2 Best Prolotherapy Clinics in the US

This is the national page for prolotherapy on Regenerated.com, listing clinics across the United States that record the treatment. Prolotherapy, also called proliferative injection therapy, regenerative injection therapy or dextrose prolotherapy (sometimes shortened to DPT), is a series of injections of an irritant solution into painful ligaments, tendons and joints. The most common solution is hypertonic dextrose, a concentrated sugar water, usually mixed with a local anesthetic such as lidocaine, and some clinicians use other solutions such as phenol, glycerin and glucose blends or sodium morrhuate. The idea, first described by the surgeon George Hackett in the 1950s, is that a brief local inflammatory response prompts the body to lay down new connective tissue at the injection site. It is delivered mainly by physicians (MD or DO), including physiatrists, sports medicine physicians, orthopedic and pain specialists and osteopathic physicians, and in some states by naturopathic doctors, nurse practitioners or physician assistants within their scope of practice. People most often compare it with platelet rich plasma (PRP) injections, corticosteroid injections, hyaluronic acid injections, ozone injections and physical therapy.

The evidence for prolotherapy is mixed and depends on the condition. Randomized trials led by David Rabago at the University of Wisconsin reported that dextrose prolotherapy improved pain and function scores in adults with knee osteoarthritis compared with saline injections and at home exercise, and smaller trials have looked at tennis elbow, Achilles and rotator cuff tendon problems and sacroiliac joint pain. A Cochrane review of chronic low back pain concluded that prolotherapy injections on their own were not shown to be effective for that use. Dextrose and lidocaine are FDA approved drugs, but no product is FDA approved for prolotherapy itself, so the injections are an off label use, and most insurers treat the procedure as investigational and do not cover it.

A typical candidate is an adult with chronic pain from a specific ligament, tendon or joint, such as a knee with osteoarthritis or a lax or overstretched ligament, who has tried rest, exercise and physical therapy without enough relief. People with an active infection at or near the injection site, a bleeding disorder or blood thinner that has not been reviewed, an allergy to the solution or the anesthetic, or pain that has not yet been diagnosed are usually told to wait or look elsewhere. So are people whose pain may come from a nerve, a fracture, an inflammatory arthritis flare or a tumor, which need a different workup first.

Supply sits mostly in outpatient settings: physical medicine and rehabilitation practices, sports and musculoskeletal medicine clinics, osteopathic and integrative practices, interventional pain clinics and some naturopathic offices. Hospital programs offer it less often, partly because it is rarely covered. Listings tend to concentrate in large metro areas and their suburbs, the browse by state links below the list show where supply is deepest, and many patients travel to see a clinician with long injection experience.

Before booking anywhere, ask who performs the injections, what license and training that person holds and whether a physician supervises. Ask exactly what is injected, at what dextrose concentration, with which anesthetic, and where the solution comes from, including whether it is compounded. Ask whether injections are guided by ultrasound, and ask for written disclosure of risks, which include post injection pain and stiffness, bruising, infection, nerve irritation and, near the chest wall, a rare collapsed lung. A clear quote itemizes the evaluation, each injection visit, any imaging guidance and follow up, and says how progress will be measured.

This national list is not for sale. Organic order is never paid ranking, Featured slots are labeled and capped, and Verified means the clinic completed credential checks, not that it spent money. Regenerated.com is free for patients, and inclusion in the directory is not an endorsement of any clinic. Open the state hubs below the list to build a shortlist of prolotherapy providers near you.

For solutions, techniques and evidence in more depth, read the prolotherapy guide. Two short explainers cover how listings work here: How to read a Regenerated city hub and Featured vs Verified vs organic.