What is Prolotherapy?

Prolotherapy is a treatment for ligament or tendon injuries. This treatment causes thickening and strengthening of weak ligaments and tendons. Prolotherapy is useful for many types of musculoskeletal pain. It may help heal joints, ligaments, tendons or other connective tissues when other more conventional therapies haven’t worked.

Ligaments hold bones together. Ligaments can become weak or injured from wear and tear or accidents. Healing of injured ligaments is slow and not always complete and after an injury, and ligaments may not heal to their original strength. 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.

How will I know if it will help?

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

How much does it cost?

Prolotherapy is not covered by MSP. Prolotherapy fees depend on the area to be treated, extent of injury involved, and number of sessions required. Please ask your physician for an estimate of the total cost of treatment for your condition.


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

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


Prolotherapy involves multiple injections to create a controlled and localized inflammatory response, which mimics the normal healing from an injury and 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

With prolotherapy, a solution containing a local anaesthetic, glycerine, phenol, and dextrose (sugar) is injected into joints, ligaments or tendons to stimulate tissue repair. You will have several injections during one treatment session. During the first session, your physician will focus the treatment on one agreed area to test response and tolerance.

Most patients 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 your tissues heal.

The ligaments and tendons may take several months to heal. For those who respond, usually patients notice benefit a few weeks after the 3rd or 4th treatment.

Like many medications, some patients will have side effects and others won’t. Your doctor will discuss these risks with you.   Common side effects:
  • Stiffness, soreness and swelling that lasts on average 2-3 days occasionally up to 10 days (patients who get very stiff and sore usually require less treatment sessions)
Rare side effects:
  • Bleeding, bruising or swelling
  • Muscle weakness or numbness
Extremely rare side effects:
  • Fever. You might experience fever symptoms in the first day after the procedure.
  • Infection. Severe pain with fever lasting more than 24 hours might be due to infection and it may be treated with antibiotics.
  • Allergic reaction

Overall, this procedure is most unlikely to worsen a chronic pain condition on the long term, unless a complication is encountered. These include: bleeding, infection, and allergic reaction to the injectate.


Other possible complications depend on the actual areas treated. Your doctor will discuss these with you

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


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

You should stop taking anti-inflammatories 2 weeks before the treatment as they interfere with its effectiveness. Examples include: Aspirin, Advil, Naproxen, Ibuprofen, Diclofenac, Aleve etc.


Anti-anxiety and/or pain medication may be used before the procedure only if needed.

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. For more pain relief after treatment, you can consider:
  • Heat or ice as needed, heat preferred
  • Gentle mobility
  • Pain medication, such as Tramadol (Ultram) 50mg 1-2 tablets every 4-6 hours as needed.

We require 48 hours notice to cancel or reschedule your appointment. If less than 48 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.

Please contact our Private Pay Services Coordinator

Call 604-566-9101, ext. 105 or


Cost of Initial Assessments - Non-MSP Medical

Private Medical Consultation (PMC) Multidisciplinary Private Assessment (MDPA)
Description Expedited, focused assessment to determine fit for non-MSP covered services requested:
IV Lidocaine Infusion, Ketamine Therapies, Prolotherapy, BOTOX, Platelet Rich Plasma (PRP).
Comprehensive functional and medical assessment with a multidisciplinary report addressing the biopsychosocial issues identified.
Care Team Pain Specialist Pain Specialist
Functional Movement Specialist
Duration 30 minutes 2 hours
Cost $450.00 $3,500.00

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Cost of Initial Assessments - Allied Health

Assessment Duration Cost
Chiropractic Initial 60 minutes $165.00
Physiotherapy Initial 60 minutes $160.00
Kinesiology Initial 45 minutes $90.00 (+ tax)
Counselling Initial 90 minutes $250.00
Acupuncture Initial 45 minutes $140.00
Ketamine Counselling Initial for Ketamine Assisted Psychotherapy 60 minutes $250.00

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