Prolotherapy, (also referred to as sclerosing injections), is an injection-based therapy for chronic musculoskeletal pain which has been used for over 60 years¹. Prolotherapy works by prompting your body’s natural repair mechanisms to heal injured or weakened joints, ligaments and tendons. (Ligaments are the tough tissues which connect bones to one another, whilst tendons are a similar type of tissue connecting muscles to bones).
It is a natural, non-surgical method of stimulating growth when ligaments or tendons have been stretched/damaged or torn. This technique can be used in most joints that are unstable, and is often used for sacroiliac joint (the joint that connects the sacrum to the hip bone) dysfunction with instability or chronic low back pain.

Prolotherapy involves injecting a solution such as dextrose (glucose sugar water) into painful ligament and tendon sites, and/or into adjacent joints². The solution is safe and water-soluble, which is easily excreted from the body after having the initial desired effect. It works by causing cells to lose water, which leads to a localised inflammatory reaction, stimulating the growth of collagen fibres and connective tissue. This process is thought to thicken, tighten and strengthen the weak tissue, resulting in a stronger tendon or ligament that can hold body structures in place more effectively.

As the weakened area heals, pain is usually reduced or eliminated. This biological process can often take up to six to eight weeks, which explains why you may not feel benefits immediately. A series of three injections are usually given six weeks apart to encourage optimal tissue growth. A local anaesthetic is used to ensure minimal discomfort with the injections. Prolotherapy is often used as an alternative to cortisone injections, which can often weaken connective tissue with long term use³.

Although prolotherapy has been used for many years, few controlled studies have properly evaluated the efficacy of this therapy. Most of these studies have been carried out for low back pain in general, with contradictory findings^2,4-6. Nevertheless, there is good evidence supporting the specific use of prolotherapy around the sacroiliac joint, with one study reporting a functional improvement in 78% of treated patients⁷. Furthermore, irrespective of the solution, the actual motion of injecting into the ligament has been shown, in some patients, to induce inflammation, resulting in significant long-term pain relief and reduced disability⁶.

Due to the local inflammation caused by prolotherapy, some bruising, pain, stiffness and/or swelling in the injected area may occur for the few days following the procedure. If pain persists you should follow up with your doctor.

Apart from a small amount of local bleeding and bruising, other possible side effects for the procedure are uncommon. Infection is rare, and minimised by the use of sterile techniques. Allergic reactions to the injected substances rarely occur.

You will be sore for several days following the injections. This is good, as it means that an inflammatory reaction is occurring, which should strengthen the ligament. However, if this flare up of pain persists for more than a week, please contact your doctor. Most importantly, you must avoid taking anti-inflammatories during this treatment.