Prolotherapy is an alternative therapy that can help repair ligaments. It’s also known as regenerative injection therapy or proliferation therapy.

This treatment is meant for injured joints and connective tissue. It’s also used to treat some people who have conditions like arthritis, whiplash, and degenerative disc disease. Prolotherapy can treat a number of areas of your body, including your back, neck, knees, shoulders, hips, pelvic floor, and hands.

Prolotherapy is considered safe for most people. However, only small studies have been conducted about its overall effectiveness.

Prolotherapy typically costs between $400–$1,000, depending on the clinic and the part of the body that’s treated.

Prolotherapy involves watery injections to relieve pain from affected joints. These injections typically contain natural substances like dextrose, saline, and sarapin, in addition to a numbing agent like lidocaine. This treatment is unlike platelet-rich plasma injections, which require stem cells from the person undergoing treatment. It’s also unlike steroid and cortisone injections.

Your doctor will make the injection to a very specific, targeted area in the injury site which triggers your body’s healing response. This leads to the growth of new, healthy ligaments or tendon fibers. As a result, you may experience reduced pain and stiffness and improved strength, function, and mobility of the joint.

Multiple treatments can be used to continue to stimulate growth of new tissues.

Because this treatment stimulates tissue growth, it’s most effective on those without underlying chronic conditions like Crohn’s disease or chronic fatigue. Ask your doctor if you’d be a good fit for the treatment, and make sure they’re aware of all chronic conditions you have even if they don’t seem relevant to the injury at hand.

The risks of prolotherapy are significantly less than the risks of surgery. There is no need for general anesthesia or hospital stays. The recovery period is much shorter, and there’s a significant decrease in the chance of infection.

While prolotherapy is generally regarded as safe and seems to have positive effects, it’s still a newer therapy. That means the possibility of risks doctors aren’t aware of yet.

Some experts, for example, have expressed concern that the dextrose in prolotherapy could cause a buildup of sugar molecules in joint tissues over a long period of time, which could potentially be damaging to those tissues.

There is no evidence of this to date. Existing research has shown overwhelmingly positive results. One small study found that 13 people given prolotherapy containing dextrose had less pain and improved flexibility than those who just received injections of lidocaine. Another study of 38 people found that those who used prolotherapy had improved flexibility and reduced pain in treated joints.

In rare cases, infection may occur after treatment. Symptoms include pain and fever. Treatment in this case requires antibiotics.

You should only ever receive prolotherapy treatments from a trained and certified professional.

Before the appointment, your doctor will want to look at any diagnostic images, including MRI scans and X-rays.

Before the procedure, your doctor cleans your skin with alcohol. Next, they apply lidocaine cream to the injection site to reduce pain. If you are already in extreme pain, your doctor may use conscious sedation or nitrous gas.

You must eat before you get prolotherapy. It’s best to include protein in this meal. Your doctor may also recommend that you stop taking anti-inflammatory medications at least three days before your appointment so that your body will respond to the treatment.

The entire process takes about 30 minutes or less, including prep when you first arrive at the facility. After you’re prepped with a local anesthetic, your doctor will carefully make the injection into the affected areas.

Immediately after treatment, your doctor will have you rest with heat packs on the treated areas for 10–15 minutes. Then you’ll be allowed to go home.

Immediately after the procedure, you’ll likely experience mild swelling and stiffness. This should resolve quickly. Most people resume normal activities the next day. Many are back to normal the exact same day as the procedure. You may notice sustained bruising, discomfort, swelling, and stiffness for up to a week.

Prolotherapy should never cause severe pain. If you experience severe pain, especially with a fever, seek medical attention as it could be a sign of infection. Infections should be treated immediately.

Your doctor may suggest multiple prolotherapy treatments to continue to stimulate growth of new tissues. Some experts recommend about three to six rounds of treatment, spaced out every four weeks.