Dr. Patrick Bartoshyk



Prolotherapy, also referred to as Regenerative Injection Therapy (RIT), is defined as both a “nonsurgical ligament reconstruction” therapy as well as a treatment for chronic musculoskeletal pain.


The word “Prolo” is short for proliferation as prolotherapy treatment enhances the growth and formation of new ligaments, tendons and cartilage in areas where there is weakness or excess scar tissue. Any joint in the body can be treated successfully with prolotherapy regardless of when the injury happened. The treatment is also beneficial for most types of musculoskeletal pain. Prolotherapy incorporates the use of a specialized dextrose (sugar) solution, which is injected into a ligament or tendon where it attaches to the bone.  The initial reaction of the treatment is localized inflammation triggering a wound healing cascade leading to increased blood supply and flow of nutrients and growth factors. This stimulates the tissue to repair itself by deposition of new collagen, the material that ligaments and tendons are made of. The new collagen then shrinks as it matures leading to ligament/tendon tightening and increased strength.

The Injection Solution is 12.5% to 20% dextrose with 1% procaine. The dextrose makes the solution more concentrated than blood, acting as a strong proliferant. Procaine is an anaesthetic that helps reinforce the diagnosis because the patient may experience immediate pain relief after the injection. The dextrose solution, in addition to being safe, will not affect a diabetic’s blood sugar level. Other injectables may be added such as hyaluronic acid or Vitamin B12 (methylcobalamin).


  • Joint pain (all locations)

  • Torn ligaments, tendons and cartilage

  • Herniated / Degenerated discs

  • Post injury / Trauma pain

  • Low Back Pain / Rib Pain

  • Neck Pain / Headaches / TMJ

  • Unstable shoulder joints (dislocations)


  • Surgical scar reduction

  • Yoga overstretch injuries

  • Post fractures

  • Pain conditions: Sciatica, Arthritis

  • Frozen shoulder

  • Whiplash injuries / Sports Injuries

  • Fibromyalgia

  • Tendonitis


Prolotherapy FAQs


How will I feel after a Prolotherapy treatment?

Immediately after the treatment many patients describe a feeling of fullness in the joint. Quite often for the first hour the joint feels better because the Procaine has numbed the joint. Once the Procaine wears off you may feel sore at the injection site for a day or two. For the first two weeks you may feel the same, better or worse as the healing process proceeds. The fourth week after the injection is the time when you can best assess the results of treatment. Any noticeable increase in strength, decrease in pain, improvement in sleep or change in other symptoms is evidence that the healing process has been triggered.

How long does Prolotherapy healing last?

Since we can continue to “wear out” or be re-injured, it is impossible to predict how long your healing will last. Sometimes patients come back a year or more later for a “booster” procedure in the same area, others have to come back sooner. Some patients don’t require any boosters. It really depends how well you take care of yourself and how your body will respond to the treatments


What can prolong or stop the healing process with Prolotherapy?

  • Patients who over-exercise the healing joint or body part.

  • Taking anti-inflammatory medications and/or supplements.

  • Giving up and stopping Prolotherapy treatments prior to complete healing.

  • Eating a diet that causes inflammation.


What are the best things to do following Prolotherapy?

  • Drink at least 2 liters of water following all injection therapies. Dehydration is the number one reason for post-injection discomfort.

  • Have soft tissue therapy (ART, physical therapy, chiropractic, etc.) as soon as possible following the injection treatment. The gains made from soft tissue treatment immediately after injections seem to be really accelerated.


What should I bring to my first prolotherapy treatment?

  • Comfortable, loose, athletic clothing.

  • Any reports of MRI’s, CT scans, x-rays, & ultrasounds, etc.

  • Copies of all recent blood work (less than 6 months old).