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Prolotherapy is also known as non-surgical ligament and tendon reconstruction. It is an alternative to invasive surgical joint repair and/or joint replacement and is commonly used as a treatment for chronic pain. It is a simple and natural technique that stimulates the body’s ability to heal itself – the term “Prolo” is short for proliferation, because the treatment causes the proliferation (growth, formation) of new ligament tissue in areas where it has become weak.

Ligaments are the structural “rubber bands” that hold bones to bones in joints. Tendons are the structures that attach a muscle to the bone. A ligament sprain or a tendon strain stimulates the immune system to repair the injured area. Because ligaments and tendons generally have a poor blood supply, incomplete healing is common after injury.

As a result of this incomplete healing, the previously taut, strong bands of fibrous or connective tissue compromising ligaments and tendons become relaxed and weak. The relaxed and inefficient ligament or tendon then becomes the source of chronic pain and weakness. To further complicate this, ligaments also have many nerve endings and therefore the person will feel pain at the areas where the ligaments are damaged or loose.


Prolotherapy uses a proliferant known as dextrose (sugar water) solution, which is injected into the ligament or tendon where it attaches to the bone. The technique initiates inflammation – the exact same process that the human body naturally uses to stimulate the body’s healing system. The localized inflammation increases the blood supply and flow of nutrients to the weakened areas, thereby stimulating the tissue to repair itself and initiating the growth of new ligament and tendon tissue. The outcome is tendon and ligament tissue that is even thicker and stronger than normal tissue, resulting in a more stabilized joint structure and consequently, complete resolution of pain.


Prolotherapy is performed every six weeks because most ligaments heal over a six-week period. As healing progresses, the quantity of injections required per treatment usually decreases. The pain generally continues to diminish with each treatment unless it is an acute injury which may heal in only two to three weeks after Prolotherapy. The actual number of treatments required will vary depending on the degree and severity of the injury, chronicity of the injury and individual capacity to heal (i.e. age, sex, lifestyle factors such as diet, smoking, etc.). The average number of treatments per individual is 3-6 per area being treated.


There are several joint and muscular injuries that can benefit from Prolotherapy. Some of the more common conditions treated include: sports injuries, dislocations, knee pain, frozen shoulder, rotator cuff pain, degenerative disc disease, low back pain, sciatica, hip degeneration, foot and ankle pain, migraines, carpel tunnel syndrome, tennis elbow, TMJ dysfunction, among others. During your initial consultation with Dr. Gurm a complete and thorough assessment is performed (including health history, orthopedic tests and possibly imaging studies) to help determine whether or not you are a good candidate for Prolotherapy.