Restart Healing in Chronic Tendon & Joint Pain
Prolotherapy is an ultrasound-guided injection treatment for long-standing (chronic) tendon problems — tendinopathy or tendinosis — as well as chronic joint, ligament, and other soft-tissue pain. A small amount of sterile dextrose solution is injected into and around the injured tissue with repeated fenestrations to trigger the body's own repair process.
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Waking Up a Stalled Healing Response
Chronic tendon injuries often fail to heal on their own. The dextrose solution acts as a mild irritant that "wakes up" the body's natural healing response in the tendon, triggering a brief, controlled wave of inflammation that the body uses to repair tissue, rebuild collagen, and strengthen the tendon over time.
Because the goal is to restart healing rather than simply mask pain, improvement is gradual. A dextrose concentration in the range of roughly 5% to 25% is used, depending on the procedure, mixed with a local anesthetic to keep the injection as comfortable as possible.
After Your Injection
Because prolotherapy works by restarting healing rather than masking pain, relief builds gradually rather than happening right away.
More Soreness at First
It is normal — and expected — for the treated area to feel more sore or achy for a few days after the injection. This temporary flare is a sign the healing response has been activated, not a sign that something has gone wrong.
Gradual Relief
As the tendon heals, pain typically begins to settle down, with meaningful relief often noticed by around 4–6 weeks.
Everyone Is Different
Some people respond faster and some slower. After the injection, Dr. Salamatipour will check in to see how you are feeling and decide together on any next steps.
Recovery & Aftercare
Take It Easier for a Few Days
Expect to take it easier for a few days while the post-injection soreness settles.
Gentle Movement Is Fine
Gentle movement and your usual daily activities are generally fine unless told otherwise.
Use Tylenol for Soreness
For soreness after the injection, it is fine to use acetaminophen (Tylenol) and rest as needed. A short course of a prescription-strength pain medication, such as tramadol, is sometimes used if pain is severe and Tylenol alone isn't enough — though this generally isn't needed.
Follow Your Loading & PT Plan
Follow any specific activity, loading, or physical therapy instructions your physician gives you.
Important: Avoid Anti-Inflammatory Medications
Because prolotherapy works by triggering a healing inflammation, anti-inflammatory drugs can blunt its effect.
Stop NSAIDs at least 5 days before your injection, and avoid them for 2 weeks afterward — this includes ibuprofen (Advil, Motrin), naproxen (Aleve), meloxicam, diclofenac, and similar medicines.
Do not stop any prescription medication — for example, aspirin prescribed by your doctor for your heart — without checking with the prescribing doctor first.
When to Call the Office
Call if you notice any of the following:
- Fever, spreading redness, warmth, or drainage at the injection site (possible infection)
- Severe or worsening pain that does not ease after several days
- Numbness, weakness, or any symptom that worries you
Please contact the office if anything about your treatment or recovery is unclear.
Where Prolotherapy Fits Into Your Care
Tendinosis, Muscle & Ligament Injuries ›
Restarts a stalled healing response in chronically degenerated tendons and ligaments.
Osteoarthritis & Joint Degeneration ›
Targets chronic joint pain and instability related to lax or injured supporting ligaments.
Buttock, Hip & Low Back Pain ›
Used for chronic ligament laxity and soft-tissue pain around the hip, buttock, and SI joint.
Plantar Fasciitis & Heel Pain ›
Stimulates healing in a chronically degenerated plantar fascia.
This list is not exhaustive. We evaluate and treat many other chronic tendon, ligament, and joint conditions with prolotherapy — contact us to schedule a consultation for a proper diagnosis and treatment options.
Common Questions
What is prolotherapy? +
An injection treatment most often used for chronic tendinopathy or tendinosis, as well as other chronic joint, ligament, and soft-tissue pain. A small amount of sterile dextrose solution is injected into and around the injured tissue, with repeated fenestrations, under real-time ultrasound guidance.
How does prolotherapy work? +
The dextrose solution acts as a mild irritant that "wakes up" the body's natural healing response in the tendon, triggering a brief, controlled wave of inflammation the body uses to repair tissue, rebuild collagen, and strengthen the tendon over time.
When will I feel better? +
It's normal for the treated area to feel more sore for a few days after the injection — a sign the healing response has been activated. As the tendon heals, pain typically begins to settle, with meaningful relief often noticed by around 4–6 weeks. Everyone responds at a different pace.
Can I take ibuprofen or other NSAIDs afterward? +
No — anti-inflammatory medications can blunt the healing response prolotherapy relies on. Stop NSAIDs (ibuprofen, naproxen, meloxicam, diclofenac, and similar medicines) at least 5 days before your injection, and avoid them for 2 weeks afterward. Acetaminophen (Tylenol) is fine for soreness. Never stop a prescription medication without checking with the prescribing doctor first.
What solution is used? +
A dextrose (sugar) concentration in the range of roughly 5% to 25% is used, depending on the procedure, mixed with a local anesthetic to keep the injection as comfortable as possible.
Why does ultrasound guidance matter? +
Blind injections frequently miss their target. Dr. Salamatipour uses ultrasound to see the tendon in real time and guide the needle precisely to the area that needs treatment.
Is this covered by insurance? +
Yes. With an accepted plan (Cigna, Anthem Blue Cross, Aetna, United Healthcare, or Medicare PPO), prolotherapy is billed to your insurance at $0 out-of-pocket cost to you. Self-pay patients are welcome with transparent, accessible rates — see our pricing page for details.
What happens at the first visit? +
A full history and physical exam plus a diagnostic ultrasound of the affected area — so you leave with an accurate diagnosis, an understanding of every factor contributing to it, and a clear treatment plan.
Find Out If Prolotherapy Is Right for You
Call or email today — we'll answer your questions and schedule your consultation with Dr. Salamatipour.
Personalized Case Review400 Newport Center Dr, Suite 602-A, Newport Beach, CA 92660 · PPO insurance, Medicare PPO, & self-pay accepted