Prolotherapy for Knee Pain: Can It Help Osteoarthritis?

Author: Mr Oliver Eaton BSc (Hons), PG.Cert – Orthopaedic Specialist
Reviewed by: Mr William Sharples BSc (Hons) – Pain Management Expert
Last Updated: September 2025

Knee pain from osteoarthritis (OA) is a common and often debilitating condition affecting millions of people globally. As the protective cartilage in the knee joint wears away, individuals may experience pain, stiffness, and reduced mobility. While conventional treatments like physical therapy, medications, and surgery remain standard, alternative therapies such as prolotherapy are gaining interest. But what is prolotherapy, and can it truly help those with knee osteoarthritis?

What is Prolotherapy?

Prolotherapy, or “proliferation therapy,” is an injection-based treatment aimed at stimulating the body’s natural healing processes. It typically involves injecting a solution — often dextrose mixed with a local anaesthetic — into ligaments, tendons, or joint spaces. The goal is to induce a mild inflammatory response, encouraging the body to repair and strengthen damaged or weakened connective tissues.

Proponents argue that this technique can improve joint stability, enhance function, and reduce pain, particularly in degenerative conditions like osteoarthritis.

How Might Prolotherapy Help Osteoarthritis of the Knee?

In knee osteoarthritis, degeneration affects not only cartilage but also surrounding structures like ligaments and tendons. Prolotherapy is thought to:

• Stimulate Tissue Repair: The injected solution promotes localized inflammation, which may facilitate healing and regeneration of connective tissues (Hauser et al., 2016).

• Improve Joint Stability: Strengthened ligaments and tendons may stabilize the joint and prevent excessive movement that can worsen OA symptoms.

• Reduce Pain and Improve Function: Several studies have reported pain relief and functional improvement following prolotherapy injections (Rabago et al., 2013).

What Does the Research Say?

While prolotherapy is still considered experimental by some medical authorities, research offers encouraging insights:

• A 2021 systematic review and meta-analysis concluded that prolotherapy provided significant improvements in pain and physical function for knee OA compared to control interventions (Liu et al., 2021).

• A randomized controlled trial by Rabago et al. (2013) demonstrated that patients receiving dextrose prolotherapy for knee OA experienced greater pain reduction and functional gains over one year compared to those receiving saline injections.

• Additional research suggests that combining prolotherapy with exercise enhances outcomes compared to exercise alone (Sit et al., 2016).

However, larger, high-quality trials are needed before prolotherapy can be universally recommended.

Benefits and Risks

Benefits:

• Minimally invasive procedure

• Performed in outpatient settings

• May reduce reliance on pain medications

• Generally low risk of serious complications when conducted by experienced clinicians

Risks:

• Temporary pain and swelling at the injection site

• Rare risk of infection

• Variable results, with some patients experiencing minimal benefit

Is Prolotherapy Right for You?

If you have knee osteoarthritis and are exploring alternatives to surgery or long-term medication, prolotherapy might be worth discussing with your healthcare provider. It’s essential to:

• Consult a trained, licensed practitioner with experience in prolotherapy.

• Understand that results can vary and the treatment is not a guaranteed cure.

• Consider prolotherapy as part of a broader treatment plan including weight management, physical therapy, and lifestyle adjustments.

Final Thoughts

Prolotherapy represents a promising but still evolving treatment option for knee osteoarthritis. While not yet mainstream, the existing evidence suggests that it can provide pain relief and functional improvement for some individuals. Ongoing research will help clarify its role in OA management.

As always, consult your healthcare provider to discuss the most appropriate treatment options tailored to your needs.

References

• Hauser, R. A., Lackner, J. B., & Steilen-Matias, D. (2016). A Systematic Review of Dextrose Prolotherapy for Chronic Musculoskeletal Pain. Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders, 9, 139–159. https://doi.org/10.4137/CMAMD.S39160

• Liu, Y., Ding, J., Zou, X., Tang, H., & Guo, Q. (2021). Dextrose prolotherapy for knee osteoarthritis: A meta-analysis of randomized controlled trials. Medicine, 100(2), e24146. https://doi.org/10.1097/MD.0000000000024146

• Rabago, D., Patterson, J. J., Mundt, M., & Kijowski, R. (2013). Dextrose prolotherapy for knee osteoarthritis: A randomized controlled trial. Annals of Family Medicine, 11(3), 229–237. https://doi.org/10.1370/afm.1504

• Sit, R. W. S., Wu, R. W. K., & Rabago, D. (2016). Dextrose prolotherapy for knee osteoarthritis: A systematic review and meta-analysis. BMJ Open Sport & Exercise Medicine, 2(1), e000086. https://doi.org/10.1136/bmjsem-2015-000086

Disclaimer: This article is for informational purposes only and does not substitute for professional medical advice. Always consult your healthcare provider before making treatment decisions.