Author: Mr Oliver Eaton BSc (Hons), PG.Cert – Orthopaedic Specialist
Reviewed by: Mr William Sharples BSc (Hons) – Pain Management Expert
Last Updated: August 2025
Table of Contents
- Introduction
- What is Prolotherapy?
- What is Surgery for Musculoskeletal Pain?
- Comparing Prolotherapy and Surgery
- Case Study: Prolotherapy Before Surgery
- When to Try Injections First
- Risks and Considerations
- FAQs
- References
Introduction
Chronic joint and ligament pain can be life-altering. Many patients face a difficult choice: try minimally invasive treatments like prolotherapy, or proceed directly to surgery. This article explores the evidence, expert recommendations, and real-world outcomes to help you make an informed decision.
What is Prolotherapy?
Prolotherapy is a regenerative injection therapy that stimulates the body’s natural healing processes. A solution—often dextrose—is injected into injured ligaments or tendons, promoting tissue repair and reducing pain [1].
Key Points:
- Minimally invasive
- Outpatient procedure
- Used for chronic musculoskeletal pain
What is Surgery for Musculoskeletal Pain?
Surgery may involve repairing, reconstructing, or replacing damaged tissues. Common procedures include arthroscopy, ligament reconstruction, or joint replacement. Surgery is typically reserved for severe cases or when conservative treatments fail [2].
Key Points:
- Invasive, requires anaesthesia
- Longer recovery time
- Higher risk of complications
Comparing Prolotherapy and Surgery
| Feature | Prolotherapy | Surgery |
|---|---|---|
| Invasiveness | Minimally invasive | Invasive |
| Recovery Time | Days to weeks | Weeks to months |
| Risks | Low (infection, soreness) | Higher (infection, anaesthesia) |
| Cost | Lower | Higher |
| Evidence Base | Growing, but limited | Strong for many conditions |
| Insurance Coverage | Often not covered | Usually covered |
Case Study: Prolotherapy Before Surgery
Patient: 52-year-old male with chronic knee pain (osteoarthritis)
History: Failed physical therapy and NSAIDs
Intervention: Three sessions of prolotherapy over 12 weeks
Outcome:
- 50% reduction in pain (VAS score)
- Improved function (WOMAC index)
- Avoided knee replacement surgery at 1-year follow-up
Reference: Rabago D, et al. Ann Fam Med. 2013;11(3):229-237. [3]
When to Try Injections First
Prolotherapy may be considered before surgery if:
- Pain is moderate and not disabling
- Imaging shows mild to moderate tissue damage
- Conservative treatments (physical therapy, medications) have failed
- Patient prefers to avoid surgery
Surgery may be necessary if:
- Severe structural damage (e.g., complete ligament tear)
- Failed response to multiple non-surgical treatments
- Progressive neurological symptoms or instability
Expert Tip: Always consult a board-certified specialist to discuss your options and ensure a personalised treatment plan.
Risks and Considerations
- Prolotherapy: Mild pain, swelling, rare infection
- Surgery: Blood clots, infection, anaesthesia risks, longer downtime
Note: Not all patients are candidates for prolotherapy. Discuss your medical history and goals with your healthcare provider.
FAQs
Q: Is prolotherapy FDA-approved?
A: Prolotherapy solutions (like dextrose) are FDA-approved for other uses, but prolotherapy itself is considered off-label [4].
Q: How many prolotherapy sessions are needed?
A: Most patients require 3-6 sessions, spaced several weeks apart.
Q: Can prolotherapy cure arthritis?
A: Prolotherapy may reduce pain and improve function, but it does not reverse arthritis.
Q: Is prolotherapy covered by insurance?
A: Coverage varies; many insurers consider it experimental.
Author Bio
Having performed over 10,000 procedures, Mr Oliver Eaton is one of the UK’s leading practitioners in the field of Prolotherapy and Prolozone Therapy, with patients travelling to see him from across the UK, Europe, and the Middle East.
He first trained in Prolozone Therapy and Prolotherapy in America with the American Academy of Ozonotherapy and continued on to complete further training with the Royal Society of Medicine, Charing Cross Hospital in London, Keele University’s Anatomy & Surgical Training Centre, and the medical department of Heidelberg University in Germany.
Mr Eaton developed his treatment and examination approach through the process of treating his own chronic symptoms and is committed to making sure his patients experience the same life-changing effects his treatments had on him.
Over the years, he has had the privilege of treating many elite-level athletes, including both Olympic and Commonwealth medallists.
Mr Eaton’s expertise has been featured in the following national and international news publications including The Independent, The Daily Mail Online, The Daily Express, Women’s Health Magazine, What Doctors Don’t Tell You Magazine, Women’s Weekly Magazine, The Weekly News, The Sunday Post, The Scotsman, East Anglian Daily Times, Men’s Running, Women’s Running, Your Healthy Living.
LinkedIn profile: https://www.linkedin.com/in/oliver-eaton-4338225b/
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All clinics offer the same award-winning prolotherapy treatment with convenient appointment times, including evenings and weekends.
References
- Prolotherapy in Primary Care Practice
Rabago D, et al. (2010). Primary Care, 37(1), 65-80.
Read the article - Treatment Options for Joint Pain
American Academy of Orthopaedic Surgeons (AAOS).
Visit AAOS OrthoInfo - Dextrose Prolotherapy for Knee Osteoarthritis: A Randomized Controlled Trial
Rabago D, et al. (2013). Annals of Family Medicine, 11(3), 229-237.
Read the study - Prolotherapy: Safety and Effectiveness
U.S. Food & Drug Administration (FDA).
FDA information on prolotherapy
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.