Destiny Family Medical Clinic

Prolotherapy (Proliferative Therapy) is a treatment designed to repair weakened tendon and ligament structures in the body, which can be causes of intermittent or ongoing chronic musculoskeletal pain. Such structures can become weak as a result of trauma or a recurring abnormal stress, such as with poor posture or work-related repetition of movement. When these structures become weak, unable to support normal amounts of work or activity, the nerves that exist within the attachments of these structures become unduly stretched and over stimulated, leading very often to pain. Prolotherapy treatment attempts to more permanently strengthen the "weld" of weak and disabled tendons and ligaments to bone by stimulating the production of new fibrous tissue cells within the area of disability. Such stimulation then produces further healing of the impaired structures.

The procedure of Prolotherapy involves the injection of an irritant solution into the weakened areas of tendon and ligament structures at the point generally where they connect to bone. The solutions more commonly used consist of concentrated amounts of dextrose, mixed with an anesthetic such as Lidocaine and a filler such as sterile water or saline. Small amounts are injected into each spot where weakness is determined to exist.

Depending on the size of the area judged to contain the symptomatically weak structures, anywhere from a couple of injections up to twenty or more may be needed to cover the affected area sufficiently. There can be a mild to moderate amount of pain experienced with the injections, and it is therefore not uncommon to need to use pain and sedative medications just prior to the procedure, although many patients do well with no such additional medication, particularly if only a small area needs to be treated. After a treatment, the patient is given pain medication recommendations, because frequently there is an increased amount of pain for the first couple of days after a treatment, as the tissues experience the degree of irritation needed to obtain the preliminary "weld" repair of tendon/ligament structure to bone.

The maximum benefit of each treatment is essentially complete about four to six weeks after the injections, and it is for this reason that, if retreatment is needed, it generally can be done four to six weeks after the first treatment. On average, between four to six treatments are usually required to get best results. The cost of each treatment varies from $100 for a toe up to $350 for back or neck.

There are generally very few risks to undergoing Ligament & Tendon Injections. As with any injection, there is a rare risk of bleeding or infection or of injury to a nerve. If bleeding occurs, direct pressure for a few minutes is usually all that is needed. If infection occurs, antibiotic treatment may be required. If a nerve is injured, it usually heals over time, and pain medicine can be given as needed while such healing occurs. There have been a few rare reports of injection-related scarring of nerves (in spinal injections) which have caused permanent nerve pain, however one needs to be aware that such occurrences have been very rare, and likely even less common than what could happen with complications of back surgery. Other rare complications can include spinal headache, pneumothorax (collapse of the lung which may require hospitalization), allergic reaction, dizziness, nausea, dark skin spots, and other rare problems.

For more information on Prolotherapy, please call Destiny Clinic Prolotherapy at 605-339-3378, or go to