Prolotherapy Injections care offered in Boulder, CO

What is prolotherapy, and who is the best candidate?

Prolotherapy, short for proliferative therapy, is the original regenerative treatment—it’s been around for over 90 years. Before PRP and stem cells became the focus of regenerative medicine, prolotherapy was the go-to solution. In recent decades, we’ve landed on dextrose (a sugar made from corn) as the safest, most consistent, and effective prolotherapy solution.

Injected at concentrations from 10% to 25%, dextrose stimulates healing of soft tissue injuries and arthritis. While it's the least strong of the regenerative injectables we use, it has unique advantages. Dextrose has a natural nerve downregulating effect, which we use in nerve hydrodissection with 5% sugar solutions. So you get both regenerative effects and pain relief in one treatment.

It’s quick, easy, and doesn’t require prolonged rest or rehab. That means patients can often continue their regular activities—including athletes in-season. And because it’s not cellular and doesn’t come from your own body, it’s more accessible and lower cost than PRP or stem cell options. It still triggers growth factor release, collagen production, and long-term pain regulation—just through a different mechanism and to a lesser degree than PRP and stem cell based treatments such as MFAT and BMAC.

At Breakthrough Regenerative Orthopedics, prolotherapy injections are commonly used to treat:

• Arthritis
• Back pain
• Joint pain
• Neck pain
• Ligament injuries
• Tendon injuries
• Muscle injuries
• Repetitive strain injuries
• Sciatica
• Sports injuries
• Joint instability
• Sprains and strains

How does prolotherapy injections compare to steroid injections?

Steroid injections are designed to suppress inflammation and the body’s immune response. But that comes at a cost—they also shut off the body’s natural healing processes. Steroids don’t heal tissue; they just provide short-term symptom relief, typically for 2–6 weeks. In some cases, like plantar fasciitis, the relief may last longer, but that’s not the norm.

Prolotherapy, on the other hand, initiates tissue healing and nerve downregulation for the long-term. While the pain from prolotherapy may be higher than steroids in the first couple weeks, the long-term results are far better. Around six weeks, prolotherapy typically outperforms steroids in pain and functional outcome clinical studies. By three months, the benefits of prolotherapy typically  surpass those of steroid injections out to a year in most studies. And this same principle applies across other regenerative therapies: the goal isn’t short-term symptom suppression—it’s long-term healing and functional recovery.

How long do prolotherapy injections last, and what does a typical treatment plan look like?

Since prolotherapy is a weaker regenerative treatment, we generally expect to perform three to four injections a month apart to see effective soft tissue healing. That’s ideal for tendon or ligament injuries, fascia tears, and other smaller soft tissue problems.

Patients typically come in for an injection once a month over the course of three to four months. We then reassess progress with a hands-on physical exam and pain/function levels. If strength has returned and pain is resolved, we consider the tissue healed.

Compared to PRP, which often requires only one or two injections, prolotherapy takes more injections—but it still gets good results. There was a great study from Australia comparing PRP and prolotherapy for sacroiliac ligament instability. At the one-year mark, the prolotherapy group had definitely improved, but PRP delivered better outcomes with fewer injections. That study really reinforced what we see clinically: both work, but prolo takes more injections as it  isn’t quite as strong of a treatment as PRP or stem cell based therapies.

What’s better—PRP or prolotherapy? And how do you decide who gets what?

It all comes down to the nature of the injury. Prolotherapy is a great option for newer, smaller injuries or for patients who want to stay active and avoid downtime. We can use it to “nurse” people through their recovery without major activity restrictions.

PRP is a stronger treatment. So if there’s more significant tendon tearing or ligament laxity—like in the SI joint or an ankle—we typically upgrade to PRP. It gets patients further, faster.

Then there are harder cases where PRP isn’t strong enough. That’s when we turn to stem cells. For example, bone marrow aspirate concentrate (BMAC) contains stem cells and   is ideal for bone and bone-tendon involvement, while microfragmented adipose tissue (MFAT) with fat-derived stem cells is excellent for large muscle/fascia and tendon tears. I especially like using MFAT in structural breakdown because it acts like a structural filler and provides a bio-scaffold— it’s also packed with regenerative potential with even more mesenchymal stem cells per volume than BMAC.

What makes prolotherapy unique among regenerative orthopedic treatments?

Prolotherapy stands out because of its simplicity, accessibility, and its ability to reduce nerve sensitivity while stimulating healing. It doesn’t require blood draws, cell processing, or significant downtime. It’s one of the most approachable entry points into regenerative medicine—and it still delivers powerful outcomes when used for the right conditions.

Whether it’s used on its own or as part of a broader treatment strategy, prolotherapy is a cornerstone of non-surgical orthopedic care.

Want to find out if prolotherapy injections can help you get back to you?

Schedule a comprehensive 90-minute evaluation at Breakthrough Regenerative Orthopedics. Dr. Mazzola will take the time to understand your history, goals, and functional challenges—and recommend the best regenerative plan to help you heal.

Book your assessment now.