Prolotherapy

Prolotherapy is a regenerative injection treatment used for certain chronic ligament, tendon, and joint pain problems. A small amount of dextrose-based solution is injected into painful or weakened connective tissue to stimulate a local healing response. It is not a numbing injection — the goal is to support stronger, more stable tissue over a series of treatments.

Prolotherapy may be considered for chronic ligament, tendon, and joint pain, including knee pain, low back pain, sacroiliac joint pain, shoulder pain, neck pain, hip pain, tennis elbow, and ankle instability. It may also help selected patients with mild to moderate osteoarthritis, particularly when pain is related to joint instability or poor tissue healing rather than advanced structural loss. Candidacy is determined after a proper history, exam, and imaging review.

The injected solution creates a controlled stimulus in the treated tissue, prompting increased local blood flow, cellular activity, and tissue repair signaling. Over a series of sessions spaced several weeks apart, the treated ligaments, tendons, or joint-supporting structures can become better organized and more stable — which is often what reduces pain and improves function over time.

No. Both are regenerative injection treatments, but they use different solutions. Prolotherapy uses a dextrose-based solution. PRP uses a concentrated sample of the patient's own platelets drawn from a blood sample taken that day. PRP is often selected for more significant tendon injuries, cartilage problems, or cases where a stronger biologic stimulus is appropriate. Dr. Borys will recommend the better option based on your specific diagnosis.

Most patients need a series of 3–6 sessions, spaced several weeks apart, though more chronic or complex problems may require a longer plan. Prolotherapy works gradually — some patients notice improvement within a few weeks, but meaningful change often develops over 6–12 weeks as the tissue response builds. Results are typically slower than a numbing injection, but may last longer when the underlying problem is being addressed.

A local anesthetic is typically used to numb the treatment area and improve comfort. Some pressure or discomfort may still be felt because prolotherapy targets sensitive ligaments, tendons, and joint-supporting tissues, but most patients tolerate the procedure well. Soreness, stiffness, or aching is common for several days afterward and is usually part of the expected healing response. Most patients can do light activity the same day, while strenuous exercise is limited for a short period.

For the first several days after treatment, strenuous exercise, heavy lifting, high-impact activity, and aggressive stretching are generally avoided. Anti-inflammatory medications such as ibuprofen or naproxen are also typically avoided around the time of treatment, as they may interfere with the healing response prolotherapy is intended to stimulate. Specific instructions are reviewed at your appointment.

Prolotherapy is generally considered safe when performed by a trained clinician using appropriate technique and ultrasound guidance. Common side effects include temporary soreness, stiffness, bruising, or swelling. It may not be appropriate for patients with active infection, uncontrolled inflammatory disease, certain bleeding disorders, or pain primarily caused by severe structural damage that warrants surgical evaluation. Candidacy is reviewed during your consultation.

Results vary depending on the condition, severity, tissue quality, and whether contributing factors such as movement patterns or loading habits are also addressed. Some patients experience long-lasting improvement, especially when treatment is combined with strengthening and rehabilitation. Prolotherapy does not prevent future injury or arthritis progression — the goal is durable improvement, not a guaranteed permanent cure.

Prolotherapy is generally a non-covered service and is paid out of pocket. The initial evaluation is a standard office visit that may be billed through insurance depending on your individual plan and coverage, and includes a thorough history and exam to understand what is driving your pain.

Dr. Borys offers prolotherapy in Bellingham, WA for selected ligament, tendon, and joint pain conditions. The initial visit helps determine whether prolotherapy is a good fit for your situation.