Prolotherapy
Stimulating the Body’s Natural Healing Response
When ligaments, tendons, or other connective tissues become frayed, worn, strained or torn, they usually do not heal completely on their own. This can contribute to muscle tension or spasm, pain, joint stiffness or instability, and this can limit your activities, affect mood and sleep, and it limits your overall health and wellness.
Prolotherapy is a regenerative medicine injection treatment designed to stimulate the body’s natural healing response and support stronger, healthier connective tissue.
Dr. Richard Nahas uses prolotherapy as part of a personalized treatment plan when a comprehensive evaluation suggests that improving tissue stability may help address the underlying cause of pain.
What Is Prolotherapy?
Prolotherapy is an injection-based treatment that uses a carefully selected irritant solution—most commonly dextrose—to stimulate the body’s normal healing response. Rather than masking pain, the goal is to encourage repair of weakened ligaments, tendons, and supporting connective tissues.
How Does Prolotherapy Work?
When connective tissue is injured, stretched, or weakened, joints can become less stable and painful. Prolotherapy works by triggering a controlled healing response that encourages tissue repair and strengthening over time.
Because healing uses controlled inflammation to stimulate tissue repair, , there may be 1-2 days of soreness after the procedure, followed by gradual improvement that continues over weeks to months.
Conditions That May Benefit From Prolotherapy
- Chronic ligament injuries
- Tendon injuries
- Joint instability
- Chronic neck pain
- Chronic low back pain
- Sports injuries
- Pelvic instability
- Shoulder pain
- Knee pain
- Ankle instability
- Persistent musculoskeletal pain
Not every patient is an ideal candidate. Dr. Nahas performs a thorough evaluation to determine whether prolotherapy is appropriate for your condition.
Why Ultrasound Guidance Matters
Whenever appropriate, prolotherapy is performed under real-time ultrasound guidance to improve accuracy and personalize treatment.
- Visualize injured structures
- Improve injection precision
- Avoid nearby nerves and blood vessels
- Target the tissues most likely contributing to pain
What to Expect
- Comprehensive evaluation and medical history review.
- Ultrasound assessment when appropriate.
- Targeted prolotherapy injections.
- Personalized rehabilitation and activity recommendations.
Prolotherapy and
Neural Therapy – and beyond
Prolotherapy is often combined with other therapies depending on your diagnosis and goals.
- Neural Therapy
-
Hydrodissection
-
Platelet-Rich Plasma (PRP)
-
Bone Marrow Aspirate Concentrate (BMAC)
-
IV Lidocaine
-
Guided rehabilitation and stretching
Frequently Asked Questions
How many treatments will I need?
Dr. Nahas augments prolotherapy with neural therapy, which improves results and requires fewer treatments than standard prolotherapy alone.
When treating pain, the plan always evolves one visit at a time. In some cases, a single treatment can resolve a longstanding issue. To repair a tendon or ligament that is frayed or torn, a series of three treatments should deliver results in most cases.
While every physician takes a different approach, Dr. Nahas relies on objective testing and your feedback. Imaging before and after, combined with your clinical symptoms are combined to assess treatment progress. After three treatments, repeat imaging can reveal the nature and extent of tissue repair.
If the imaging is not better, PRP or BMAC can be considered as a more effective option. If imaging is better but your symptoms are the same, then a neural therapy approach may be recommended as the next step. This can target other areas that may be restricting movement or causing pain.
Is prolotherapy painful?
Some temporary soreness after treatment is expected and is part of the normal response to prolotherapy. Dr. Nahas uses an approach that reduces side-effects, treating restrictions in nerves and fascia that improve healing and recovery.
When will I notice improvement?
Tissue repair takes time, but you will likely feel immediate pain relief. Your improvement should gradually increase over time, and should increase with each treatment. .
Can prolotherapy be combined with other regenerative treatments?
Yes. Dr. Nahas will typically combine neural therapy with prolotherapy at no additional cost, but he may recommend PRP, BMAC, or other treatments if they are necessary or appropriate.
Why Dr. Nahas Uses Prolotherapy
Dr. Nahas does not recommend prolotherapy simply because a joint hurts. He uses it when a patient’s evaluation suggests that weakened tendon or ligament is affecting joint instability or contributing to persistent pain. As with all treatments in his practice, prolotherapy is integrated into a personalized plan that addresses the whole person rather than treating symptoms alone.
Schedule a Consultation
If chronic ligament, tendon, or joint pain has limited your ability to stay active, prolotherapy may be an option. During your consultation, Dr. Richard Nahas will review your history, perform a comprehensive evaluation, and determine whether prolotherapy is an appropriate part of your personalized treatment plan.
Related Conditions
- Chronic Neck Pain
- Chronic Low Back Pain
- Sports Injuries
- Joint Instability
- Persistent Musculoskeletal Pain
Related Treatments
- Neural Therapy
- Hydrodissection
- Platelet-Rich Plasma (PRP)
- Bone Marrow Aspirate Concentrate (BMAC)
- IV Lidocaine
- BodyMap Assessment