a man with arthritic knees, topical pain relievers, arthritis pain

As Americans get older and grayer, we also have to cope with more joint pain. We swallow large quantities of anti-inflammatory drugs (NSAIDs such as ibuprofen or naproxen). Many of us take supplements such as boswellia, turmeric or glucosamine, either instead of medication or along with them. Relatively few have tried prolotherapy. Is it a reasonable treatment for joint pain?

Prolotherapy for Knee Osteoarthritis:

Q. What are the pros and cons of prolotherapy for knee osteoarthritis? I am not ready for knee replacement surgery, but my knees make it hard for me to exercise.

A. Prolotherapy has been around for decades. It involves injecting sugar water (dextrose), salt water (saline) or some other substance such as platelet rich plasma (PRP) into or around the joint. The theory is that this process creates localized targeted inflammation that leads to natural repair and joint stabilization.

How Well Does Prolotherapy Work?

A review of ten studies in the British Medical Bulletin (June 1, 2017) concluded,

“Moderate evidence suggests that prolotherapy is safe and can help achieve significant symptomatic control in individuals with OA [osteoarthritis].”

This treatment is not usually covered by insurance, and out-of-pocket costs can be hundreds of dollars. Nonetheless, it is a way of soothing joint pain without surgery.

Learn More:

You can learn about other non-surgical approaches to alleviating knee pain in our Guide to Alternatives for Arthritis. This online resource is too long to print or to mail.

You might also want to listen to our interviews with Loren Fishman, MD, and Brian Shiple, DO, in our Show 963: Easing Joint Pain Without Surgery. Dr. Fishman describes the use of yoga, while Dr. Shiple’s expertise is prolotherapy.

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  1. Wayne
    Indiana
    Reply

    I was having increasing pain in my knees especially first thing in the morning but sometimes making climbing a ladder painfun any time. I did not find boswellia, Celadrin capsuels, or glucosamine to be helpful, but there is a topical cream sold under the name Celadrin containing the Celidrin fats, menthol and many otherr ingredients that completely eleminated the problem less than a hour after application and lasting atleast 24 hours.

  2. Doug
    BC
    Reply

    Three years ago, I could barely go up or down the stairs at my walk up condo, I’m sure I almost ripped the handrail off trying. I tried prolotherapy, and the first time it caused a great deal of pain, the naturopath doctor halved the amount of injection next time and there was no pain, also I could once again climb the stairs almost normally.

    In all, I had 4 treatments to both knees and now almost 3 years later I am walking without pain and using stairs without pain. I workout on a treadmill for an hour ever day and walk for one or two hours outside.

    I would definitely give it a try before even considering knee surgery of any kind.

  3. Virginia
    GA
    Reply

    Instead of prolotherapy, try trigger-point dry needling. Nothing is injected into your body & it really works. It has saved me much pain and only rarely need a pain pill. It’s covered by Medicare and is performed by a physical therapist. I swear by it!

  4. Bob
    South Carolina
    Reply

    I had pain in both my knee and hip joints. I was convinced that I would have to have replacements in both of these areas. I made an appointment with the surgeon but he suggested that I first try physical therapy. I also asked about taking hyaluronic acid (HA) vitamins which is a natural lubricant for joints and he agreed that this would be helpful.

    After the first PT session, both areas felt better and after several weeks of therapy, as well as taking HA, the pain was completely gone. I found the same to be true with my back issues, which can result in severe pain if I don’t keep those muscles and tendons properly stretched.

    I exercise a lot but in the past never did any stretching exercises. Apparently the muscles tighten up to point where they increase the forces/pressures on these joints which then results in pain. Now I am pain free and perform an array of stretching exercises at least 3 or 4 times a week.

    I take HA on occasion and only if I feel a slight indication of the pain returning. Meds never did anything for my pain issues and even if they did I wouldn’t want to be on them constantly for the rest of my life.

  5. Barbara
    NM
    Reply

    I injured the tendons around my thumb, which made daily life difficult. I had prolotherapy and was pleased with the results. I had been in acute pain but this settled down quickly. I wish more doctors were trained in this, rather than just handing out pain meds. Chiropractors are ahead of traditional medical doctors, in some ways.

  6. Dianne
    Houston
    Reply

    I used to go to a retired Vietnamese army doctor who injected my very sore knee with a saline solution. It did help.

  7. Elizabeth
    Neptune, NJ
    Reply

    Where would I find someone proficient in prolotherapy for arthritic knees? Many times, a new technique becomes popular and all of a sudden every doctor can do it.
    Is there a certification needed before the doctor can do the injections? Can chiropractors administer them? Pain management doctors?
    Thank you.

  8. Honin
    Reply

    I am a survivor of a life threatening knee infection. I had been getting injections at the orthopaedic surgeon’s office . I was on IV antibiotics for a long time.After I was fully recovered, I had both knees replaced at 7 weeks apart in a major urban hospital on the east coast.The next surgeon who saw me before my surgeries warned me to never ever get any more knee injections. It does not solve the arthritic issue and the injections can be a pathway to a serious infection. I personally cringe at the thought of prolotherapy with which I am totally unfamiliar.

  9. Nancy
    NY
    Reply

    Had prolotherapy for gluteal tendinitis two years ago. It was $700 washed down the drain! Absolutely no help at all. But to be honest neither have any other treatments helped.

  10. Carl
    WA
    Reply

    Prior to having total knee replacement surgery, I tried many options, as I always viewed surgery as the last option. In addition to the old stand-by physical therapy, there were a series of injections directly into the knee joint (Synvisc & Supatz) I believe they were called. The first series, something like five injections every 2 to 3 weeks relieved my knee pain for about 6 months. A second and third series did nothing. At that point, I learned about Prolotherapy and tried that: a series of 4 injection into the knee 3 weeks apart. The result was disappointing. No pain relief whatsoever. I am no fan of surgery by any means but I had my knee replacement in 2010, and I have been able to ski and play tennis after the recovery without all the pain I had before. I would say that my knees still hurt but only at about 10% of the level of pain prior to the replacement.

  11. vera
    Reply

    How can some people say tomatoes and bananas are not good with arthritis?

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