Regenerative orthopedics
Prolotherapy
A minimally invasive treatment that aims to stimulate repair of ligaments, tendons and joints. It is indicated only after a medical evaluation.
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What it is
Prolotherapy is a regenerative procedure. A proliferant solution is applied to weakened or injured tissues to stimulate the body’s own repair response.
It is not surgery. The clinical goal is to improve function and pain in selected patients.
When it may be considered
It is often considered for mechanical joint or soft-tissue pain — for example the knee, shoulder, hip, spine or plantar fascia, or ligament and tendon injuries. Indication depends on the clinical exam and imaging.
It may help selected patients with:
- Chronic muscle pain
- Ligament, tendon and enthesis injuries
- Joint instability
- Osteoarthritis and joint degeneration
- Low-back, neck and spine pain
Related: knee pain, spine pain, ultrasound-guided injections, viscosupplementation.
How it is performed
Case evaluation
A detailed physical exam and clinical history, supported with ultrasound.
Targeted application
A proliferant solution is applied to the ligament, tendon or joint.
Tissue response
The aim is to stimulate the body’s own repair process.
Follow-up
The plan and number of sessions are defined case by case.
Before and after
Before the procedure, let us know which medications you take (especially blood thinners), and whether you have a bleeding disorder or allergies.
It is normal to feel pain, tenderness or discomfort in the area after prolotherapy: the treatment triggers a controlled inflammatory response to start tissue repair. It usually lasts 3 to 10 days, sometimes up to 2 weeks, and improves gradually. On days 1 to 3, discomfort is mild to moderate; on days 4 to 7 it may increase slightly and then level off; on days 8 to 14 it improves progressively.
Afterward, the most important thing is not to overload the joint: too much effort can irritate the treated area and slow recovery.
- Rest for the first 24–48 hours. Avoid demanding activities and repetitive movements.
- Stay active, but in moderation: light activities such as easy walking, as tolerated.
- Avoid overloading the area: lifting weights, strength training, running, jumping or impact, going up and down stairs too much, standing or squatting for long periods, high-impact sports, and twisting or sudden movements.
- Apply ice locally for 15–20 minutes, 2–3 times a day during the first 2–3 days.
- You can take acetaminophen (paracetamol) if you need it. Anti-inflammatories are not recommended unless a doctor indicates them.
- Drink enough water during the day.
- After the first few days, gentle stretching as your doctor indicates, and, if there is no pain, a stationary bike at an easy pace, swimming, and light mobility and balance exercises.
A mild inflammation or discomfort is normal. Every body is different and recovery times vary. If fever, redness, significant warmth or swelling appear, or severe pain that gets worse as the days go by, seek medical attention right away.
In short, in infographics by Dr. Lizeth Ortiz:
Slide 1 of 2
Slide 2 of 2What this treatment does not promise
Results vary. Not everyone is a candidate. It does not always replace surgery or rehabilitation. Expectations, risks and alternatives are reviewed in consultation.
Frequently asked questions
What is prolotherapy?
It is a regenerative procedure. A proliferant solution is applied to weakened ligaments, tendons or joints to stimulate the body’s own repair response. It is not surgery. The goal is to improve function and pain in selected patients.
How many sessions will I need?
There is no fixed number. Tissue repair happens in phases; a chronic injury is not resolved in a single visit. The plan and the follow-up are defined case by case. Follow-up matters as much as the procedure itself.
How much does the consultation cost? And the treatment?
The evaluation visit costs MXN $500 (Mexican pesos). Treatment (prolotherapy, viscosupplementation, injections or another procedure) has no fixed price: it depends on the area, the procedure and the number of sessions you need, which are decided at your evaluation. Before starting, we tell you the cost of your plan.
Are results guaranteed?
No. Results vary depending on the person, the tissue and what has already been tried. Expectations are reviewed honestly during the consultation.
What is the difference between prolotherapy and viscosupplementation (hyaluronic acid)?
They are different treatments that can complement each other. Viscosupplementation consists of placing hyaluronic acid inside the joint, mainly to improve the joint environment and help ease pain and discomfort associated with joint degeneration. Prolotherapy, by contrast, seeks to stimulate a repair response in structures such as ligaments, tendons and entheses. Entheses are the zones where these tissues attach to bone. In some patients, combining both therapies can be useful because it addresses both the joint itself and the structures that support and stabilize it. The combination and the number of applications depend on the injury, the symptoms and each patient’s evaluation. They do not do the same job, but they can complement each other within a personalized treatment plan.
Further reading
Physical therapies and inflammation: what we know about M2 macrophages
In the lab, several physical therapies change how macrophages behave. What has been proven in patients, what has not, and what to check before using them.
Repair is not instant
A chronic injury is not “cured” in a single session. Tissue repair happens in phases.
Book a visit
Care in Guadalajara and Mexico City, by appointment.
Guadalajara: Bari Medical Center, San Juan de Los Lagos 21, Vallarta Poniente, 44110 Guadalajara, Jalisco, Mexico. Monday through Saturday.
Mexico City: Medical San Francisco, Rosa María Siqueiros 229, San Francisco Culhuacán, Coyoacán, 04420 Mexico City, Mexico. One week a month; ask us for the dates on WhatsApp.
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