Chronic joint pain can sideline you from the activities you love, and for many people, surgery or long-term medication use feels like the only option. But what if your body already has the capacity to heal, and it just needs the right stimulus? Prolotherapy is a time-tested, regenerative injection therapy that harnesses your immune system’s natural repair processes to strengthen damaged ligaments and reduce chronic pain.
At FoRM Health in Portland, OR, our naturopathic physicians have administered prolotherapy throughout their careers, bringing clinical depth and an individualized approach to every patient they treat.
What Is Prolotherapy?
Prolotherapy (prolo = proliferative) has been around officially since the 1950s, with variants predating that. It is a minimally invasive treatment in which a carefully formulated solution — most commonly dextrose-based — is injected into damaged or weakened ligaments and tendons to stimulate the body’s natural healing response and promote tissue repair. The primary goal of this therapy is to strengthen ligaments, the supportive structures of all joints. Prolotherapy can stimulate an immune response similar to PRP, and you may benefit from combining the two therapies.
Conditions Prolotherapy Can Treat
If you suffer from chronic joint pain where ligament damage is present, prolotherapy may effectively treat your joint by stabilizing these ligaments. Since the main component of the solution injected is typically dextrose (a type of sugar), this therapy is exceptionally safe, with minimal side effects or adverse reactions. Recent research also shows dextrose has a beneficial effect on nerve pain (see more about our nerve hydrodissection services here).
Common conditions prolotherapy is used for include:
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Arthritis
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Chronic sprains, strains, tendinosis (Tennis elbow, plantar fasciitis, patellar tendonitis, Achilles tendonitis, etc)
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Rotator cuff injuries
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Chronic shoulder subluxation (dislocation)
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Ligament laxity and joint instability, including Ehlers-Danlos spectrum
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Osgood-Schlatter
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Chronic pain from motor vehicle accidents, whiplash
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Spine-related pain (cervical, thoracic, lumbar, sacroiliac)
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Chronic headaches
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Rib, costovertebral pain
FAQ
Because the main component of the injected solution is typically dextrose (a type of sugar), the therapy was not funded for extensive trials and lost favor to more extensively studied drug or surgical approaches over the years. In part due to its clinical success, however, along with its high level of safety as an injection therapy, more recent research has helped prove its effectiveness, including Level I studies (the top tier and most conclusive from a research standpoint). A landmark study showed undeniable benefit for knee arthritis, and several other smaller studies support its use in other conditions, particularly those involving ligament damage or laxity. (For those wanting research, see Dr. Dean Reeves’ (of the University of Kansas School of Medicine) summary here (opens in new tab)!)
In general, yes. Often, prolotherapy is used for joint injuries that involve ligament damage or laxity (weakness). Since there are many ligaments around a joint, including the joint capsule itself, most, if not all, of the ligaments are treated to help get maximal stability. When a joint is injured (sprain, rolled ankle, etc), it is virtually impossible to injure just a single ligament because of the stretch that occurs through the entire joint.
A local anesthetic is used at the injection site to reduce needle/injection discomfort; this part is generally well tolerated. Prolo is meant to stimulate an immune response, which starts with inflammation (and is the reason for pain during any injury). Because Prolo helps stimulate this response, soreness may increase to varying degrees after treatment, typically for 2-3 days.
Tylenol is allowed for pain relief. Low-dose opioid medications are occasionally prescribed for certain injections (typically only needed for 2-3 days following treatment). Anti-inflammatory (NSAIDs) and steroid medications are not allowed (rare exceptions) as these interfere with a normal inflammatory and healing response.
This depends on the type of injury, location, and how long it has been since onset. As a general rule, it takes 2-3 months for the initial stages of regeneration and repair to occur. At this point, patients typically see and feel results. Repair processes can continue for many months after injections. For osteoarthritis, pain reduction can actually occur much more quickly, within a couple of weeks. Dextrose can also help with certain types of nerve irritation; injections may reduce this type of pain much more quickly.
Again, this varies depending on the condition. Prolotherapy is usually better tolerated and recovers faster than PRP, but healing still takes time. Typically, major exercise is avoided for the first week after treatment, with a return to normal activity levels over the 2nd week. Exceptions are discussed after the initial visit.
Baseline prolotherapy solutions include dextrose (a sugar), a small amount of anesthetic (usually lidocaine or procaine), and saline. Vitamin B12, testosterone, or other natural substances may be added depending on the condition or strength of response needed. Aside from the anesthetic, no other pharmaceutical medications are used.
No. Dextrose prolotherapy stimulates a regenerative response, with collagen production and strengthening/tightening of ligaments. This does not cause scarring. This should not be confused with sclerotherapy, another term often confused with prolotherapy. Sclerotherapy involves injecting substances into damaged blood vessels, typically smaller veins, to irritate and destroy them.
Prolotherapy is generally very safe and well tolerated with most medications or other medical conditions. We always review a full medical history before initiating treatment. Patients on immunosuppressive medications, with active cancer, or with an infection around the site to be treated are contraindications to treatment.
While our office is located in SE Portland, Oregon, many of our patients travel from the greater Portland area, including Lake Oswego, Beaverton, Hillsboro, Tigard, Milwaukie, Happy Valley, and Oregon City, for in-office visits and procedures. We also offer virtual office visits, which allow us to provide care to anyone seeking care in Oregon, except for procedures, which must be performed in-office.
Why Choose FoRM Health for Prolotherapy in Portland, OR?
At FoRM Health, experienced naturopathic doctors Dr. Ryan Minarik, ND, LAc, and Dr. Brittany Krake, ND, MDR administer prolotherapy and have practiced this technique throughout their careers. Our providers take a thorough, individualized approach, reviewing your full history, understanding your goals, and tailoring each treatment plan to your specific condition.
As an integrative clinic, we can also combine prolotherapy with complementary therapies such as PRP, functional medicine, or physical therapy when appropriate. We’re committed to non-surgical, regenerative solutions that support your body’s natural healing processes. If you’re seeking expert prolotherapy care in Portland, OR, our team is here to help you move and feel your best.
Schedule a Consultation Today
Ready to find out if prolotherapy is right for you? Call FoRM Health at (503) 232-5653 to speak with our team and schedule a consultation. Our experienced providers are here to answer your questions, review your history, and help you decide if this regenerative treatment is the right fit for your condition and goals.
