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Prolotherapy Denver

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Prolotherapy, short for proliferative therapy, is a medical treatment aimed at stimulating the body’s natural healing processes to repair damaged tissues, particularly ligaments and tendons. 

Also known as regenerative injection therapy, prolotherapy involves the injection of a solution, often containing dextrose or other irritants, into the affected area. This solution triggers a localized inflammatory response, prompting the body to initiate the healing cascade. This article discusses the finer points of prolotherapy at the Centeno-Schultz Clinic in the Denver area.

What Is Prolotherapy or Regenerative Injection Therapy (RIT)?

Prolotherapy is a natural healing alternative to drugs or surgery. It prompts your body to naturally heal damaged and degenerated tissues. It involves a series of simple injections into the injured area, once a month for three to six months. 

This is not a steroid, which blocks healing. Prolotherapy inititates a cascade  that heals and strengthens the ligaments and joints. The primary goal of prolotherapy is to strengthen weakened or injured connective tissues, alleviate chronic pain, and improve joint stability. 

By promoting the growth of new collagen and tissue, prolotherapy aims to address the root cause of musculoskeletal issues rather than merely managing symptoms. This non-surgical and minimally invasive approach has gained attention as an alternative or complementary treatment for conditions such as chronic pain, osteoarthritis, and sports-related injuries.

Common Conditions Prolotherapy Injections Treat

Prolotherapy has emerged as a versatile and promising treatment for various musculoskeletal conditions, providing an alternative or complementary approach to conventional therapies. This regenerative injection therapy is particularly employed to address a spectrum of issues, ranging from arthritis to sports injuries. 

Let’s delve into how prolotherapy is utilized in the treatment of specific common conditions.


Prolotherapy is increasingly recognized as an option for managing arthritis, especially osteoarthritis. 

Injections into affected joints can help improve the joint fluid environment and reduce inflammation. Injections around the joint ligaments and tendons can help stimulate tissue regeneration, and improve joint stability, potentially offering relief for those grappling with the degenerative effects of arthritis in the thumb, knees, ankles, and spine

Back Pain

For individuals suffering from chronic back pain due to ligament and disc issues, prolotherapy injections target weakened soft tissue structures around the spine. This can strengthen the supporting tissues, reduce pain, and contribute to improved overall spinal function.

Neck Pain

Neck pain often results from ligament laxity or instability. Prolotherapy injections can be administered to reinforce weakened ligaments in the cervical spine, promoting structural integrity and relieving neck discomfort.

Knee Pain

Prolotherapy has shown promise in addressing knee pain, particularly associated with ligament injuries and osteoarthritis. Injections around the knee joint stimulate the growth of new, resilient tissue, providing support and potentially reducing pain and stiffness.


Sciatic nerve pain often stems from inflammation or compression. Prolotherapy injections can target the underlying ligament or SI joint issues contributing to sciatica, offering relief by promoting healing and reducing nerve compression.

Sports Injuries

Athletes frequently turn to prolotherapy for the treatment of sports-related injuries, such as sprains and chronic joint instability. By enhancing the body’s natural repair processes, prolotherapy aids in faster recovery, enabling athletes to return to their activities with improved joint function.


Prolotherapy injections can be employed to treat tendinitis by promoting the regeneration of damaged tendon tissues. This targeted approach helps strengthen tendons and reduce inflammation, addressing the root cause of tendinitis-related pain.

Ligament Sprains

Ligament sprains often lead to persistent instability and discomfort. Prolotherapy injections can strengthen and stabilize weakened ligaments, facilitating the healing process and reducing the likelihood of recurrent sprains.

How the Prolotherapy Procedure Works

Prolotherapy works by prompting your body’s natural repair mechanisms to heal damaged or degenerated tissues. While most of our daily injuries heal completely, severe ligament tears, degenerated and worn-out tissues, and tissues with a poor blood supply (such as meniscus, tendons, and ligaments) don’t usually mend themselves. 

Prolotherapy starts by injecting an irritant into the damaged area. For most prolotherapy this is a hypertonic dextrose solution. The hyper osmotic solution draws water out of local cells causing stress, leading to a release of inflammatory chemicals.  This inflammation causes your body to release its own natural growth factors in the injured tissue.

These go to work immediately, directing your body’s natural healing mechanisms to repair painful tissues. The first stage of healing usually takes about a week, but the tissue continues to strengthen for four to six weeks after the injection.

Over the weeks following the initial prolotherapy session, patients often observe gradual improvements in pain levels, joint stability, and overall function. The injections stimulate the growth of new collagen and tissue, contributing to the long-term strengthening of the treated area.

Depending on the severity of the condition and the individual’s response to treatment, a series of follow-up prolotherapy sessions may be recommended. These sessions are typically spaced apart a few weeks to allow sufficient time for the body to regenerate tissues and respond to the treatment.

In conjunction with prolotherapy, healthcare professionals may recommend physical therapy or rehabilitation exercises to complement the treatment. These exercises help enhance the strength and flexibility of the treated area, promoting optimal recovery.

Patients will be monitored closely by their healthcare providers to assess progress and make any necessary adjustments to the treatment plan. This ongoing evaluation ensures that the prolotherapy injections are effectively addressing the underlying issues and optimizing the healing process.

What to Expect During Your Appointment

Following a prolotherapy session, patients can anticipate a recovery process that involves several stages. While experiences may vary based on individual health conditions and the specific areas treated, here is a general overview of what patients can expect during the recovery period.

What Does Recovery of Prolotherapy Look Like?

Here’s what the recovery looks like:

  • Immediate post-injection period:

    Commonly a local anesthetic is used within a prolotherapy injection so the area may feel numb with some mild swelling. Later that day it is common for patients to experience some mild discomfort, swelling, or pain at the injection sites. 

    This is often a result of the localized inflammatory response triggered by the prolotherapy solution. Healthcare professionals may observe patients for a short period after the injections to ensure there are no adverse reactions.
  • Initial 24 hours

    Rest and avoidance of strenuous activity are key. Patients are usually advised to rest and avoid engaging in strenuous activities for the initial 12-24 hours post-prolotherapy to allow the healing process to commence without unnecessary stress on the treated areas. 

    You want to avoid ice and that can inhibit the healing process. 
  • Subsequent days to weeks

    Over the days and weeks following the prolotherapy session, patients often experience a gradual improvement in symptoms. This includes reduced pain and increased joint stability as the treated tissues undergo regeneration. Patients can usually resume normal daily activities based on the guidance of their healthcare providers. 

    However, it is essential to avoid overexertion or activities that may compromise the healing process.
  • Follow-up appointments

    Depending on the treatment plan, patients may have scheduled follow-up appointments for additional prolotherapy sessions. These sessions are spaced to allow the body sufficient time to respond to the initial injections and promote ongoing tissue healing.
  • Ongoing monitoring and adjustments

    Patients can expect regular follow-ups with their healthcare providers to assess progress, discuss any concerns or changes in symptoms, and make any necessary adjustments to the treatment plan.
  • Physical therapy

    In some cases, healthcare providers may recommend physical therapy or exercises to complement the effects of prolotherapy and enhance overall recovery.
  • Long-term benefits

    Many patients experience long-term benefits from prolotherapy, with sustained relief from pain and improved joint function. The regenerative effects of the treatment contribute to ongoing tissue repair and strengthening.

Why Use This Prolotherapy Treatment

Prolotherapy has been successful in treating many disorders, including neck, shoulder, knee, and ankle pain. Dr Centeno published an article in The Journal of Prolotherapy discussing the use of X-ray guidance with prolotherapy. This ensures that the injection is in the correct place to maximize clinical results. 

While prolotherapy can be done unguided (without the use of live X-ray or ultrasound guidance, image guidance should be the standard in the 21st century. Imaging guidance with ultrasound or X-ray increases the accuracy of the procedure, reduces the risks, and reduces pain during and after the procedure.

Dr Centeno also discusses the utilization of prolotherapy for treating neck, knee, sacroiliac joint, ankle, ischial tuberosity, and shoulder pain. 

At Denver’s Centeno-Schultz Clinic, X-ray or ultrasound-guided prolotherapy is just one of the therapies utilized for successful pain treatment. There are additional therapies as well, which we discuss further below.

Related Treatments That May Work for Your Condition

Depending on the specific diagnosis, circumstances, and individual health factors, several related treatments may complement or be considered alongside prolotherapy. These treatments aim to address musculoskeletal issues, promote healing, and improve overall function. Here are three notable options:

  • PRP therapy (platelet-rich plasma): 

    PRP therapy involves using the patient’s blood. This is then processed to concentrate platelets, growth factors, and other components that facilitate healing, and the resulting PRP is injected into the injured area. 

    This concentration of growth factors aims to stimulate tissue repair and regeneration. PRP therapy is often used for conditions such as tendon injuries, ligament sprains, osteoarthritis, spine issues, and soft tissue injuries. PRP therapy is sometimes used in conjunction with prolotherapy to enhance the regenerative effects and accelerate the healing process.
  • Stem Cell Therapy

    Stem cell therapy involves the use of stem cells, often derived from the patient’s own tissues (autologous) or from donor sources (allogeneic), to promote tissue repair and regeneration. These cells have the potential to develop into various cell types, aiding in the repair of damaged tissues. 

    Stem cell therapy is explored for a wide range of musculoskeletal conditions, including osteoarthritis, tendon injuries, ligament damage, and degenerative joint diseases. Like PRP therapy, stem cell therapy can be used in conjunction with prolotherapy to enhance the regenerative potential and improve treatment outcomes.
  • Physical therapy

    Physical therapy involves a customized program of exercises, stretches, and manual techniques designed to improve strength, flexibility, and overall function. Physical therapists work to address specific musculoskeletal issues, improve biomechanics, and optimize recovery. 

    Physical therapy is widely employed for various musculoskeletal conditions, including back pain, neck pain, joint injuries, and post-surgical rehabilitation. Prolotherapy and physical therapy often complement each other. While prolotherapy focuses on tissue regeneration, physical therapy targets functional improvement and helps prevent future injuries by addressing biomechanical issues.

Embrace Healing at the Centeno-Schultz Clinic

At the Centeno-Schultz Clinic, the journey toward healing takes center stage with the innovative and patient-centric approach of prolotherapy. Individuals grappling with various musculoskeletal conditions, including arthritis, back pain, neck pain, knee pain, sciatica, sports injuries, tendinitis, and ligament sprains, can embrace the healing potential of prolotherapy at the Centeno-Schultz Clinic. 

By harnessing the body’s natural healing processes, prolotherapy not only targets symptoms but addresses the root cause of these issues, promoting lasting recovery and improved function. Discover a path to renewed vitality, improved function, and a life free from the constraints of chronic musculoskeletal pain.

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Christopher J. Centeno, MD

Christopher J. Centeno, M.D. is an international expert and specialist in Interventional Orthopedics and the clinical use of bone marrow concentrate in orthopedics. He is board-certified in physical medicine and rehabilitation with a subspecialty of pain medicine through The American Board of Physical Medicine and Rehabilitation. Dr. Centeno is one of the few physicians in the world with extensive experience in the culture expansion of and clinical use of adult bone marrow concentrate to treat orthopedic injuries. His clinic incorporates a variety of revolutionary pain management techniques to bring its broad patient base relief and results. Dr. Centeno treats patients from all over the US who…

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John Schultz, MD

John R. Schultz M.D. is a national expert and specialist in Interventional Orthopedics and the clinical use of bone marrow concentrate for orthopedic injuries. He is board certified in Anesthesiology and Pain Medicine and underwent fellowship training in both. Dr. Schultz has extensive experience with same day as well as culture expanded bone marrow concentrate and sees patients at the CSC Broomfield, Colorado Clinic, as well the Regenexx Clinic in Grand Cayman. Dr. Schultz emphasis is on the evaluation and treatment of thoracic and cervical disc, facet, nerve, and ligament injuries including the non-surgical treatment of Craniocervical instability (CCI). Dr. Schultz trained at George Washington School of…

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John Pitts, M.D.

Dr. Pitts is originally from Chicago, IL but is a medical graduate of Vanderbilt School of Medicine in Nashville, TN. After Vanderbilt, he completed a residency in Physical Medicine and Rehabilitation (PM&R) at Emory University in Atlanta, GA. The focus of PM&R is the restoration of function and quality of life. In residency, he gained much experience in musculoskeletal medicine, rehabilitation, spine, and sports medicine along with some regenerative medicine. He also gained significant experience in fluoroscopically guided spinal procedures and peripheral injections. However, Dr. Pitts wanted to broaden his skills and treatment options beyond the current typical standards of care.

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Jason Markle, D.O.

Post-residency, Dr. Markle was selected to the Interventional Orthopedic Fellowship program at the Centeno-Schultz Clinic. During his fellowship, he gained significant experience in the new field of Interventional Orthopedics and regenerative medicine, honing his skills in advanced injection techniques into the spine and joints treating patients with autologous, bone marrow concentrate and platelet solutions. Dr. Markle then accepted a full-time attending physician position at the Centeno-Schultz Clinic, where he both treats patients and trains Interventional Orthopedics fellows. Dr. Markle is an active member of the Interventional Orthopedic Foundation and serves as a course instructor, where he trains physicians from around the world.

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Brandon T. Money, D.O., M.S.

Dr. Money is an Indiana native who now proudly calls Colorado home. He attended medical school at Kansas City University and then returned to Indiana to complete a Physical Medicine and Rehabilitation residency program at Indiana University, where he was trained on non-surgical methods to improve health and function as well as rehabilitative care following trauma, stroke, spinal cord injury, brain injury, etc. Dr. Money has been following the ideology behind Centeno-Schultz Clinic and Regenexx since he was in medical school, as he believed there had to be a better way to care for patients than the status quo. The human body has incredible healing capabilities…

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Am I a Candidate?

To answer this question, fill out the candidate form below to request a new patient evaluation, and a patient advocate will reach out to you to determine your next steps. Your one-hour, in-office or telemedicine evaluation will be with one of the world’s experts in the field of Interventional Orthopedics.

Insurance may cover office visits, consultations, diagnostic testing, examinations and bracing. However, most insurance does not currently cover Regenexx Procedures at this time.