Prolotherapy is a regenerative injection treatment that works by stimulating the body’s own healing process to repair damaged ligaments, tendons, and joints. Understanding the mechanism helps explain why it produces lasting results where cortisone and other treatments do not.
The underlying problem prolotherapy addresses
Most chronic joint pain – in the knee, shoulder, hip, ankle, elbow, or spine – originates in damaged connective tissue. Ligaments hold bones together. Tendons connect muscle to bone. When either is stretched, partially torn, or weakened through overuse or injury, the joint loses stability. The body compensates by overloading surrounding muscles and altering movement patterns, which accelerates cartilage wear and produces chronic pain.
Cortisone injections reduce the inflammation that results from this damage, but they do not repair the underlying structural problem. The pain returns when the cortisone wears off – and repeated cortisone injections further weakens the collagen in tendons and ligaments over time.
What the injection does
Dr. Franchi injects a solution of 50% dextrose (a natural sugar) and 2% lidocaine into the ligament or tendon in proximity to where the tissue is damaged. The dextrose solution acts as a mild irritant at the injection site, triggering a natural and controlled local inflammatory response.
This response signals the body to begin tissue repair. Fibroblasts – the cells responsible for producing collagen – migrate to the site and begin generating new collagen fibers. Over a series of treatments, this new collagen strengthens and tightens the damaged ligament or tendon, restoring structural integrity to the joint.
Why anti-inflammatories must be avoided
This mechanism explains a critical instruction Dr. Franchi gives all patients: do not take NSAIDs (ibuprofen, naproxen, aspirin) during the treatment period. These medications suppress the inflammatory response that prolotherapy is designed to trigger. Taking them would counteract the treatment. Tylenol (acetaminophen) is safe to take for pain.
Why experience matters
Prolotherapy injections must be placed wherever the tear in the ligament or tendon happens to be. This requires both anatomical knowledge and a lot of clinical experience. Dr. Franchi has practiced orthopedic medicine for over 40 years and has performed prolotherapy injections for more than 20 years. He is a classically trained orthopedic surgeon and has seen the anatomy of thousands of patients – which informs the optimal places to inject his patients. Nobody in all of New England has performed more prolotherapy procedures than Dr. Albert Franchi.
What results look like
Prolotherapy does not produce instant relief. Because it works by stimulating tissue repair – a biological process – improvement develops gradually over the course of treatment. Most patients begin noticing meaningful reduction in pain and improvement in joint stability after the second or third treatment. Full results are typically apparent two to three months after completing the treatment series.
Because the improvement reflects actual structural repair rather than temporary pain suppression, results are durable. The repaired tissue typically does not revert. Most patients do not require additional treatments unless they sustain a new injury.
Dr. Franchi offers a complimentary phone consultation to evaluate whether your condition is appropriate for prolotherapy. Call 833-Go-Prolo (833-467-7656) or 781-299-7521. Boston Prolotherapy and Orthopedics, 92 Montvale Avenue, Suite 4650, Stoneham, MA.
I’m 26 years old. I grew up showing horses and I have and injury where I injured my L4 and L5 vertebrae in my lower back. Would I be a good candidate for prolotherapy?
Possibly. The key to prolotherapy is if you have point tenderness in your lower back. Some people think prolotherapy is helpful for herniated disc. I disagree with that. I think it’s too invasive a procedure. But if you have areas on your back where you can say, “I know exactly where this hurts,” prolotherapy is very appropriate. Because when we give you the injections, we give them at the point of pain, because that’s telling us where the ligament or tendon is damaged.
For an older relative of mine, he often experiences shoulder pain, possibly arthritis. Could prolotherapy help him?
Yes. I had a woman come to me who could not raise her shoulder. She had severe arthritis. She also had what’s called adhesive capsulitis.
She came to me and asked if I’d do prolotherapy. At the time I was a little skeptical. I gave her the injections and also an intensive physical therapy program to get her shoulder moving again.
She is my favorite patient now. She is so happy. She has 90% motion in her shoulder and her pain has gone away. I didn’t believe it so much, so I took another x-ray, and actually some of the arthritis was decreased. Really.
I had another woman with a torn rotator cuff who refused to have surgery. I said, OK, I’ll treat you. She had an MRI which showed the rotator cuff. She came back three months later like this [raises his arm]. Is said, “Do you mind if I do another MRI? I’ll pay for it myself.” The MRI report showed no rotator cuff tear – it was completely healed.