Prolotherapy
Prolotherapy (Dextrose Injection Therapy)
Injection of dextrose (sugar water) solution into damaged joints, tendons, and ligaments to stimulate the body's natural healing response. Decades of use in sports medicine with growing RCT evidence for knee and low back pain.
How Prolotherapy Works
Prolotherapy involves injecting an irritant solution — most commonly hypertonic dextrose (12.5-25%) — into damaged ligaments, tendons, or joint capsules. The hyperosmolar solution causes local cellular dehydration and micro-injury, triggering a controlled inflammatory cascade. This inflammation recruits growth factors (PDGF, TGF-beta, FGF) and fibroblasts to the injection site, stimulating the production of new collagen and connective tissue. Over multiple treatments, this strengthens and tightens lax or damaged ligamentous structures, improving joint stability and reducing chronic pain.
📊 Evidence by Outcome
Rabago et al. RCTs show significant pain and function improvement in knee OA at 12 months vs saline injection.
8 studies • Consistency: Moderate • Effect: Moderate
Mixed evidence for chronic low back pain. Some RCTs positive, others show no benefit over saline controls.
6 studies • Consistency: Mixed • Effect: Small
Key Research
Peer-Reviewed Evidence • 2 Citations
Dextrose prolotherapy for knee osteoarthritis: a randomized controlled trial
Rabago D et al.•Ann Fam Med•2013•PMID: 23420128
Key Finding: RCT showed dextrose prolotherapy significantly improved pain and function in knee OA at 52 weeks vs saline injection.
View on PubMedA systematic review of dextrose prolotherapy for chronic musculoskeletal pain
Rabago D et al.•Clin J Sport Med•2005•PMID: 15782048
Key Finding: Systematic review found prolotherapy effective for chronic low back pain and knee OA in most controlled trials.
View on PubMedCitations sourced from PubMed, Cochrane Library, and peer-reviewed journals. Study findings are summarized for accessibility. Always consult the original publication for full methodology and results.
Side Effects & Safety
Interactions & Contraindications
Drug Interactions
- •NSAIDs — should be avoided for 2-3 days before and 1-2 weeks after treatment as they suppress the inflammatory response that prolotherapy relies upon
- •Corticosteroids — directly counteract the mechanism of prolotherapy and should be avoided
- •Anticoagulants — increased bleeding risk at injection sites
- •Local anesthetics mixed with the solution may mask pain needed for accurate needle placement
Supplement Interactions
- •High-dose anti-inflammatory supplements (curcumin, omega-3) may reduce efficacy if taken perioperatively
- •Vitamin C and collagen supplements may support the healing response
Food & Timing
- •Adequate protein and vitamin C intake supports collagen synthesis post-injection
- •Avoid alcohol for 48 hours post-treatment
Who Should Avoid
- •Active local or systemic infection
- •Allergy to the injection solution components (dextrose, lidocaine)
- •Bleeding disorders or current anticoagulation therapy that cannot be paused
- •Complete tendon or ligament tears (prolotherapy supports healing, not reconstruction)
- •Acute gouty arthritis in the target joint
📋 Protocol Snapshot
Protocols are for informational purposes only. Always consult a qualified healthcare provider before starting any treatment protocol.
Cost Guide
AED 1,000-3,000/session
Estimated UAE pricing. Costs vary by provider, dosage, and treatment plan.
Frequently Asked Questions
Evidence is mixed. The strongest support exists for chronic low back pain with ligament laxity, knee osteoarthritis, and lateral epicondylitis (tennis elbow). Several RCTs show benefit over placebo for these conditions. However, some systematic reviews have been inconclusive due to heterogeneous treatment protocols and small study sizes.
Most patients receive 3-6 sessions spaced 2-6 weeks apart. Improvement is typically gradual, with meaningful results appearing after 2-3 sessions. Some chronic conditions may require additional treatments. Many sports medicine and orthopedic clinics in Dubai offer prolotherapy treatment courses.
The injections cause temporary discomfort — a brief sting followed by a deep ache as the solution spreads through the tissue. Most practitioners use a local anesthetic in the solution. Post-injection soreness is normal for 2-5 days. Pain tolerance varies, but most patients find it manageable.
Prolotherapy is the simplest and most affordable of the three regenerative injection therapies. PRP adds concentrated growth factors from your own blood. Stem cell therapy introduces live cells. Evidence quality is similar across all three, and some UAE clinics offer combined protocols. Prolotherapy is often a good first step before escalating to more expensive options.
Where to Get It (UAE)
Related Treatments
Medical Disclaimer: The information on this page is for educational purposes only and is not intended as medical advice. Kamura Scores reflect a combination of research evidence, safety, accessibility, and value — they are not clinical recommendations. Research citations are provided for reference; always consult the original publications for complete study details. Consult a qualified healthcare provider before starting, stopping, or modifying any treatment. Individual results may vary.