Prolotherapy for Lower Extremity Pain
What is prolotherapy?
Prolotherapy (short for proliferative therapy) is a regenerative injection treatment used to help strengthen and repair injured or weakened ligaments, tendons, and joint structures. It involves injecting a natural solution — most commonly a glucose solution (also known as dextrose), which is often mixed with a common local anaesthetic (lignocaine) — into the affected area.
Prolotherapy has been used in medicine and health care for over 60 years to treat musculoskeletal conditions. It is used by podiatrists, medical practitioners, physiotherapists and other health care professionals.
The purpose of prolotherapy is to stimulate the body’s natural healing response rather than simply reducing pain or inflammation.
How does prolotherapy work?
When ligaments or tendons become overstretched, degenerated, or partially torn, they may not heal well on their own. Prolotherapy works by creating a mild, controlled inflammatory response at the injection site.
This response encourages:
- Increased blood flow
- Activation of the body’s healing cascade
- New collagen formation
- Improved tissue strength and stability over time
- As the tissues heal and strengthen, pain often reduces and function improves.
What conditions can prolotherapy help with?
Prolotherapy may be recommended for a range of chronic foot and ankle conditions, particularly when symptoms have not adequately improved with conservative care.
Common podiatric indications include:
- Chronic plantar fasciitis / plantar fasciopathy
- Achilles tendinopathy (mid-portion or insertional)
- Ankle ligament sprains and instability
- Midfoot or forefoot ligament pain
- Mortons neuroma and bursitis
- Osteoarthritis
- Chronic heel or arch pain related to soft tissue overload, fat pad, bursae
Your podiatrist will determine if prolotherapy is appropriate for your specific condition.
What is in a prolotherapy injection?
Prolotherapy typically involves the use of injections, which historically has been done using of a variety of different solutions to act as 'irritants' to damaged tissues, and promote healing.
These days, the most common approach involves the use of a glucose sugar solution (around 15% dextrose), which is often mixed with a small amount of a common local anaesthetic known as lignocaine (also known as lidocaine).
Adverse Effects
These injections are considered extremely safe, but occasionally some adverse effects can occur.
There can be some slight discomfort during the injections, but we use very fine needles (similar to Botox injections), that cause very little pain. Sensitivity or allergy to local anaesthetics (if used) can occur but is extremely rare. Some local bruising or tenderness may occur at the site of the injection, and is more common. It is also possible (but very rare) to develop an infection at the injection site.
Sterile solutions, syringes and needles are always used for prolotherapy injections, along with careful technique to reduce the risk of an contamination at the injection site.
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