Prolotherapy is a way of alleviating or even eliminating muscle, ligament, bone, joint, and tendon pain without the use of pills or surgery. Many people who have these sorts of injuries or ailments like arthritis feel that they’re limited either to going under the scalpel, taking medication for the rest of their lives, or simply living with oftentimes debilitating pain.

There is another option! Prolotherapy is a medical treatment option consisting of injecting small amounts of medicine between the muscle and bone. It sounds like this would be a painful procedure, but the needles used to inject the medication are of the same width as an acupuncture needle, making it nearly imperceptible as is. During the treatment itself, a numbing spray is applied to the skin as well, which renders the treatment painless for most patients.




Insofar as surgery is concerned, often times there is a high risk factor involved with it and there’s always a chance that the surgery will either be ineffective or possibly even make the situation worse. Pills have to go through your entire system before they start eliminating the pain, meaning that you have to take a relatively high dose in order for the medicine to digest and start relieving the pain.

With prolotherapy, the medicine is injected directly into the areal that needs the therapy, so it doesn’t need to go through the rest of your system before being effective. Prolotherapy also helps your body help itself by enhancing your body’s ability to heal – many people who undergo prolotherapy find that the pain doesn’t return.

Dr. Marc Darrow describes the prolotherapy process and how it can bring pain relief and help eliminate surgeries. He also talks about a new technology called PRP that’s related to prolotherapy. Dr. Darrow also talks about how quick the prolotherapy procedure is.

After using prolotherapy treatment for several years now in my practice, I have noticed that many patients evaluating prolotherapy have a common set of questions about this unique form of pain management. Here are those most common questions and their answers.


1. What is Prolotherapy?
Prolotherapy treatment is the injection of an irritant (Dextrose- pharmaceutical-grade sugar water) in the painful area or joint that creates a short duration of inflammation. The Prolotherapy rapidly produces collagen and cartilage, the soft tissues of the body, which stimulates the immune system’s own healing mechanism. The new collagen and cartilage strengthens and restores joints, and supporting soft tissue, reducing or eliminating many different types of pain.
2. What do you inject?
In most cases I inject Dextrose (pharmaceutical grade sugar water), and lidocaine, a numbing medicine.
3. Does it Hurt?
Prior to injection, most parts of the skin are numbed with a cold spray so that the patient doesn’t feel the needle insertion very much, if at all.
4. What will it be like after a Prolotherapy treatment?
After a treatment, some patients feel stiffness for a short while, which can last up to 24 hours, or occasionally more. I have done sports after my Prolotherapy treatments without difficulty (although I advise my patients to rest the area till the next visit, and do cross-training if exercise is an important aspect of their life). Some patients are immediately “healed” while many feel nothing during the first week after their procedure.
5. How many treatments do I need?
Every patient is different. Every injury or pain is different. And it is difficult to forecast how many treatments will be needed. Wrists, ankles, and knees usually heal in about 2-4 treatments. Backs and necks often take twice as long. The speed of healing is also related to how patients take care of themselves.
6. What percentage of patients feel better after Prolotherapy?
Every Prolotherapist I have met concurs that about 80-90% of their patients feel better after treatments.
7. Are there any things patients can do to prolong or stop the healing process with Prolotherapy?

There are three things that can inhibit healing:

  • Patients who over-exercise the healing joint or body part.
  • Taking anti-inflammatory drugs.
  • Giving up and stopping therapy prior to complete healing.
8. How do I know if Prolotherapy will work on my condition?

One key is to palpate (press firmly) the area where the pain is located. If you can find the spot that hurts, Prolotherapy will usually work there. Prolotherapy also works in areas where you press and can not find the pain. This applies to the inside of joints, and deep connections of tendons and ligaments where they attach on the bone, including but not limited to the neck and back.

9. Does my insurance cover Prolotherapy?

Generally, Prolotherapy is not covered by medical insurance. However, this is on an individual basis, and we have had patients tell us that they have been reimbursed.

10. What is the cost of Prolotherapy?

Prolotherapy costs vary depending on the part or parts of the body that we treat. Please call the office at 310-231-7000 for specific details that pertain to your condition.

11. Is Prolotherapy experimental?

Medicare considers Prolotherapy to be experimental since it states that not enough studies have yet been performed.
In my opinion, more studies have been done on Prolotherapy, showing its healing ability, than on most medical procedures. I have included studies on this site, but you can Google the word Prolotherapy, and find copious studies. In the following FAQ, I discuss our previous United States Surgeon General’s opinion of Prolotherapy, and why insurance has a problem paying for it. The answer is not because Prolotherapy is experimental. Please read ahead.

12. C. Everett Koop’s (previous United States Surgeon General’s) opinion of Prolotherapy.

Please read this letter from C. Everett Koop:Although I have not been practicing surgery for about 15 years, I continue to see many people who have benefited from Prolotherapy as a treatment for ligament laxity.
In my own case, I had been diagnosed by two separate neurological clinics as having intractable pain. My symptoms and the lack of sleep were affecting my work. I obtained complete relief from prolotherapy. After that, I began using it on the parents of my pediatric patients.
I saw remarkable benefits when the method was used with proper indications. Certainly, if used properly, prolotherapy does no harm but can be of extraordinary benefit. I have changed many lives.
Watching some of my colleagues fight the system for the payment for Prolotherapy in their practices has led me to believe that those who make the decisions about what will and will not be covered by insurance plans are those surgical specialists who benefit most by operative procedures which are frequently not indicated, expensive, and ineffective.
Sincerely yours,
C. Everett Koop, MD

13. Why do we perform Prolotherapy instead of surgery?

There are several reasons why prolotherapy treatments are used instead of surgery:

  • The two procedures are exact opposites of each other. Prolotherapy naturally stimulates the body to produce more collagen and rejuvenate an area to reduce or eliminate pain. Surgery is most often used to cut tissue out of the body, and eventually destabilize the tissue.
  • Prolotherapy in most cases has little to no side effects, whereas surgery has a very high risk potential.
  • Prolotherapy is relatively inexpensive. Surgery is extremely expensive.
  • There is no rehabilitation or time missed from work with Prolotherapy. Surgery often requires months of rehabilitation and time off work.
  • Prolotherapy can be performed in our office. Surgery must be performed in a hospital or outpatient setting.
  • No one needs to take care of you or drive you home after Prolotherapy. Surgery requires a caregiver.
  • Prolotherapy is natural and requires no drugs or anesthetic. Surgery requires both.
  • Studies now show that fake knee surgeries work as well as real knee surgeries (so why have the real surgery). From an article by Donald Murphy…..The failure rate of surgery for low back pain is very high. On average, about 53 percent of all L5-S1 disc surgeries fail to produce relief of symptoms. Quite frequently, the patient ends up in worse shape than before the operation.
14. How long do Prolotherapy treatments last?

It only takes a couple of minutes to administer the Prolotherapy. There is no recuperation period, and the Patient may leave the office immediately. Often a Patient will be in the office for an hour or more on the first visit to give a medical history and to take a physical, go over diagnostic films and their medical reports and labs, and have time to ask questions, and have the answers fully explained.

15. How quickly do patients feel better after Prolotherapy?

Like most medical treatments, patients have different reactions to prolotherapy:

  • Some patients feel better immediately.
  • Some patients feel the same after one or several procedures.
  • Some patients feel better after a nondescript period of time.
  • Some patients feel no better until a series of injections are completed.
16. How often are Prolotherapy treatments performed?

Your program can be tailored to meet your needs. Prolotherapy can be performed once a week, or can be scheduled at 4-6 week intervals. No matter what the time period between sessions, collagen is stimulated to grow, and this process continues to mature over a three-month period.

Although Prolotherapists disagree about how often treatments should be performed, I have found the fastest healing to occur with weekly treatments. This keeps the collagen being stimulated frequently, and keeps patients from being frustrated for long time periods of not being able to function or get back to their sports. Nevertheless, get Prolotherapy whenever it is available to you to get your healing started. One treatment is better than no treatment.

17. How many Prolotherapy treatments will I need?

Each patient heals at their own pace. It is often difficult to project how soon healing takes place. And some areas of the body will typically heal faster than others, depending on the injury type. At the time of your exam, I will be able to give you a better idea of your healing time, and how many treatments you may need.

18. Once I am healed by Prolotherapy, will that healing last forever?

This is sort of a trick question. Most people are born pain-free, and suffer injuries, arthritis, or overuse injuries over time. In other words, most people are “perfect” when they are born. Since we can continue to “wear out” or be reinjured, it is impossible to predict how long your healing will last. Sometimes patients come back a year or more later for a “booster” procedure in the same area. It really depends how well you take care of yourself. Many patients, including myself, have had a dozen or more pain-free years.

19. Can Prolotherapy heal torn tendons or ligaments?

I have treated countless patients with rotator cuff tears in the shoulder, meniscal tears in the knee, or fibrocartilage tears in the wrist. Most of them have healed.

Rarely will a patient have a follow-up MRI of the area once the pain is gone (why spend the money). This did occur recently with a college-level golfer from one of the top golf teams in the country, whose wrist was ready for surgery. I performed Prolotherapy on his wrist and his orthopedic surgeon ordered an MRI since he became pain-free under my care, and the ortho wanted to know if the golfer was ready to compete again. The ortho said this was the first tear of this type that he had ever seen heal. I got a call from my patient as he walked off the course from his first tournament at Riviera Golf Club in Los Angeles, thanking me for his “miracle”.

There is a study showing that Prolotherapy can tighten loose knees from anterior cruciate ligament laxity, and reduce or eliminate the pain.

20. Where can I get Prolotherapy treatment in Los Angeles?

The Prolotherapy doctor in Los Angeles that has seen the most patients and has the most experience is Dr. Darrow who practices at the Darrow Sports & Wellness Institute. He has seen over 10,000 patients since his residency at UCLA.

It can be difficult to find a prolotherapy doctor in your area, as it is difficult to find any professional service provider in many ways. You want to find someone that you can trust completely. The patient and prolotherapist relationship is a sacred one, as the patient will basically be putting their future potential for pain relief and restored movement in the prolotherapist’s hands.


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