternative to surgery for appropriate candidates.
Approved for: Musculoskeletal conditions under physician supervision
Not a licensed medicine for this specific indication but legally practiced by physicians as an off-label use of licensed dextrose solutions. Not available on NHS. Available at private sports medicine and pain management clinics. British Institute of Musculoskeletal Medicine (BIMM) supports its use.
Prolotherapy using dextrose solution is not specifically FDA-approved but exists in a legal grey area — dextrose is FDA-approved as an IV fluid; its use for proliferative injection is off-label. Practiced by physicians specialising in pain management, sports medicine, and physical and rehabilitative medicine (PM&R). Not covered by most US insurance; considered experimental by many insurers despite decades of use.
Practical details
Frequency: Series of 3–6 sessions, 2–4 weeks apart; additional series if needed
Results last: Temporary soreness 24–72 hours post-injection; improvement typically noted after 2–3 sessions
Contraindications:
- Active infection at injection site
- Allergy to corn (dextrose is corn-derived)
- Acute injury in initial inflammatory phase (wait for sub-acute phase)
- Cancer at or near injection site
- Blood clotting disorders
- Anti-inflammatory medications use (reduces treatment effectiveness)
Always consult a licensed medical professional before undergoing any treatment. This information is educational only and does not constitute medical advice.