Prolotherapy is a regenerative injection therapy used to address chronic musculoskeletal pain. This non-surgical treatment aims to stimulate the body’s natural healing processes. It is also known as “proliferation therapy.” The overall goal is to encourage tissue repair and growth.
How Prolotherapy Addresses Knee Pain
Prolotherapy works by stimulating a localized inflammatory response at the injection site, often in weakened ligaments and tendons. This response triggers an influx of reparative cells. The most common solution used, concentrated dextrose, acts as a mild irritant to initiate this process.
The temporary, low-grade inflammation signals the body to synthesize precursors to mature collagen, which reinforces connective tissue. This leads to the proliferation of new collagen fibers. These new fibers are deposited in the injured ligament or tendon and contract over time, re-establishing the integrity and strength of previously weakened structures. The strengthening of these knee structures can improve joint stability and reduce pain.
Knee Conditions That May Benefit from Prolotherapy
Prolotherapy is often considered for chronic knee conditions where ligamentous laxity or instability contributes to pain. One common application is for osteoarthritis of the knee, particularly when joint instability due to weakened ligaments is a contributing factor. Unresolved ligament sprains can lead to ligament relaxation, changing joint biomechanics and potentially accelerating osteoarthritis.
Conditions such as patellofemoral pain syndrome, which involves pain around the kneecap, may also benefit from prolotherapy by addressing underlying ligament or tendon issues. Chronic ligament sprains, affecting structures like the medial collateral ligament (MCL) or lateral collateral ligament (LCL), can cause persistent instability and pain, making them potential targets for this therapy. Meniscal injuries, if associated with joint instability rather than a purely mechanical tear, might also see improvement.
What to Expect During a Knee Prolotherapy Session
Before a knee prolotherapy session, patients undergo an assessment to determine treatment suitability. During the procedure, imaging guidance, such as ultrasound or fluoroscopy, ensures precise placement of injections into affected ligaments, tendons, or joint capsules. This helps target the specific areas requiring tissue regeneration.
The injected solution contains dextrose, a sterile sugar solution, which acts as the primary proliferant. Local anesthetic, such as lidocaine, may also be included to minimize discomfort during the injections. A single session may involve multiple injections, depending on the number and extent of weakened structures. The procedure is relatively short, taking 15 to 30 minutes. A course of treatment usually requires 3 to 6 sessions, spaced several weeks apart, for optimal results.
Recovery and Results After Knee Prolotherapy
Following a knee prolotherapy session, patients can expect temporary side effects. Common reactions include localized pain, stiffness, and swelling at the injection sites, which subside within a few days. Applying ice packs and taking over-the-counter pain relievers, as advised, can help manage this initial discomfort.
The improvements from prolotherapy are gradual, as the body requires time to generate new collagen and strengthen the treated tissues. Patients may notice initial relief within the first few sessions, but more significant and lasting results emerge over several weeks to months as the healing process progresses. Expected outcomes include reduced pain, improved function, and increased stability in the knee joint, allowing for greater participation in daily activities and exercise.