Prolotherapy Injections in the Knee for Osteoarthritis 

Why is prolotherapy used?

Prolotherapy is an alternative to surgery for treating chronic pain.

Many bodily pains, particularly back and spinal pain, are often “referred” pains. Although the pain may be felt at a specific point on the patient’s body, the actual source of the pain may be located far from that point.

An easy example of this is arm pain, which is actually caused higher up in the body by a pinched nerve in the neck.

Even in the best circumstances, surgery is a serious consideration. Although most modern surgical techniques are well-proven, they are not always the appropriate first step for a particular problem.

Modern diagnostic imaging techniques, however powerful they may be, cannot always pinpoint the exact origin of joint or back pain with 100% certainty.

The body structures treated by prolotherapy are often hidden, difficult to visualise, or too worn for surgical repair.

By reconstructing tissue directly in these problematic areas, this therapy can often repair connective tissue damage to ligaments and tendons that surgery cannot address.

What is treated with prolotherapy?

Prolotherapy is used for chronic pain caused by conditions of the musculoskeletal system.

It can reduce pain associated with various diseases or disorders affecting bones and tissues, including ligaments, muscles, tendons, and cartilage.

Prolotherapy is beneficial for individuals with the following conditions:

• Arthritis.
• Arthrosis.
• Ligament instability.
• Fibromyalgia or chronic pain.
• Degenerative disc disease.
• Tendinopathies.
• Low back pain.

What to do before prolotherapy?

Talk to Dr. Alfonso Porcar before starting prolotherapy. He will tell you if it is necessary to pause any medications you are taking or other pain control techniques you are using.

Before proceeding with prolotherapy, it is essential to perform a detailed examination of the patient’s conditions.

• This involves an accurate clinical and imaging diagnosis of the source of the pain. It is also crucial to determine the exact location for the injection of the substance, which sometimes requires the assistance of ultrasound guidance.
• It is also essential to consider that, in parallel to prolotherapy, those biomechanical factors that contributed to the deterioration of the joint, tendon or ligament, such as overweight, inadequate posture, poor sports technique, postural imbalances, among others, should be adjusted.
• For complex cases of osteoarthritis of the knee, we can use a prolotherapy-only approach, or we can combine it with PRP (platelet-rich plasma) treatment, or autologous cytokine-rich serum.

What happens during prolotherapy sessions?

In the same session, once we have your diagnosis, we will inject a solution containing hypertonic dextrose (or other solution) into the joints, tendons or ligaments where you feel pain.

We may use an imaging tool, such as ultrasound, to guide the injections.

How many prolotherapy sessions do I need?

Depending on the type of injury you will need to receive prolotherapy in several injection sessions. Typically three to six injections over the course of all prolotherapy sessions. The number and frequency of injections will depend on the area of the body being treated and what your doctor recommends.

Large, complex joints such as the knee and shoulder usually require a series of five injections, spaced over time, to achieve a full healing effect.

Smaller joints, such as elbows or ankles, may need only one or two injections.

What care is necessary after prolotherapy?

Most of the time, prolotherapy does not require any special follow-up.

Due to the irritation of the treated area generated by the prolotherapy, it may happen that after the injection the pain worsens. If this is your case we can give you analgesics to treat the pain.

This pain is a normal reaction and usually subsides within a few days.

What are the advantages of prolotherapy?

The advantages of prolotherapy are:

• Pain reduction: many people report a marked reduction in pain after injections.
• Very few side effects: it is a low-risk treatment that does not usually have serious side effects.
• It can be combined with other treatments: we can use prolotherapy in addition to other treatments and techniques to control your pain.

What are the risks of prolotherapy?

Fortunately, prolotherapy has no serious side effects.

You may feel some pain at the injection site and bruising is rare.

There is a very low risk that the injections will damage nerves, joints or other tissues near the injection site, but prolotherapy is no more risky than any other injection.

The risks most associated with prolotherapy have more to do with its efficacy than with physical damage to the body.

How much does a prolotherapy session cost?

Most insurance plans do not cover prolotherapy injections, which means you will have to pay the full cost out of pocket.

The cost may vary depending on your city and the clinic, but you may have to pay from 100 to 150 € per prolotherapy session. In our clinic the price per session is 75 €.

What is the recovery time after prolotherapy?

Prolotherapy sessions require little recovery time.

You should be able to resume all your normal activities immediately. You may have some soreness at the injection site, but you should be able to resume all of your normal activities without interruption.

Talk to your doctor before resuming strenuous physical activities, such as strenuous workouts or playing sports, after an injection.