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Prolotherapy: Achieving Results When All Else Has Failed

Prolozone Therapy: An Advanced Form Of Prolotherapy

About Prolozone Therapy

What is Prolozone Therapy? It is an advanced form of prolotherapy in the UK which has built a reputation for achieving results when all other treatments have failed. Studies have proven that it can relieve pain, repair, strengthen and regenerate the following structures: joints, cartilage, spinal discs, muscles, ligaments, tendons, meniscus, and bursa.

The treatment was named ‘Prolozone Therapy’ because it involves the injection of medical ozone and nutrients to proliferate cells in a weak or damaged region of the body. To proliferate cells means to multiply and increase the number of them.

Prolozone Therapy proliferates chondrocyte and collagen cells. Cartilage is formed mainly of chondrocytes. Spinal discs, muscles, ligaments, tendons, meniscus, and bursa are formed mainly of collagen. The treatment increases the number of these cells through activating chondroblasts and fibroblasts, which are the pre-curser building blocks to chondrocytes and collagen.

Prolozone Therapy has the ability to provide complete relief of symptoms, even in severe conditions that have been present for many years. Medical Ozone is naturally anti-bacterial, so deemed one of the safest injections on offer within medicine.

Prolozone Therapy works on just about any pain problem you might have, including:

  • Arthritis of any joint (Osteoarthritis or Rheumatoid Arthritis)
  • Neck pain
  • Back pain
  • Hip pain
  • Spinal disc herniations (bulges)
  • Shoulder pain
  • Elbow pain
  • Wrist or hand pain
  • Foot and ankle pain
  • Knee pain
  • Tendon & ligament injuries
  • Fibromyalgia
  • Sacroiliac joint (SI Joint) pain and pelvic instability
  • Cervical instability
  • Sternoclavicular (SC) joint pain
  • Meniscus tear
  • Acromioclavicular (AC) joint pain
  • Headaches and Migraines
  • Bursitis
  • Virtually any injury or condition in the body causing pain and dysfunction.

What is the difference between Prolozone and standard Prolotherapy?

Prolozone Therapy uses a regenerative form of oxygen (Medical Ozone) to stimulate repair and regeneration. Standard Prolotherapy injections use an irritant in the form of sugar (dextrose solution) to cause an inflammatory response. This inflammatory response helps to stimulate healing but has the following limitations: Standard dextrose prolotherapy injections can be extremely painful and sometimes requires gas and air during the procedure. The pain experienced during a Prolozone injection procedure is minimal and smaller needles are used.

It takes much longer to reach the repair phase with standard prolotherapy, meaning that prolozone achieves results in a faster time-frame.

Standard Prolotherapy requires many injections, whereas Prolozone only requires a few, making it much less expensive for the patient.

Prolozone also has the ability to spread further around the site of injection, meaning it not only has a positive effect on the injury itself, but also the surrounding tissues that may also have been under strain due to compensation.

For example, a patient comes into the clinic with knee or hip arthritis. Prolozone will not only reduce pain, inflammation, and aid the regeneration of cartilage within the joint, but it will also help to repair and strengthen other neighbouring structures around it. These other structures include ligaments, muscles and tendons that would have been put under additional strain from the instability that arthritis causes within a joint.

Or if a patient has a spinal disc injury, Prolozone will also have a positive effect on the supporting spinal joints, muscles, ligaments and tendons that are attached around the injured disc.

The health of the structures that are attached around an injury, will always determine the results achieved with an injection, and the ability for those results to last. This is why Prolozone in our clinic has been shown to achieve results where standard prolotherapy has either failed or only provided temporary relief.

PLEASE NOTE: We do also offer standard Prolotherapy with dextrose for individuals who would prefer to have it for any reason.

Why Choose Us?

  • Extensive Experience – Our award-winning clinic has been performing Prolozone Therapy longer than any other clinic in the UK. Over 10,000 injections have been performed to date. We have had the privilege of treating many elite-level athletes, including both Olympic and Commonwealth medalists.
  • Increased Safety & Comfort – We have developed a unique, safer injection approach called the ProloSafe® Technique, which requires the use of smaller-sized needles compared to what is normally used by other clinics.
  • Enhanced Results In Fewer Appointments – Alongside the injections, we put our patients on the Pulse XL Pro device during each appointment (if deemed suitable). Based on technology developed by NASA, research has shown that it enhances the results of the injections and also helps to reactivate muscles that have become weak around the injury site.
  • Longer Lasting Results – We prescribe tailored exercise programs alongside the treatment to help to strengthen and stabilise the muscles around the injection site.
  • Comprehensive Examination – we use digital biomechanical scans to help to identify misalignments, imbalances, and areas of inflammation in the body that fail to show up on MRI and X-ray scans. Spending up to 90 minutes during each appointment with our patients gives us the time to carefully identify and treat these issues during the same appointment as the injections. This combined approach significantly enhances the results achieved from the injections and prevents an individual’s symptoms from returning.
  • Trusted Technology – Much of the treatment and examination technology we use at the clinic is used by elite-level athletes and professional sports teams – including Manchester United FC and Team GB.

PRACTITIONER - Mr Oliver Eaton BSc (Hons) Ost Med, PG.Cert

Having performed over 10,000 injections, Oliver 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 and Prolotherapy in America with the American Academy of Ozonotherapy and continued on to complete further injection 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.

Oliver’s treatment and examination approach at the clinic was learned through the process of treating his own chronic pain and he is committed to making sure his patients experience the same life-changing effects that his treatments had on him.

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Frequently Asked Questions

What is the success rate?

Our clinical audits show that 95% of our patients experience results with our treatment.

Our success rate is higher than what is typically stated in studies, as we often combine the treatment with other rehabilitation therapies within the same appointment as the injections to enhance the results. These therapies include advanced orthopaedic massage, stretching, and strengthening techniques.

For the 5% of patients that fail to experience any results or pain relief, we help to point them in the right direction of another practitioner or therapy that may be able to help.

How long does it take for the treatment to work?

The speed at which an individual starts to experience symptom relief is all dependent on the type of pain condition that they come in to see us with.

Some patients start to experience relief after a few hours, some after a few days, and some not until a few weeks after their third appointment. 80% of our patients start to experience results after just one appointment.

What happens during a Prolotherapy consultation and examination?

Your practitioner will start by taking down a full medical case history. This will involve asking you detailed questions about your current symptoms, and any previous conditions or incidents that may have had an influence.

Many individuals come to see us because they have failed to experience relief with other therapies. Sometimes we find that the issue wasn’t necessarily with the other therapies themselves, but the fact that the practitioner performing that therapy may not have accurately assessed and examined the individual properly to start with, and therefore not applied the therapy appropriately.

This is why we conduct a thorough examination using computerized biomechanical technology to help identify issues and imbalances in the body that previous practitioners may not have identified. The information that our technology provides, helps us to perform more targeted and effective treatment for our patients.

Is prolotherapy offered on the NHS?

Unfortunately, the treatment isn’t offered on the NHS at this point in time.

What is the recovery period after each injection?

Most patients are able to go about their daily activities straight away after the treatment. It is advised to modify any strenuous activity for a few days.

Are there any side effects?

It is normal to experience pain and discomfort around the injection site for a few days as part of the repair process, but it shouldn’t stop you from continuing on with your daily activities.

It is common to experience temporary bruising at the injection site. Using an ice pack may help for the first 6-12 hours after the procedure. Then, only heat is helpful in the healing process.

Do you prescribe any exercises to perform alongside Prolotherapy?

If appropriate, we will provide specific physical therapy exercises for you to perform at home in between each appointment. These exercises will help to enhance the effect of prolotherapy and prolozone treatment.

Do I have to avoid doing anything after the treatment?

We advise you to avoid public hot tubs, swimming pools, and lakes for 3 days following each appointment to avoid the injection site being exposed to bacteria. You are allowed to have a shower or bath during this time.

How safe is the treatment?

Medical Ozone, the main ingredient of Prolozone, has been shown to be one of the safest substances used within medicine.

According to the International Scientific Committee of Ozone Therapy: Medical Ozone is not a drug and as such it does not cause side effects, does not cause allergic reactions and in general, there are no interactions with other drugs.

When administered in prescribed amounts by a qualified practitioner, the chances of experiencing adverse reactions are extremely small. For example, a German study on 384,775 patients evaluating the adverse side effects of over five million medical ozone treatments found that the rate of adverse side effects was only 0.0007 per application. This figure is far lower than any other type of medical treatment.

Will I get treatment on the first visit?

We always leave enough time during your first visit for treatment. If you are a complex case and multiple areas need treating, then please notify the receptionist upon booking, as you may require a double-slot appointment.

How do Prolotherapy and Prolozone injections compare to the injections offered to me by my local doctor?

Many of the injections offered by your local doctor only have the ability to temporarily reduce inflammation and cover up the pain, with many potential negative side effects that can reduce the health of connective tissue in the body. Many of these negative side effects have been reported in a recent study performed at the medical department of Boston University.

In comparison, Prolozone injections aim to not only reduce inflammation and pain but primarily repair and strengthen a damaged or weak area of the body. Prolozone injections have an excellent safety profile and DO NOT have the same negative side effects as the injections offered by your doctor.

How long has the treatment been around?

Medical Ozone injection therapy has been used in Europe since the 1950s. It is most commonly used in Germany with over 7000 practitioners offering the treatment to help provide chronic musculoskeletal pain relief. In parts of Italy, it is included as a medical treatment in their own national health service.

How does it help to repair and regenerate?

According to the International Scientific Committee of Ozone Therapy: Different data coming from scientific research recognizes that a medical ozone injection has a dual-action mechanism: analgesic and anti-inflammatory.

These effects seem to be due to its way of acting on diverse targets: 1) Decrease the production of mediators of the inflammation. 2) The oxidation (inactivation) of metabolic mediators of pain. 3) It clearly improves local blood microcirculation, with an improvement in the oxygen delivery to the tissues, essential for the regeneration of anatomic structures; the elimination of toxins, and in general to the resolution of the physiological disturbance that generated the pain.

There are many systematic reviews and randomized controlled trials proving the effects of prolotherapy treatment for joint pain. Research presented at a meeting at the American College of Rheumatology outlined the improvements in pain, mobility, and overall wellbeing with the use of medical ozone injections for knee osteoarthritis.

How does the treatment help cartilage?

‘Once articular cartilage is damaged, it has limited potential to repair itself. Many treatment modalities that are used to repair damaged articular cartilage show limited efficiency. Medical ozone, the main ingredient of Prolozone Therapy, has shown to be effective in the treatment of damaged articular cartilage in osteoarthritis.

A medical ozone injection inhibits the inflammatory milieu which damages the cartilage matrix and induces apoptosis of chondrocytes. It produces its beneficial effects by normalizing the cellular redox balance and through the actions of cytokines.’ Please refer to the following scientific review

My doctor said that Prolozone Therapy or Prolotherapy isn’t going to help me.

Unfortunately, many doctors in the UK don’t fully understand how prolozone and prolotherapy works. This is because it isn’t part of their original medical training.

If they think that the treatment is new, it shows that they are unaware of the decades of research and patient results supporting its use for the treatment of chronic pain, sports injuries, and osteoarthritis.

How does Prolozone Therapy help to heal spinal discs?

To treat spinal discs we adopt a specific method developed by a doctor called Dr. Cesare Verga. This method is called the ‘Discosan Method’.

To understand how the method works, it is important to understand the anatomy of a spinal disc. It is comprised of two main sections: an outer band called the annulus fibrosus, and an inner gel-like structure called the nucleus pulposus. A herniation develops when fibres rupture in the outer rings of the annulus fibrosus. This then causes the inner nucleus pulposus to protrude and compress a nerve root. This compression is what causes the pain associated with a herniated disc.

How does the Discosan Method help?

  1. The method helps to undo the bonds holding the herniation together, in turn reducing the size of the herniation.
  2. It reduces swelling in the area, which helps to take further pressure off the nerve root.
  3. The method helps to improve micro-circulation in the disc, therefore increasing the level of oxygen and nutrients to assist the healing of the ruptured fibres.

A study published in the International Journal of Spine Surgery in 2014 claims to be the first to look at how patients are doing long-term after medical ozone spinal injections—five and 10 years later. Based on MRI scans, 79 percent of patients had a reduction in herniation volume, and the average reduction was 56 percent.

Among the 108 patients who underwent medical ozone treatment in the study, 89 did not have any subsequent back surgery, and in this group, 82 percent had improvement at five years, and 88 percent had improvement at 10 years after receiving the ozone injections. Since the ozone injections were also very safe, the researchers concluded that “the risk-reward profile for this treatment is favorable.”

Do you offer dietary advice to help my body repair?

Yes, we provide dietary recommendations that help to enhance the effects of prolotherapy and prolozone therapy, alongside speed up the repair process.

What forms of payment are accepted?

We accept most forms of payment: debit and credit cards, including American Express. Apple Pay. Cash.

Can I claim for Prolotherapy on my health insurance?

While we don’t hold any associations with any health insurance providers, we will provide you with a detailed receipt of payment that can be submitted to a private health insurance provider. Occasionally, we have had patients who have said that they have been reimbursed for prolotherapy by their provider.

Am I too old for a prolotherapy procedure?

We have treated patients well into their 80’s with great success. The more we can keep our elderly patients mobile and without pain, the more they can keep active and independent, which in turn keeps the rest of their physical and emotional health well. Many of our elderly patients come to see us after being told that they are too old for surgery due to the risks involved. We have found that Prolozone Therapy is a great pain management alternative to surgery and painkillers for seniors suffering from chronic pain.

Can the treatment help with ligament laxity?

The use of prolotherapy for ligament laxity began in the 20th century with Dr. George Hackett and Dr. Gustav Hemwall. Prolotherapy works by creating a healing response to stimulate growth factors within the connective tissue in order to improve its strength. Previous soft tissue injuries such as low back pain, sprains and degenerative conditions such as knee osteoarthritis can cause ligament laxity. Other procedures such a platelet-rich plasma (PRP) can also help ligament laxity but not as effectivity as dextrose injections and prolozone.

Interested to find out how much Prolozone Therapy and Prolotherapy costs?


Prolotherapy has built a worldwide reputation for achieving results when all other treatments have failed. There are two types of Prolotherapy. Prolozone Therapy and Dextrose Prolotherapy.

It is always important to fully understand how each type of Prolotherapy injection works before making a decision about whether it is right for you. This is why we have collated all the best information about the treatments and condensed it all into one simple guide.

The more you read, the more you will understand why both every-day people and professional athletes such as Tiger Woods and Rafael Nadal, all hail Prolotherapy as a miracle treatment that helped to change their lives. The below video is a collection of testimonials of some of these people.

This is a list of what is included in the guide:

  1. Definition of Prolotherapy
  2. Benefits of Prolotherapy
  3. Types of Prolotherapy injections
  4. How does prolotherapy work?
  5. Prolozone Therapy verses Dextrose Prolotherapy
  6. How is a Prolotherapy injection performed?
  7. How often do I need the treatment?
  8. How long does Prolotherapy take to work?
  9. Prolotherapy risks & side-effects
  10. Do Prolotherapy injections hurt?
  11. Prolotherapy contraindications
  12. Prolotherapy aftercare
  13. Prolotherapy success rate
  14. How to enhance Prolotherapy results
  15. Prolotherapy cost
  16. Prolotherapy reviews
  17. History of Prolotherapy
  18. How to find Prolotherapy near me
  19. Prolotherapy for Hypermobility

Definition of Prolotherapy

What is prolotherapy? It makes sense to start off with a definition according to the Merriam-Webster dictionary:

“Prolotherapy is a non-surgical regenerative treatment. Short for “proliferation” therapy, Prolotherapy works by stimulating the body’s own natural healing mechanisms to repair injured musculoskeletal tissue.”


The use of prolotherapy in regenerative medicine-

Reduces pain: the treatment helps to address the root cause of an individual’s pain, which then helps to prevent it from returning.

Repair: When an injury occurs, the body stimulates a natural process to attempt to repair the damaged tissue. Most soft tissue and connective tissue injuries will heal on their own this way. For those that don’t, outside help is needed.

Prolotherapy injections help to increase the number of healing compounds and growth factors in an injured area or joint, providing additional tools for the damaged tissue to repair.

Improves tissue strength: Both Soft tissue and connective tissue structures in the body can suffer from weakness and laxity. This is often due to a lack of blood circulation, the most common being ligaments, tendons, discs, and meniscus. Prolotherapy helps to strengthen the fibres within these structures which can help to provide pain relief.

Improves stability: The main tissue structures involved in keeping a joint stable are ligaments and tendons. If they are weak, the laxity can cause a joint to move at angles that it wasn’t designed to. This can eventually lead to injury. Prolotherapy works to reinforce the fibres of ligaments and tendons, ensuring that they can perform their job of stabilising a joint properly during movement. An example of a ligament is the iliolumbar ligament in the back. If this is weak, then it can lead to low back pain. An example of a tendon is the supraspinatus tendon, which is part of the rotator cuff complex.

Improve function and mobility: By repairing and strengthening the tissues within and around a joint, function and mobility is therefore restored.

Reduces stiffness in muscles: The cause of muscle stiffness is often due to laxity in neighbouring ligaments as they have to work harder to compensate and stabilise a joint. The treatment helps to improve the strength of ligaments which then helps to take the workload of muscles and reduce stiffness as a result.

Types of Prolotherapy

Dextrose Prolotherapy –   a sugar solution is used in the form of dextrose to act as an irritant. Its aim is to induce an inflammatory response in an attempt to stimulate the release of healing compounds.

Prolozone Therapy – uses an activated form of oxygen called Medical Ozone (O3) to stimulate the release of healing compounds, without having to induce an inflammatory response.

Types of prolotherapy showing medical ozone and dextrose

What areas of the body can be treated?

The majority of injuries and chronic musculoskeletal pain conditions can benefit from Prolotherapy, including neck pain, low back pain, shoulder pain, hip pain, knee pain, elbow pain, wrist pain, hand pain, ankle pain, foot pain, Achilles tendinopathy, knee osteoarthritis.

The use of Prolotherapy for knee degenerative conditions has been widely studied. It can be used during a knee arthritis treatment program for both knee osteoarthritis and rheumatoid arthritis. If you would like specific clarification on whether Prolotherapy treatment can help you or not, feel free to send us an email after you have read this guide.

How does prolotherapy work?

To first understand how prolotherapy treatment works, it’s important to understand why many chronic musculoskeletal pain conditions struggle to heal on their own, and why physical therapy or other injection therapy treatments fail to provide pain relief.

One of the most common reasons is that ligament and tendon around an injured area are weak, and aren’t able to provide a stable environment for the injury to heal properly. That injured area may be a joint, muscle, spinal disc, or even a ligament or tendon. Whether it’s low back pain, neck pain, achilles tendinopathy or knee pain, if those structures neighbouring ligaments and tendons are weak, then that structure will struggle to heal properly.

The below video describes the difference between ligament and tendon.

As previously explained, the reason why ligaments and tendons can become weak is due to the fact that they both have a poor blood supply. On top of that, as we age, general blood circulation becomes less efficient due to the thickening and stiffening of our blood vessels. This means that over time, ligaments and tendons don’t have the capacity to stay as strong as they once were, as they aren’t receiving the same level of oxygen and nutrients from their blood supply anymore.



Collagen fibres of ligaments and tendons

Ligaments and tendons are made of collagen. Collagen is the most abundant protein in the body and is a core component of many different structures in the body.

Both Prolozone Therapy and Dextrose Prolotherapy help to stimulate the production of fibroblasts, which then bring about the deposition of new collagen fibres. When new collagen matures, it shrinks. This shrinking process helps to tighten up ligaments and tendons, resulting in increased strength and stability and a reduction in joint pain.

Treating these structures around the site of an injury helps to create a stable environment for the injury to heal properly. It fixes the main issue that was preventing the injury from healing on its own or with physical therapy.

Quote about how prolotherapy works

Prolozone Therapy verses Dextrose Prolotherapy

The main benefit that Prolozone Therapy has over dextrose prolotherapy is its anti-inflammatory properties. I will explain how these properties speed up the healing process.

If an injured area is inflamed, like in low back pain or knee pain, it can cause pressure within that area. This pressure can prevent circulation from getting to it. We need adequate levels of circulation to heal.

Prolotherapy helping to increase circulation to an injury

Oxygen is the main component of our circulation that helps to heal injured connective tissue. As described earlier in the guide, the medical ozone component of Prolozone injections is an activated form of oxygen. It helps not only to reduce inflammation to allow circulation back in but also to provide a direct supply of oxygen to enhance the repair process.

Due to dextrose prolotherapy being an irritant, it doesn’t have this ability to reduce inflammation and increase oxygen levels in the same way, therefore it doesn’t help an injury to repair as quickly as Prolozone Therapy. Dextrose prolotherapy is known to be much more painful, so many practitioners will mix a local anaesthetic with the dextrose solution.

How is a Prolotherapy injection performed?

There are two types of areas in the body that injection therapy can be performed, intra-articular or extra-articular.

An intra-articular injection is an injection performed into the middle of a joint. This is typically used for joint pain that is being caused by internal structures, such as cartilage with knee osteoarthritis, or a sprain of an internal ligament. Examples of internal ligaments are the cruciate ligaments in the knee.

Diagram of internal ligaments that an injection can treat

Meniscus injuries in the knee can also be treated with an intra-articular injection.

Extra-articular injections are performed into connective tissue structures outside of a joint, such as external ligaments, tendons, muscles, and bursa. An example of external ligaments is the capsular ligaments of the spine which wrap around the outside of each spinal joint. Weakness in these ligaments can lead to neck pain and low back pain. An example of a tendon is the Achilles tendon. When it becomes inflammed it is referred to as achilles tendinopathy.

Prolotherapy doctor pointing towards the ligaments of the spine

How often do I need the treatment?

Prolozone Therapy – the optimal gap between appointments is normally 2 weeks.

Dextrose Prolotherapy – the gap can be between 3 and 6 weeks depending on the condition being treated.

You may be wondering why this gap is much longer than Prolozone Therapy? This is due to the different healing stages and the way that dextrose stimulates the repair process compared to medical ozone.

Dextrose has to first create inflammation in order to promote the production of healing compounds. This inflammatory stage can take up to 6 days.  In comparison, medical ozone bypasses the inflammatory stage and starts stimulating the production of these compounds immediately after an injection. As a result, Prolozone Therapy completes the repair work in a much shorter time-frame.

How Many treatments do I need?

The average number of prolotherapy treatments required ranges between three and six. On occasions, some people may only require one treatment, and some as many as seven or eight follow-up treatments. The number you need depends on how debilitating your condition or joint pain is. For example, low back pain normally requires three appointments to resolve.

There are many factors that can influence the number of treatments that a person needs. These factors include age, muscle health, and body alignment.

Graphic showing what things effect prolotherapy results

Age has a direct effect on the rate of repair and the body’s ability to produce the compounds needed to heal.

Muscles play a large role in supporting an injured area. If they are tight and weak, then they are unable to create an optimal environment for healing to take place.

If the structures around an injured area are not in proper alignment, then this can potentially undo the repair work of Prolotherapy treatment. For example, the alignment of your hips and ankles have a direct effect on the angle of your knee. So, if you came into the clinic with a knee injury, we would also examine your hips and ankles during the consultation. If you came in with low back pain, then we would also examine your hips and pelvis.

During your consultation, if a misalignment or an issue with any of your muscles is identified, then it can be addressed during the same appointment as prolotherapy injections. Gentle massage and stretching techniques are the most common way that we help to address these issues. Your practitioner may even prescribe simple exercises for you to perform at home.

How long does it take before I start seeing results?

An impatient person waiting for prolotherapy injections to work

Symptom relief can be experienced at different stages along an individual’s course of treatment. This usually depends on the type and location of the condition that is being treated. 80% of our patients will experience a degree of symptom relief after just one appointment.

Prolozone Therapy – the usual pattern involves up to a seven-day long window of symptom relief due to its anti-inflammatory effects. This is followed by a milder version of the original symptoms returning until the next appointment. With each appointment, the intensity of the symptoms returning should subside until they go completely.

Dextrose Prolotherapy – the pattern is slightly different compared to prolozone injection therapy due to the timing of the repair process and the different healing stages. There is an initial window of symptom relief that can last up to 14 days. The initial stabilization induced by the dextrose during this window then starts to subside, and a milder form of the original symptoms will return until the next appointment. Again, the intensity of the returning symptoms will subside until they have gone completely.

Sometimes, a patient will experience a complete reduction of their symptoms in between an appointment. This doesn’t mean that full healing has taken place. The treatment may have repaired the injury enough to reduce the pain, but if there are still fibres that need strengthening, then finishing a course of treatment too early can run the risk of the injury returning.

Your doctor or practitioner will determine the stage of healing that your injury is at during the examination performed at the beginning of each appointment.

In some cases, patients don’t experience any symptom relief until after their third appointment. There are many reasons for this. The most common is because the condition of the injury was quite severe to start with. Another is that the structures around the injured area are in poor health and need attention too.

As explained previously, the speed of the healing process can be dictated by the health of the structures around an injured area.

During your consultation and examination, your doctor or practitioner will be able to provide you with an estimated number of treatments that may be required for your particular condition.

Prolotherapy Risks

There have only been a small handful of side effects reported by patients:

  • Mild pain and irritation at the injection site. This is likely to last no longer than 72 hours.
  • Bruising can develop over the course of 24 hours following the treatment. If you are aware that you bruise easily, then your practitioner can limit this by placing a cold pack over the injection site for a few minutes before the procedure.
  • A light-headed feeling during or immediately after the treatment. This normally passes within a few minutes.
  • Temporary headaches are common if you are receiving treatment in the neck. This tends to come on several hours after the treatment or the next day.

The only adverse risks associated with Prolotherapy are the following:

  • Temporary nerve damage
  • Allergic reaction to any of the substances used
  • Infection

These risks are extremely low. Both dextrose and medical ozone are naturally anti-bacterial, so the risk of infection is considerably lower than other injections.

Do the injections hurt?

It is normal to experience a brief sharp scratch as the needle first pierces the skin. To reduce this sensation, many practitioners will use a cold spray to numb the injection site.

The sensation experienced during the procedure differs from patient to patient. Some experience no pain at all, and others can experience a bee-sting type sensation that can last for up to a couple of minutes. That sting is then likely to turn into a dull ache, which subsides within five minutes. The sensation is different for different body areas. An individual with low back pain for example can experience a sensation of pressure as the injection is performed. In comparison, an individual with neck pain can experience more of a sting.

The usual pattern is, the more inflamed an injury is, the more discomfort an individual is likely to experience during the procedure. As mentioned previously, Dextrose prolotherapy is known to be considerably more painful than prolozone injections.

It is important to be aware that there are many ways that your practitioner can reduce the pain of the injections if needed. This will be discussed during your consultation.

Prolotherapy contraindications

You are not suitable for prolotherapy or proliferation therapy if you are aware of having any of the following conditions:

  • Cellulitis – a painful skin infection. Characteristic symptoms are redness and swelling.
  • Bleeding disorders – such as hemophilia or any other known conditions affecting the blood’s ability to clot.
  • If you are taking any anticoagulant medication.
  • Septic arthritis – a form of arthritis caused by an infection.
  • Presence of an abscess around the proposed injection site.

Please make your practitioner or provider aware of any allergies to the following substances and materials:

  • Hypo-allergenic plasters
  • Nitrile gloves
  • Anti-bacterial wipes
  • Ethyl-Chloride (numbing spray)
  • Stainless steel (Hypodermic needle material)
  • Medical Ozone
  • Procaine

Your treatment provider can make modifications and adaptations to your treatment if you have any allergies.

Treatment Aftercare

Two seniors stretching as part of their prolotherapy aftercare

The following information is advised after each appointment:

  • If the injection site is sore, then you can use an ice-pack during the first 6-12 hours after the procedure. Do not use for any longer than 10 minutes at a time.
  • We advise our patients to modify any strenuous sports and fitness activities for two weeks after each procedure to give the injected site a chance to repair, regenerate, and strengthen.
  • If your practitioner gives you any exercises, it is advised to perform them as suggested, and stop any previous pain management activities unless instructed otherwise.
  • Keep the injection sites clean and avoid hot tubs, swimming pools, and lakes for 3 days following the procedure. Showering the same day is fine.
  • It is fine to carry on with your daily activities immediately after your appointments.

Your treatment provider will give you an aftercare sheet with this health information on during your first appointment.

Prolotherapy success rate

A bar chart showing different percentages

In our experience, 95% of our patients experience results with Prolotherapy. This is a much higher figure than what is stated in many studies. The reason for this is that we often combine the treatment with other therapy modalities to enhance the results. More information about these therapies can be found under the next heading.

There are many different variables that can influence the success rate of Prolotherapy. Despite these variables, it remains a treatment that has built its reputation on achieving results when all other treatments have failed. There are many published systematic reviews and randomized controlled trials proving the positive effects of the treatment.

After your doctor or practitioner has examined you during your consultation, they will be able to provide you with information on the level of success you are expected to experience.

How to enhance prolotherapy results

A graphic showing how to speed up prolotherapy results

As previously described in this guide, there are many factors that can affect both the level of results achieved and the speed at which you achieve those results.

Two of those factors are:

  • Muscle health
  • Body alignment

Muscle health – Muscles have three main roles in the body. They help the body to move, keep stable, and absorb shock. When muscles around an injured area are tight or weak, then they aren’t able to perform their roles effectively. As a result, this can slow down the repair process of an injury through a lack of stable movement and support.

Body alignment – If the structures surrounding an injured area aren’t in proper alignment, then it can create unnecessary force transferring through that area at angles that the body wasn’t designed to move in. This creates a poor environment for the injury to heal properly and can lead to chronic pain.

During a consultation and examination, your practitioner or provider will conduct a comprehensive assessment of both your symptomatic area and the structures that connect to it. This is done with the aid of computer analysis technology. The data and images collected will help us to identify misalignments and muscle problems around the area that may not have been picked up by an x-ray or MRI scan. If any issues are identified, then we can use the following additional therapies to enhance the effects of the prolotherapy injections:

Percussion massage: this is a form of massage that targets dysfunctional fibres with a specialised vibrating device to increase muscle tone and flexibility. On certain parts of the body, we can use the device over the injection site to increase the absorption of the injected substances.

Stretching techniques: this involves gentle stretching of certain structures that commonly cause misalignments in the body. For example, the pelvis is the most common part of the body to misalign. It can cause joint pain in many different parts of the body, from the neck to the feet.

Exercise prescription: we will often prescribe certain exercises to compliment the effects of the massage and stretching. These exercises can help an individual to sustain the results of the injections, and prevent their injury and joint pain from returning.

Prolotherapy cost UK

The cost of prolotherapy at our clinic is considerably lower than most other clinics. The main reason for this is that we feel the treatment should be accessible to as many people as possible.

Prolotherapy UK cost – Each appointment costs £245 and includes the following:

  • Prolozone therapy
  • Percussion massage
  • Advanced stretching techniques
  • Prescription of strengthening and stabilisation exercises

The consultation and examination fee is £95. Treatment for additional areas is charged at £70 per area.

History of the treatment

Prolotherapy and proliferation therapy has a long history and dates back to ancient times, with the Egyptians using it to treat crippled animals. It was performed using a hot iron cautery.

The use of Prolotherapy and proliferation therapy in humans dates back to 400 BC when Hippocrates developed a way to repair a dislocated shoulder by using a hot poker as an irritant in the armpit.

Fast-forward to 1835. Dr. Alfred Velpeu was known as the father of Prolotherapy treatment and started using iodine injections to heal his patients. Later in that century, Dr. Rene Lerich started piloting the first research into the treatment of ligaments and painful areas.

From the 1940s onwards, practitioners such as Dr. Earl Gedney and Dr. George Hackett revolutionised the treatment into what it is today. Dr. Hackett was a trauma surgeon based in Ohio. He began studying the effects of dextrose injections as an irritant to help increase the thickness of ligaments in order to provide pain relief.

One of his students, Dr.Gustav Hemwall, then developed the library of scientific data further by making important discoveries that are still recognised today. He treated more than 10,000 patients worldwide and reported his clinical experiences in a study on 8,000 of those patients.

In 1974, Dr. Hemwall presented a survey of 2,007 patients to the Prolotherapy Association. Pain relief was noted in a staggering 99% of those patients.

How to find Prolotherapy near me

We offer the treatment at two different clinics in the UK. London and Bedford.

Unfortunately, the treatment isn’t that common elsewhere in the UK at the moment. One of the reasons may be due to there not being many prolotherapy training courses available in Europe.

There used to be Prolotherapy NHS orthopaedic doctors that performed the treatment in a primary care setting, but cuts to NHS funding over the years has meant that they don’t offer it in a primary care setting anymore. They mainly used it for the treatment of low back pain. Unfortunately, it is unlikely that prolotherapy in primary care practice will be on offer anytime soon on the NHS.

If you would like to go ahead and book an appointment or would like to ask us a question, then head over to our contact page for more information on how to do so.

Prolotherapy versus PRP

Platelet-rich plasma (PRP) and dextrose prolotherapy have a very similar healing process and healing response when it comes to repairing connective tissue. They are both irritants that aim to provide pain relief through stimulating growth factors. Prolozone Therapy has a much faster healing response. Platelet-rich plasma (PRP), endorsed by the mayo clinic, tends to be the most expensive out of the three treatments and hasn’t got much research proving its effectiveness for certain conditions such as low back pain. The Mayo Clinic has published a study for the treatment of TMJ pain which is a condition that can also be treated.

Prolotherapy for Hypermobility

Hypermobility is a term used to describe joints that move beyond the range that they are supposed to. There are different severities on the hypermobility spectrum and it can be present in just a few joints or the whole body. It most commonly causes neck and low back pain.

The most common hypermobility condition is called Ehlers-Danlos Syndrome (EDS). It is a group of genetic connective tissue disorders that effect the strength of the structures that surround blood vessels, joints, and organs. Individuals suffering from this condition are at the severe end of the hypermobility spectrum.

A newsletter published by the famous mayo clinic talk about the effectiveness of Prolotherapy for strengthening the ligaments around the joints in order to improve stability and take pressure of the muscles, which often have to compensate.

Sports Medicine

Prolotherapy has been used in sports medicine for many decades to treat a variety of ligament and tendon conditions. It is known that Tiger Woods has used the treatment for low back pain. Below is a comprehensive list of reviews, studies and a randomized controlled trial from PubMed studies which help to dismiss the effects of the treatment as being placebo.

Rabago, D., Best, T.M., Beamsley, M. and Patterson, J., 2005 et al. A systematic review of prolotherapy for chronic musculoskeletal pain. Clinical Journal of Sport Medicine15(5), p.E376. PubMed.

Hauser RA, Lackner JB, Steilen-Matias D, Harris DK et al. A systematic review of dextrose prolotherapy for chronic musculoskeletal pain. Clinical Medicine Insights: Arthritis and Musculoskeletal Disorders. 2016 Jan;9:CMAMD-S39160.

Rabago, D., Best, T.M., Zgierska, A.E., Zeisig, E., Ryan, M. and Crane, D., 2009 et al. A systematic review of four injection therapies for lateral epicondylosis: prolotherapy, whole blood and platelet-rich plasma. British journal of sports medicine43(7), pp.471-481.

Yelland, M.J., Del Mar, C., Pirozzo, S. and Schoene, M.L., 2004 et al. Prolotherapy injections for chronic low back pain: a systematic review. Spine29(19), pp.2126-2133.

Dagenais, S., Yelland, M.J., Del Mar, C. and Schoene, M.L., 2007 et al. Prolotherapy injections for chronic low‐back pain. Cochrane Database of Systematic Reviews, (2).

MJ, Y., CO, M., ML, S. and Wyatt, L.H., 2004 et al. Prolotherapy injections for chronic low-back pain: a systematic review. Journal of the American Chiropractic Association41(12).

Sit, R.W., Chung, V.C., Reeves, K.D., Rabago, D., Chan, K.K., Chan, D.C., Wu, X., Ho, R.S. and Wong, S.Y., 2016 et al. Hypertonic dextrose injections (prolotherapy) in the treatment of symptomatic knee osteoarthritis: a systematic review and meta-analysis. Scientific reports6, p.25247.

Hassan, F., Trebinjac, S., Murrell, W.D. and Maffulli, N., 2017 et al. The effectiveness of prolotherapy in treating knee osteoarthritis in adults: a systematic review. British medical bulletin122(1), pp.91-108.

Arias-Vázquez, P.I., Tovilla-Zárate, C.A., Legorreta-Ramírez, B.G., Fonz, W.B., Magaña-Ricardez, D., González-Castro, T.B., Juárez-Rojop, I.E. and López-Narváez, M.L., 2019 et al. Prolotherapy for knee osteoarthritis using hypertonic dextrose vs other interventional treatments: systematic review of clinical trials. Advances in Rheumatology59.

Sanderson, L.M. and Bryant, A., 2015 et al. Effectiveness and safety of prolotherapy injections for management of lower limb tendinopathy and fasciopathy: a systematic review. Journal of foot and ankle research8(1), p.57.

Lin, M.T., Chiang, C.F., Wu, C.H., Huang, Y.T., Tu, Y.K. and Wang, T.G., 2019 et al. Comparative effectiveness of injection therapies in rotator cuff tendinopathy: a systematic review, pairwise and network meta-analysis of randomized controlled trials. Archives of physical medicine and rehabilitation100(2), pp.336-349.

Hung, C.Y., Hsiao, M.Y., Chang, K.V., Han, D.S. and Wang, T.G., 2016 et al. Comparative effectiveness of dextrose prolotherapy versus control injections and exercise in the management of osteoarthritis pain: a systematic review and meta-analysis. Journal of pain research9, p.847.

Krstičević, M., Jerić, M., Došenović, S., Kadić, A.J. and Puljak, L., 2017 et al. Proliferative injection therapy for osteoarthritis: a systematic review. International orthopaedics41(4), pp.671-679.

Morath, O., Kubosch, E.J., Taeymans, J., Zwingmann, J., Konstantinidis, L., Südkamp, N.P. and Hirschmüller, A., 2018 et al. The effect of prolotherapy on chronic painful Achilles tendinopathy—a systematic review including meta‐analysis. Scandinavian journal of medicine & science in sports28(1), pp.4-15.

How does regenerative injection therapy help neck pain?

There aren’t many treatment options on the NHS available for neck pain other than physiotherapy or orthopedic surgery. Prolotherapy can be an effective treatment option for the majority of different types of neck dysfunction. The irritant solution helps to stimulate healing and as a result, strengthens and stabilises the ligaments and discs in the spine. A tailored exercise program is then prescribed after the third treatment as part of the integrated health care program offered at our clinic.

The role of regenerative injection therapy for chronic low back pain?

Again, long-term treatment options on the NHS for low back pain are limited apart from physiotherapy, orthopedic surgery and other spinal injection procedures that only provide temporary pain relief. The most common chronic back pain dysfunctions we see in the clinic are disc herniations, degenerative disc disease, sacroiliac joint dysfunction and pain (SI joint), and an unstable pelvis. Depending on the dysfunction, we can use either prolozone or a dextrose solution to strengthen and stabilise the ligaments and relieve pain in that area.

Knee Pain Relief –

There are many different knee conditions that the injections can help with. These include knee osteoarthritis, rheumatoid arthritis, meniscus tears, ligament tears and sprains, tendon strains, patellar tendinopathy, quadriceps tendinopathy. Alongside the injections, we also examine the alignment of the knee and the muscle health around the joint. If we identify any issues then we treat these issues during the same appointment as the injections.

Treating Chronic Musculoskeletal Pain with Prolotherapy-

Most patients have struggled to resolve their chronic musculoskeletal conditions because areas of the body with a poor blood supply are struggling to perform their job properly. Injections therapies such as dextrose prolotherapy injections, prolozone therapy and platelet rich plasma within a sports medicine practise can help. They are not just an option for pain management but their aim is to repair and restore a joint back to full function. The treatment is often referred to as alternative and complementary medicine but often isn’t widely available by family medicine practitioners.

We have separate pages on how a Prolotherapy procedure and Prolozone therapy can help the following chronic musculoskeletal conditions of the body:

  • Knee pain
  • Low back pain
  • Hip pain (including hip arthritis)
  • Shoulder pain (including rotator cuff)
  • Upper back or neck pain
  • Ankle pain
  • Medial tibial stress syndrome

There are parts of the body that we don’t have any separate pages for but can still help with. These include elbow, wrist, hand, feet, TMJ joints and SI joints. If there is a part of the body that isn’t listed, then please contact us to confirm whether we can help.

Prolotherapy isn’t just pain management, it helps to heal, repair and regenerate. Compared to other injection therapies prolotherapy injections work to relieve pain through fixing an injury.

This type of injection therapy can also help a common overuse injury.

The risk of an allergic reaction and worsening pain is extremely low compared to other types of injections due to it being a natural treatment.