Prolotherapy is an injection technique to stimulate the growth of healthy, strong connective tissue to help eliminate many chronic painful conditions.
The solution most veterinarians use for injection includes Dextrose, lidocaine or procaine and Vitamin B12. This solution causes proliferation of fibroblasts resulting in the strengthening of stretched or weakened ligaments and tendons.
When sprains or strains occur, the excessive laxity in a joint causes pain, in part due to the activation of stretch receptors in the sensory-nerve-rich fibro-osseous junctions. Not only is there local pain at these sites, but referred pain to sites are often quite distant from the original injury.
Traditional treatments for these injuries include ice, rest and anti-inflammatories which helps relieve the pain, but does nothing for the stretched structures which, due to their poor blood supply do not heal well and continue to be lax, causing further pain down the road and resulting in a chronically weakened structure that is easily re-injured.
After the prolotherapy solution is injected, there is a 2 to 4 day period of inflammation as the area is infiltrated with lymphocytes. The patients may be more sore during this period and need additional analgesics to provide comfort. Then the treated tissue moves into a strengthening and healing phase for the next 4 to 5 weeks where, histologically, one can see fibroblastic organization and capillary proliferation in the tissues.
Once this healing period is complete, the patient can be re-evaluated for joint laxity and pain and, if needed, the treatment is repeated. I generally treat patients with prolo once monthly for 3 to 5 treatments. Because prolotherapy relies on inducing inflammation which leads to healing, the patient cannot take NSAIDs, Prednisone or strong anti-inflammatory supplements (ginger, curcumin) while being treated with prolotherapy. For pain control, I have the patients take tramadol or acetaminophen (dogs). Common injuries which respond well to prolotherapy include cranial cruciate injury (partial or complete tears), luxating patellas, hip dysplasia, elbow displasia and chronic spinal pain.
Prolotherapy is most effective where there hasn’t been a lot of degenerative joint disease and osteophyte production. In these very chronic cases, much of the laxity in joints has been reduced by the thickened joint capsules and bony proliferation and the pain is more likely due to chronic joint inflammation and bone spurs.
A useful, human prolotherapy website for more information is found at