When Prolotherapy Fails

Although prolotherapy is extremely effective at treating pain and injuries, it can on occasion fail to deliver optimal results. The success of prolotherapy treatments depends on several factors with the most important being the skill of the prolotherapist. The treatment is completely dependent on how skilled the doctor is at assessing and injecting the correct structures causing the pain and dysfunction. Thus, an inexperienced prolotherapist may hinder the success of your prolotherapy treatment.

Also, if the area isnít treated completely (with enough injections), with a strong enough solution or with an adequate volume of solution, then the patient will not receive the full benefit of prolotherapy because of insufficient inflammation. Remember, the body heals by inflammation. A person should feel stiffness, tightness and soreness for at least one to two days following a prolotherapy treatment. If they donít, then the immune reaction may not be strong enough to regenerate enough connective tissue needed to heal the structures treated. In this case, the physician needs to investigate the reason for the poor immune response.

Usually most people are cured of their pain with three to six Prolotherapy sessions. If a patient continues to suffer from pain or there is not significant improvement, and assuming that the correct structures are being treated with adequate inflammation, chances are that there is an underlying cause that hasnít been identified.

Below is a list of factors that may prevent affective healing of connective tissue thus causing dissapointing results after prolotherapy treatments. It becomes important that any deficiencies and illnesses be corrected in order to strengthen the immune system to allow the body to respond to Prolotherapy.

Factors Affecting Healing of
Connective Tissues


Overall health status ie: chronic illness

Lack of blood Supply/poor circulation ie: smokers,



pH and lactate concentration ie: too acidic

Degree of hypoxia (systemic and local)

Pharmacological agents (drugs) ie: steroids

Dietary intake ie: poor diet

Psychological influences (placebo
effects and psychoneuroimmunological
links) ie: negative outlook

Electrical fields

Severity of injury

Growth factors, cytokines, eicosanoids ie: EFA deficiency

Structural (physical) deformities

Hormonal influences ie: elevated estrogen,

decreased growth hormone, DHEA

testosterone and progesterone


Mechanical load forces

Timing and return to physical activity

Metabolic and cell turnover rates of
connective tissue

Type of injury

Mobility (local & whole body)

Type of onset (acute or chronic)

Muscular strength and forces

Type of tissue(s) affected

Nutritional status ie: poor digestion, food allergies

Underlying disease processes