What is Prolotherapy?


Prolotherapy is a treatment for ligament or tendon injuries.  Prolotherapy causes new growth of weak ligaments and tendons.

Ligaments hold bones to other bones in joints. Ligaments can become weak or injured. They may not heal to their original strength. Healing of injured ligaments is slow and not always complete. Ligaments have many nerve endings. A person may feel pain in areas where ligaments are damaged or loose. 

Tendons are similar to ligaments, but they connect muscles to bones. Tendons may also become injured and cause pain.   When ligaments and tendons become damaged or over-stretched, bones no longer fit well together. This makes the muscles work harder and causes spasms and pain.  

Prolotherapy is useful for many types of musculoskeletal pain including:

  • Arthritis
  • Back pain
  • Carpal tunnel syndrome
  • Cervicogenic headache
  • Chronic tendonitis
  • Knee injuries
  • Hip pain
  • Neck pain
  • Partially torn tendons, ligaments, and cartilage
  • Sacroiliac arthropathy
  • Sciatica
  • Shoulder injuries
  • Sports injuries
  • Tennis elbow
  • TMJ
  • Unresolved whiplash injuries

How does it work?

Prolotherapy involves multiple injections to create a controlled and localized inflammatory response, which causes new tissue growth.

At CHANGEpain, our goal for prolotherapy  is to restore healthy biomechanics of the body, provide pain relief and improve overall function. With pain relief given from prolotherapy, you may be able to benefit more from other therapies, such as physical therapy, even if these have failed in the past.

Prolotherapy is recommended to be combined with:

  • Treatment of myofascial pain, such as Intramuscular Stimulation (IMS) or Trigger Point Injections (TPI)
  • Physical therapy and movement
  • Lifestyle changes such as increased activity, a healthy diet and good sleep

How will I know if it will help me?

A CHANGEpain physician needs to assess you first, and will recommend this procedure if he or she thinks it may help you.  

You will only know for sure after you try about 3 or 4 treatments.

How much does it cost?

Prolotherapy is not covered by MSP, the provincial health insurance plan.    

Total prolotherapy fees depend on the the areas to be treated and extent of injury involved.  Please ask your physician for an estimate of the total cost of treatment for your condition. 

Prices are based on the following: 

$400     Prolotherapy Assessment  

$400     Each Non-Spine Prolotherapy Treatment, per area 

$800     Each Spine Prolotherapy Treatment

Note:  Most people need an assessment plus 4-8 treatments per area.

Some extended health plans and other insurers may cover the cost of treatment. Please check with your insurer to find out if you are covered.

Who should NOT have prolotherapy?

  • People who are very afraid of needles

  • Smokers (smoking decreases blood circulation needed for the therapy)

  • People allergic to the local anesthetic medication injected

  • People who are severely overweight, depending on the area to be treated

What does treatment involve?

First you need an assessment to confirm treatment is suitable for you.

Prolotherapy treatments inject a solution containing a local anaesthetic and dextrose (sugar) into joints, ligaments or tendons to stimulate tissue repair. You may have several injections during one treatment session.

Most people require 4-8 treatments, and treatments are usually administered every 2-6 weeks. The number of sessions required depends on your goal, the injury, the area, and how fast your tissues heal.

The ligaments and tendons may take several months to heal.  Most people notice real benefit after the 3rd or 4th treatment.

How long does pain relief last?

The results are different for each person.  If prolotherapy addresses the underlying problem, the pain may be completely resolved.

The first treatments are always to be considered trial treatments to understand whether the treatment will work.

There is the potential for no improvement in pain levels.  For some people, prolotherapy will have little or no effect on pain levels.

Preparing for treatment

Stop taking anti-inflammatory medication starting two weeks before the treatment. These include:  Aspirin, Advil, Aleve etc.  Please ask your doctor if you are unsure about a medication you are taking.

Please bring someone who can drive you home, as your physician can provide anti-anxiety medication for the procedure if you need it.

After prolotherapy you can continue all normal activities, but be careful not to overdo it.  Physical therapy is recommended as soon as possible and can increase the benefit of prolotherapy.

A healthy, protein rich diet, and Vitamin C (500mg daily) may also improve your results.

Caring for yourself after the injections

Side Effects

Overall, this procedure has very few risks. However, as with any procedure, there are some risks that mainly depend on the injected area. Like many medications, some patients will have side effects and others won’t. Your doctor will discuss these risks with you. Side effects may include:

  • Stiffness and soreness
  • Bruising and swelling

You might experience fever symptoms in the first day after the procedure.  Rarely, severe pain with fever past 24 hours may be due to infection and is usually treated with antibiotics. 

How long will it take to complete a course of treatments?

Every course of treatment is different for each person. It depends upon how fast you heal. Some people may only need a few treatments while others may need 6 or more.

The average number of treatments is 3-6 for an area treated.

Cancellation and Refund Policy

We must have 24 hours notice to cancel or reschedule your appointment. If less than 24 hours notice is provided, we will charge the full fee.

We do not give refunds.  This includes if the procedure must be stopped for safety reasons or if there is no benefit from the procedure.