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What is Prolotherapy?


The pain becomes chronic and persistent if it develops over the course of a disease. Chronic pain has a negative impact on all aspects of an individual’s life, including emotional, physical, financial and social elements. Chronic pain of any member of a family dramatically affects the whole family. Prolotherapy is an American method that has been used in the U.S.A. for nearly 60 years, it is known as a non-surgical treatment for the reconstruction of ligaments, tendons, and the joints of the musculoskeletal apparatus. First of all it is important to understand the word “Prolo” which derives from the Latin “Proles” (NPT) which means “Stimulation of Growth.” In “Prolotherapy” a solution of glucose (sugar and water) is used, and it is infiltrated directly into the damaged ligament or tendon / sufferer which is “attached” to the bone.

In this weak area, following the infiltration of glucose, a local acute inflammatory reaction with increased perfusion bleeds, and the interest of the cell repair factors that determine a true “self-repair” is thus created. “Prolotherapy” has established itself as a non-surgical treatment for the reconstruction of ligaments and chronic pain. The “Prolotherapy” is a Real Pain solution without surgery, without drugs, without rest or work disability, suitable for all, men and women, young and old, sportsmen and athletes, for all those people who want to solve the chronic pain problems without resorting to surgery.


The weakened ligament causes the vertebra to change its position over the disc, causing pressure on the disc, thus increasing the possibility of herniated disc.



The ligaments that support the back are strong and move the vertebrae into their proper alignment by relieving pressure over the disc.

The conditions that can get benefits with Prolotherapy are:

• Painful syndromes
• Neck pain
• Dorsal and lumbar pain
• Rib pain
• Shoulder and scapular Pain
• Pain in the lower limbs
• Sciatica
• Disc disease (herniated disc of the spine)
• Pain in the hips
• Pains in the knees
• Pain in the ankles and feet
• Pain in the back

• Pain in the elbows
• Pain in the wrist
• Headache
• Migraine
• Cefalea
• TMJ (jaw pain)
• Post-traumatic pain
• Sport post-traumatic pain
• Fibromyalgia
• Tendinitis
• Post-fracture pain

How can Prolotherapy help me?

The basic mechanism of Prolotherapy is simple. A substance is injected into damaged unstable tissue causing an inflammatory reaction. This local inflammatory reaction triggers a series of complex processes of healing with new collagen tissue production. The former new collagen gradually reduces during maturation. The ligaments that have been injected are physiologically stronger and more robust, thanks to collagen properties bringing a local complex stability.

Prolotherapy is 90% effective eliminating chronic pain and is very effetive in the treatment of many sports injuries. The very important point is that the infiltration is targeted only to weakened structures. If these areas are properly infiltrated, the chances of success in healing are excellent.

Cervical spine

Many people have disorders of the cervical spine because of degenerative or post traumatic origins including disorders related to incorrect posture. By correcting the various causes of the instability of this important rich structure of ligaments, you will get good results with prolotherapy. Many patients after prolotherapy treatment of the cervical spine report that they do not have any more headaches, muscle pain, tingling of the hands, etc., and, finally, very important, do not take any more pain medication.


Disturbances associated with this joint are often sports related or in many cases due to overuse of the ligaments and tendons(epicondylitis, or tennis elbow) which becomes a chronic problem with many disabilitiy issues if not corrected. Prolotherapy can help a great deal not using any steroids to improve natural healing. The athleic sometimes abandons his sport activity due to his/her chronic pain and because of the failure of traditional therapy.

Lumbosacral spine

Sciatica and blockage of the lumbar spine: this disease is very common and Prolotherapy is truly effective as a treatment. Disc pathology like herniated disc – facet syndrome.

Wrist and hand

These joints are rich in ligaments and tendons that can become painful in post traumatic situations. Chronic pain in the wrist can arise also from non-traumatic factors such as degenerative arthrosis. Prolotherapy is very effective even in these structures as for example in carpal tunnel syndrome.


The shoulder is an important pivot in the muscle tendon structures. When these structures undergo degenerative muscle or tendon injury, the shoulder becomes incapacitated with a clear functional reduction. Often anti-inflammatory drugs are prescribed, without resolving the cause of the pain. Prolotherapy offers an excellent non-surgical treatment to the shoulder. The rotator cuff is often a surgical pathology that can be now treated with Prolotherapy avoiding surgery, but if there are complete lesions of the rotor cuff tendons, then surgery is the only option.

Hip and pelvis

The large joints of the hip are important because they often go into degenerative processes that unbalance the muscle-tendon and legamentous structures causing pain. Clearly, here too it is important to consider and correct your posture. Prolotherapy is advisable in solving the painful framework by treating the cause and promoting “self-healing”.

Foot and ankle

These structures are rich in their complex of joints and ligaments which respond with excellent repair to prolotherapy injections if targeted to vulnerable structures such as the legamental structures of the ankle. It is very important to understand the bio-meccanics of the foot which can result excellent when associated with prolotherapy. The treatment of the foot associated with a correct re-education of the posture is also important.

The first clinical visit

The patient is first evaluated in an interview by the doctor, where the patient is carefully examined and evaluated including review of all diagnostical data including x-rays. The patient will be thoroughly informed, and will be shown how “prolotherapy” works in regards to the clinical situation of the patient.

Finally the patient is visited by the doctor, and informed on the best strategy to solve his or her health problem.

IIf I do prolotherapy, what should I expect in the following days?

A few hours after infiltration with prolotherapy, the anesthetic effect wears off and the patient may experience a dull or local pain that may continue for a few days (inflammatory phase – lasting a week or so).

If I feel too much pain can I take an aspirin?

Who performs Prolotherapy will strictly instruct you to NOT take anti-inflammatory drugs including aspirin (aspirin, Voltaren, Brufen, Aulin, Moment, painkillers, etc.) during the period of 2-3 weeks. In case of pain analgesics are recommended (Tylenol, Tramadol, etc.).

If I do feel very sick in the following days after prolotherapy, what should I do?

Contact your prolotherapy doctor.


Every medical procedure has risks, but it is equally known that undeniable discomfort and suffering from chronic pain needs to be solved. Let’s look at some of the risks of people with chronic pain and risks in life with chronic pain

Risks associated with living with chronic pain:

• Depression
• Economic Problems related to working inability
• Increasing negative stress
• Sleep disturbance
• Progressive physical deterioration
• Problems in the couple relationship

• Physical interruption in sporting activities leading to depression
• Loss of self-esteem
• Dependence on pain medications
• Increase weight due too lack of movement and sports activities

So the risk of chronic pain is huge !! Chronic pain leads to other pathologies such as depression, anxiety, insomnia, chronic fatigue, hormonal changes, and many other … The psychological price of dealing with your family and with the people around you is very important. So what should this person do?

The suffering person can choose from one of many treatments that the market offers with its risks and costs. (Acupuncture, hypnosis, massage, electro stimulation, cortisone, mesotherapy, and many others).Prolotherapy as all therapies still has its risks and contraindications if not done properly by well trained physician –prolotherapist experts.

What are these risks?:

• Bleeding at the injection site
• Local Bruising
• Local pain
• Local swelling

• Stiffness
• Infection
• Pneumothorax
• Spinal headache


Prolotherapy is a relatively new method for treating chronic pain. It is based on the assumption that chronic pain in many cases involving numerous parts of the body is due to ligamentous laxity. Ligament laxity can be eliminated by strengthening the ligaments using prolotherapy injections made up of an irritating substances that stimulate connective tissue proliferation. The solutions are different mixtures that may contain phenol, glycerin, glucose hypertonic solution associated with local anesthetics. Prolotherapy injection treatment is very effective in association with physical therapy, together with the use of supplementation of minerals and vitamins.

May athletes have benefit from Prolotherapy?

Many sports injuries are often distracting and distorting in origin; meaning that sports trauma dominantly injure the tendons and ligaments. If these athletes are treated appropriately and targeted with Prolotherapy, they can recover very quickly and be physically ready to play their sport again with excellent results. For example, knee sprain ligament causes a joint instability. With Prolotherapy, applied to injured tissue, there is a direct immune attack causing proliferation which accelerates the healing of unstable ligament. In this way, the instability treated (eg. Knee, shoulder, back, etc.) resumes its physiological function and provides a guarantee that it will not lose its function because the new tissue is regenerated and reinforced.

As regards sports injuries, Prolotherapy is an absolutely a beneficial treatment and well recommended. Numerous clubs, sports clubs and individual athletes, have already tested and used Prolotherapy with great success: The United States SCI team, as well as many US teams, professional and not, Basketball and American Football are using this fabulous therapy avoiding surgery for their athletes, with extraordinary results.

The function of ligaments

Ligaments are used to hold the bones together. The ligaments are robust structures similar to nylon fabrics that have the function to securely hold together the bone structures and which allow limited movement of the latter. Any excessive stretching to the physiology of ligaments may result in instability of the associated complex structures. Ligaments are very important structures for joint stability and are sometimes sensitive subject to strains and injuries.

The spine is full of ligaments and for the above reasons there may be frequent reasons for instability of the spine (back/neck pain). The ligaments have an elastic energy, very similar to “elastic bands”. The ligaments that lose or reduce this elastic function, become unstable and insecure and thus allow the micro-movements of the bones or abnormal movements of the bony structures that cause the pain.

Many athletes of the italian american
football league (Aquile di Ferrara) have
used Prolotherapy with excellent results.


“First of all you need a thorough investigation to identify the injured tissues”, says Dr. Cavallino.

“The affected areas are marked with a drawn diagram. At this point the actual treatment begins: the specialist proceeds with multiple injections, on the previously marked points, with first a local anesthetic solution and then with the injection of dextrose (ie sugar), into the periosteal insertions of ligaments.”

Why does prolotherapy treatment have to be repeated after some time?
“The purpose is to stimulate the body to produce new collagen-fibrous tissue which ensures tightness of the ligaments to the bone”, clarifies Dr. Cavallino. This will increase stability in the joints and definitely reduce pain. “Prolo your pain away”

Prolotherapy is indicated in cases particularly in which the pain is caused by low back pain, knee osteoarthritis, shoulder pain, hip pain as well as many clinical situations like the suffering so-called “tennis elbow”.