There are several types of injections that can help relieve pain and stiffness for those with knee osteoarthritis. The most common injection option is cortisone (steroid), but there are several others too, including viscosupplementation and platelet-rich plasma (PRP) injections.

The goal of prolotherapy is to stimulate natural tissue repair in the body. Prolotherapy typically involves 15-20 injections to the affected soft tissue. See Therapeutic Injections for Knee Arthritis

One option that’s gaining attention for its positive outcomes and lack of side effects is prolotherapy.

See Cortisone Injection Risks and Side Effects


What is prolotherapy?

Prolotherapy, also known as proliferation or regenerative injection therapy, is based on an idea that runs counter to a common goal in arthritis treatment: to decrease inflammation.

See Osteoarthritis Treatment

In fact, the goal of prolotherapy is to inject an irritant into the joint, which temporarily increases inflammation. This inflammatory response increases blood flow and stimulates new growth and healing in the damaged tissues.

See How Arthritis Causes Joint Pain

The most commonly used irritant in a prolotherapy injection is dextrose, but substances like glycerine, lidocaine, or phenol may also be used.

See Knee Pain and Arthritis

What studies say about prolotherapy

Prolotherapy is a relatively new injection option, so there aren’t a lot of large scientific studies about its effectiveness. But small studies so far have revealed positive results for those with knee osteoarthritis.

See Knee Osteoarthritis Causes

One study with 90 adults with knee osteoarthritis involved some participants getting monthly prolotherapy injections of dextrose for 3 to 5 months. Those who received prolotherapy saw a significant improvement in pain, function, and stiffness scores. 1 Rabago D, Patterson JJ, Mundt M, et al. Dextrose prolotherapy for knee osteoarthritis: a randomized controlled trial. Ann Fam Med. 2013;11(3):229-37. This was true even after following up with 60 of these subjects over 2 years later. 2 Rabago D, Mundt M, Zgierska A, Grettie J. Hypertonic dextrose injection (prolotherapy) for knee osteoarthritis: Long term outcomes. Complement Ther Med. 2015;23(3):388-95. Also, none of the subjects receiving prolotherapy reported adverse effects.

See Knee Osteoarthritis Symptoms

In addition, a systemic review of many studies on the use of prolotherapy determined there was reliable evidence based on 7 studies (including the 2 mentioned above) that it yields positive results for those with knee osteoarthritis. 3 Hauser RA, Lackner JB, Steilen-matias D, Harris DK. A Systematic Review of Dextrose Prolotherapy for Chronic Musculoskeletal Pain. Clin Med Insights Arthritis Musculoskelet Disord. 2016;9:139-59.

Prolotherapy is low risk and unlikely to produce adverse effects, but pain and irritation can result immediately after the injection. Some doctors prescribe pain medication to help with post-injection pain.

See Hyaluronic Acid Injection for Knee Osteoarthritis: Procedure and Risks

If you have osteoarthritis of the knee and have tried other injections options without much success, ask your doctor if prolotherapy may be right for you.

See Arthritis Treatment Specialists

Learn more:

Knee Osteoarthritis Diagnosis

Stem Cell Therapy for Arthritis