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Ligament and tendon injuries can lead to ongoing discomfort, joint instability and stiffness that affect everyday movement. These problems often persist when soft-tissue structures are weakened through overuse, poor healing or repeated strain. When pain continues despite rest, physiotherapy or medication, some patients may benefit from a treatment that helps strengthen these tissues rather than simply easing symptoms. Prolotherapy offers a minimally invasive option for selected cases, supporting the body’s natural repair processes to help stabilise weakened areas and reduce chronic soft-tissue pain.

What is prolotherapy?

Prolotherapy is a minimally invasive injection treatment used to encourage healing in weakened or irritated soft-tissue structures. The injection contains a solution that stimulates a controlled healing response at the targeted area, prompting the body to strengthen ligaments, tendons or surrounding tissue that may be contributing to chronic pain or instability. By addressing these underlying soft-tissue weaknesses, prolotherapy aims to improve support around the affected joint and reduce symptoms that have not responded fully to conservative care.

Prolotherapy is a minimally invasive treatment that stimulates the body’s healing response to strengthen weakened ligaments and tendons.

Why consider prolotherapy?

Prolotherapy may be considered when pain arises from weakened ligaments or chronic tendon irritation that continues despite physiotherapy or medication. The treatment aims to strengthen supporting structures rather than only masking symptoms, making it suitable for selected soft-tissue injuries.

Benefits include:

  • Support for tissue repair — stimulates the body’s healing response in ligaments and tendons that have become overstretched or irritated.
  • Improved joint stability — helps strengthen supporting structures, which may reduce episodes of buckling, giving way or mechanical discomfort.
  • Reduced chronic soft-tissue pain — calming irritated structures can lessen persistent ache or stiffness around a joint.
  • Minimally invasive — involves small injections with no surgical incisions.
  • Low downtime — most patients resume light activity soon after treatment.
  • Complementary to rehabilitation — improved tissue support may enhance the effectiveness of physiotherapy.

What conditions can prolotherapy treat?

Prolotherapy is used for soft-tissue injuries where pain or instability stems from weakened ligaments or irritated tendons. It may be considered when symptoms persist despite rest, physiotherapy or medication and imaging does not show structural damage that requires surgery.

Common conditions include:

  • Ligament sprains and laxity — overstretched or weakened ligaments that contribute to joint instability or recurrent discomfort.
  • Tendon injuries — chronic tendinopathy affecting areas such as the Achilles, patellar or rotator cuff tendons.
  • Chronic joint instability — joints that feel loose, unstable or prone to giving way due to insufficient ligament support.
  • Overuse injuries — repetitive strain affecting tendons or ligaments, often seen in active individuals or those with physically demanding routines.
  • Persistent soft-tissue pain — ongoing discomfort around a joint that has not improved adequately with conservative treatment.

How is prolotherapy performed? 

Prolotherapy is carried out as an outpatient procedure and does not require general anaesthesia. The focus is on accurately targeting the weakened or irritated soft-tissue structure to stimulate repair while keeping discomfort to a minimum.

The general steps include:

  • Assessment and planning — your pain specialist identifies the ligament, tendon or soft tissue contributing to your symptoms based on examination and imaging findings.
  • Preparation of the area — the skin is cleaned thoroughly, and a local anaesthetic may be used to reduce discomfort.
  • Precise injection technique — a small amount of solution is injected into the targeted soft-tissue structure. Ultrasound guidance may be used when deeper or less accessible areas need to be reached.
  • Completion and dressing — a simple dressing is applied and you can return home shortly after the procedure.
  • Follow-up schedule — prolotherapy often involves a series of sessions spaced several weeks apart, depending on the condition being treated and your response.
Prolotherapy is performed by injecting a targeted solution into the weakened ligament or tendon, often under guidance, to stimulate a controlled healing response.

Prolotherapy vs other injection therapies

Prolotherapy differs from other injection options because it focuses on supporting the body’s natural repair processes in ligaments and tendons rather than providing temporary symptom relief. Understanding how it compares with other treatments can help patients know when it may be appropriate.

Prolotherapy — supports tissue strengthening

Uses an injection solution to stimulate healing in weakened ligaments and tendons. Best suited for chronic soft-tissue pain and joint instability.

PRP injections — concentrated growth factors for tissue healing

Uses the patient’s own platelets to aid repair in damaged tendons, muscles and ligaments. Often chosen when a stronger regenerative effect is required.

Steroid injections — short-term reduction of inflammation

Helps reduce swelling and acute pain but does not strengthen tissue. May be useful for temporary relief in inflamed joints or tendons.

Hyaluronic acid injections — lubrication for arthritic joints

Improves joint cushioning and movement in osteoarthritis but does not address ligament or tendon weakness.

Each treatment has a different purpose, and the choice depends on the underlying cause of pain, imaging results and response to prior therapies.

Contraindications — When prolotherapy may not be suitable

Prolotherapy is not recommended in certain situations where the injection may interfere with healing or where another form of treatment is more appropriate. A thorough assessment is carried out to determine suitability before the procedure.

Prolotherapy may be contraindicated in individuals with:

  • Active infection — including skin infections at the injection site or systemic infection.
  • Uncontrolled medical conditions — such as poorly managed diabetes, bleeding disorders or severe cardiovascular disease.
  • Immunocompromised states — where healing may be impaired or infection risk is higher.
  • Allergy to components of the injection solution — although this is uncommon.
  • Pregnancy — prolotherapy is generally avoided as a precaution.
  • Structural injuries requiring surgical management — such as full-thickness tendon tears or significant joint instability not responsive to conservative options.
  • Recent use of certain medications — for example, strong anti-inflammatory drugs may interfere with the intended healing response.

Your pain specialist will review your medical history, imaging findings and current medications to ensure prolotherapy is both safe and appropriate for your condition.

What to expect after prolotherapy — Recovery and aftercare

Recovery after prolotherapy is generally straightforward because the procedure is minimally invasive. Some temporary discomfort is expected as the body initiates its healing response in the treated area.

You may notice:

  • Mild soreness or stiffness — common for a few days and usually settles without intervention.
  • Gradual improvement — benefits often develop over several weeks as the tissue strengthens.
  • Activity modification — light movement is encouraged, while heavy lifting or strenuous exercise should be avoided initially.
  • Complementary physiotherapy — strengthening exercises or rehabilitation may be recommended to support recovery and enhance stability.
  • Follow-up sessions — some patients require more than one prolotherapy session depending on the severity and location of the injury.

Most individuals return to normal daily activities shortly after treatment, with improvements becoming more noticeable as the tissue repair process progresses.

Risks and side effects of prolotherapy

Prolotherapy is generally considered safe when performed by trained practitioners, as it uses small injections and does not involve surgical incisions. Most side effects are mild and temporary.

Possible effects include:

  • Local soreness or swelling — often settles within a few days as the healing response begins.
  • Bruising at the injection site — uncommon but may occur in areas with thinner soft tissue.
  • Temporary increase in discomfort — some patients experience heightened tenderness before improvement begins.
  • Infection — rare, but a risk associated with any injection procedure.
  • Allergic reactions — extremely uncommon, as the solution used is typically well tolerated.

Your pain specialist will assess whether prolotherapy is suitable based on your condition, medical history and imaging, helping to minimise any risks.

Summary 

Prolotherapy offers a minimally invasive way to manage chronic soft-tissue pain and instability that arise from weakened ligaments or irritated tendons. By stimulating the body’s natural repair processes, the treatment aims to strengthen supporting structures and reduce symptoms that have not improved sufficiently with rest, physiotherapy or medication. Improvements often occur gradually as the treated tissue responds and prolotherapy can complement rehabilitation to help restore stability and function over time.

If you have ongoing ligament or tendon-related pain that continues to affect daily activity, a specialist assessment may help determine whether prolotherapy is an appropriate option. Schedule a consultation with Total Pain Specialist to explore the next steps in your care.

Treatment choice depends on the underlying cause of the neck pain, its severity, and the individual’s overall health and preferences. Individuals need to consult a pain specialist to determine the most appropriate treatment plan for their specific condition. If you are suffering from neck pain, schedule an appointment with us for a thorough diagnosis and an appropriate treatment plan.

Frequently asked questions

Prolotherapy is used to treat pain or instability caused by weakened ligaments, chronic tendon irritation and certain soft-tissue injuries that have not responded well to conservative treatment.

Most patients feel only mild discomfort during the injection and any soreness afterwards usually settles within a few days as the tissue begins its healing response.

The number of sessions varies depending on the injury and response to treatment, but many patients require a series of injections spaced several weeks apart.

Improvement is gradual and may take several weeks as the ligaments or tendons strengthen. Some patients begin noticing changes earlier, while others see benefits over a longer period.

Prolotherapy is generally safe when performed by a trained specialist, with most side effects being mild and temporary, such as local soreness or swelling.

Consult a doctor if neck pain is severe, persists for several days without relief, is accompanied by symptoms like numbness, tingling, or headache, or results from an injury like a car accident. 

It may be considered for selected shoulder conditions involving ligament or tendon irritation, especially when symptoms have persisted despite physiotherapy.

Yes. Strengthening and stabilisation exercises often complement prolotherapy and may enhance long-term results.

Prolotherapy may not be recommended for individuals with active infections, certain medical conditions or structural injuries such as full-thickness tendon tears.

Fees vary depending on the number of injections required and the complexity of the condition. Your specialist will provide details during consultation.