Prolotherapy

Prolotherapy is the injection of an irritant solution, most commonly hypertonic dextrose, into painful tendon and ligament attachments or into a joint, intended to provoke a local healing response.

The name comes from proliferant, reflecting the original idea that the injection stimulates new collagen. It has been used for decades in sport and exercise medicine (SEM) for tendinopathy, ligament laxity, osteoarthritis (OA) and low back pain.

Dextrose is inexpensive and generally well tolerated in small studies, but the evidence for benefit is limited and inconsistent, and it has never become standard treatment. This page covers what is injected and why, what the evidence shows for each condition, and how to counsel a patient who asks for it.