Doctor Robert David Multari, DO

Doctor Robert David Multari, DO

Prolotherapy For Musculoskeletal Pain Services Provided By Doctor Robert D. Multari

About Prolotherapy:

Prolotherapy is a method of injection treatment designed to stimulate healing. This treatment is used for musculoskeletal pain which has gone on longer than 8 weeks such as low back and neck pain, chronic sprains and/or strains, whiplash injuries, tennis and golfer’s elbow, knee, ankle, shoulder or other joint pain, chronic tendonitis/tendonosis, and musculoskeletal pain related to osteoarthritis. Prolotherapy works by raising growth factor levels or effectiveness to promote tissue repair or growth. Because prolotherapy works to repair weak and painful joint areas, it is a long term solution rather than a palliative measure such as drugs, and should be considered prior to the use of long term drugs or surgery in appropriate patients.

Prolotherapy is sometimes called "Regenerative Injection Therapy" (RIT), "Reconstructive Therapy," "Non-Surgical Tendon, Ligament, and Joint Reconstruction, or Growth Factor Stimulation Injection." "Sclerotherapy" is an older, inaccurate term for prolotherapy, based on the original theory that scar formation was the treatment mechanism. However, biopsy studies have not demonstrated scar formation with mechanical, inflammatory, or growth factor prolotherapy with the agents and concentrations currently in use. Rather, studies have shown a proliferation of new, normal, thicker, and stronger connective tissue after prolotherapy injections (thus "prolo" for proliferation).


Prolotherapy has been used to successfully treat a large variety of musculoskeletal syndromes, including cervical, thoracic and lumbar pain syndromes, patients diagnosed with “disc disease,” mechanical low back pain, plantar fascitits, foot or ankle pain, chronic rotator cuff or bicipital tendonitis/tendonsis, lateral and medial epicondylitis, TMJ dysfunction, musculoskeletal pain related to osteoarthritis, and even finger or toe joint pain including “turf toe.”

The Florida Academy of Pain Management laid out indications for prolotherapy (Regenerative Injection Therapy or RIT) based on their review of the literature:


Active infection or cancer is a contraindication to treatment, as is any underlying illness which could interfere with healing.


While the most common risk is soreness after treatment, prolotherapy is a medical procedure and, as such, there are risks. While prolotherapy is a low risk procedure, any possible risk should always be fully discussed with a patient prior to treatment and a medical consent signed.

Typical Treatment Course

Treatment intervals are spaced according to how that individual heals. On average, the treatment interval is usually 3 to 4 weeks between treatments. In some people it is shorter, in others it is longer. The average number of treatments for any given area is usually between 4 and 6 total treatments, each treatment involving multiple injections to a particular area. Improvement is sometimes noticed after the initial treatment, however it is more often noticed by the second or third treatment. Some individuals require more than 6 treatments, and, in some cases, less treatments are needed. Individuals with hypermobility often take longer.

For more information read the full Prolotherapy For Musculoskeletal Pain article by Dr. Donna Alderman, DO.