Prolotherapy (injections)

Prolotherapy (injections)

Can prolotherapy relieve arthritis pain?

Prolotherapy, also called hypertonic dextrose injections, is the injection of a sugar water solution (dextrose) into joints, ligaments or tendons. There has been some research conducted into the effectiveness of prolotherapy for treating osteoarthritis (OA). Unlike other types of injections, such as steroid injections, the basic science behind how prolotherapy works is poorly understood. Some experts think the pain relief it provides may be due to a placebo effect, that is, patients having a belief in its effectiveness regardless of medical effect. In addition, no established procedures exist in Canada for prolotherapy. 

Some researchers believe that prolotherapy injections can help promote the growth of normal cells and tissues. An injection is inserted into a weakened ligament with the intention of causing inflammation. The idea is that the body will respond to the inflammation by increasing blood flow to the area and stimulating the ligament or joint to repair itself. 

Recent reviews of several studies showed that there is some low-quality evidence that suggests prolotherapy may help achieve  control of symptoms in individuals with OA. However, more safety and efficacy research is needed together with a better understanding of the best way to deliver prolotherapy, in terms of volume and concentration of injected substances, the number of treatment sessions, and time between treatments. In addition, research is needed to compare prolotherapy with other injection and non-injection treatments for knee OA,, as well as a clear understanding of whether prolotherapy may only provide symptom relief or is a disease-modifying therapy. 

Because of the current uncertainty about how to deliver prolotherapy, the costs involved, how it works, and whether it results in any meaningful improvement in arthritis symptoms, it is currently not recommended in international OA treatment guidelines. 

Learn more about prolotherapy at these links:

This information was reviewed in August 2020 with expert advice from:

Dr. Lauren King, MSc, MBBS, FRCPC
Rheumatologist, Sunnybrook Health Sciences Centre