(this therapy is not offered at the clinic . At this clinic we use Biomesotherapy as our preferred injection therapy)
A 2015 review found limited evidence that prolotherapy is safe and effective for Achilles tendinopathy, plantar fasciosis, and Osgood Schlatter disease. The quality of the studies was also poor. Another 2015 review assigned a strength of recommendation level A for Achilles tendinopathy, knee osteoarthritis and level B for lateral epicondylosis, Osgood Schlatter disease, and plantar fasciosis. Level A recommendations are based on consistent and good-quality patient-oriented evidence while level B are based on inconsistent or limited-quality patient-oriented evidence. Two 2016 review articles expanded level B strength of recommendations to include low back/sacroiliac pain and rotator cuff tendinopathy. As of 2016 evidence to support the use of prolotherapy in acute pain, myofascial pain or as first-line therapy, could not be determined.
Low back pain
A 2007 Cochrane review of prolotherapy in adults with chronic low-back pain found unclear evidence of effect. A 2009 review concluded the same for subacute low back pain. A 2015 review found consistent evidence that it does not help in low back pain. There was tentative evidence of benefit when used with other low back pain treatments. Evidence of benefit remains tentative (level B) for dextrose prolotherapy in low back or sacroiliac pain. 
A 2009 systematic review of the efficacy in the treatment of lateral epicondylitis concluded that these therapies may benefit people with lateral epicondylitis, but the evidence was limited. A 2010 review concluded moderate evidence exists to support the use of prolotherapy injections in the management of pain in lateral epicondylitis, and that prolotherapy was no more effective than eccentric exercise in the treatment of Achilles tendinopathy. A 2016 review found a trend towards benefit in 2016 for lateral epicondylitis. A 2017 review found tentative evidence in Achilles tendinopathy.
In 2012, a systematic review studying various injection therapies found that prolotherapy and hyaluronic acid injection therapies were more effective than placebo when treating lateral epicondylitis. Of the studies evaluated, one of ten glucocorticoid trials, one of five trials for autologous blood injection or platelet-rich plasma, one trial of polidocanol, and one trial of prolotherapy met the criteria for low risk of bias. The authors noted that few of the reviewed trials met the criteria for low risk of bias.
Tentative evidence of prolotherapy benefit was reported in a 2011 review. One 2017 review found evidence of benefit from low-quality studies. A 2017 review described the evidence as moderate for knee osteoarthritis. A 2016 review found benefit but there was a moderate degree of variability between trials and risk of bias.
Patients receiving prolotherapy injections have reported generally mild side effects, including mild pain and irritation at the injection site (often within 72 hours of the injection), numbness at the injection site, or mild bleeding. Pain from prolotherapy injections is temporary and is often treated with acetaminophen or, in rare cases, opioid medications. NSAIDs are not usually recommended due to their counter action to prolotherapy-induced inflammation, but are occasionally used in patients with pain refractory to other methods of pain control. Theoretical adverse events of prolotherapy injection include lightheadedness, allergic reactions to the agent used, bruising, infection, or nerve damage. Allergic reactions to sodium morrhuate are rare. Rare cases of back pain, neck pain, spinal cord irritation, pneumothorax, and disc injury have been reported at a rate comparable to that of other spinal injection procedures.
Prolotherapy involves the injection of an irritant solution into a joint space, weakened ligament, or tendon insertion to relieve pain.  Most commonly, hyperosmolar dextrose (a sugar) is the solution used; glycerine, lidocaine (a commonly used local anesthetic), phenol, and sodium morrhuate (a derivative of cod liver oil extract) are other commonly used agents. The injection is administered at joints or at tendons where they connect to bone.
Prolotherapy treatment sessions are generally given every two to six weeks for several months in a series ranging from 3 to 6 or more treatments. Many patients receive treatment at less frequent intervals until treatments are rarely required, if at all.
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Prolotherapy involves a series of injections designed to produce inflammation in the injured tissue
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