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Prolotherapy for Foot Problems

What is Prolotherapy for the Foot?

Prolotherapy, also called proliferative therapy, is a medical procedure performed to treat connective tissueinjuries and can be used to relieve musculoskeletal pain in your foot.

The procedure involves injecting an irritant into the connective tissue such as injured ligaments or tendons, or the joint spaces of the foot. The purpose is to promote healing of the connective tissue that has been weakened, torn or pulled, resulting in tissue looseness and joint instability in the foot.

Prolotherapy is an excellent non-surgical option for progressive and chronic foot pain caused by sport, falls, daily activities, accidents, and certain medical conditions.

An irritant is a natural substance that causes slight but precise inflammation of the targeted tissue.

Prolotherapy typically uses a local anesthetic and any of the following irritants:

  • Sugar water (dextrose)
  • Saline (a mixture of sodium chloride and water)

Modern prolotherapy formulas may include platelet-rich plasma (PRP) and autologous stem cells (cells or tissues taken from the patient)

Concept of Prolotherapy

Prolotherapy works by encouraging the body’s natural healing mechanism to produce new tissue at the injured or weakened site.

Under normal conditions, the connective tissue in the foot firmly holds the bones and joints together. When this tissue is injured or weakened, the bones or joints they are holding become destabilized, leading to pain.

Once injected, the irritant triggers the body’s healing response by creating a local, but controlled inflammation. This leads to increased blood flow to the area and production and growth of new connective tissue in the foot.


Repeated prolotherapy over time allows a gradual buildup of new tissue in the foot resulting in strengthening of the connective tissue and stabilization of the joints. Once the foot joints are better supported and stabilized, the pain resolves on its own.

Therefore, prolotherapy is also referred to as a regenerative injection technique, as it stimulates cells to regenerate and heal connective tissue.

Common Foot Problems Treated with Prolotherapy

Prolotherapy can treat several foot problems including:

  • Plantar fasciitis
  • Bunion pain
  • Morton’s neuroma
  • Osteoarthritis
  • Tendonitis or tendinitis
  • Achilles tendinopathy
  • Fallen arch
  • Heel pain

These conditions are often the result of ligament laxity and joint instability in the foot.

Preparing for Prolotherapy

Prior to prolotherapy, you will be evaluated thoroughly with your medical history followed by a physical examination. An imaging test such as an X-ray or MRI of the affected foot may also be performed.

Additionally, you will be instructed to:

  • Stop taking any anti-inflammatory medications 2 to 3 days before the procedure
  • A protein-rich meal is recommended just prior to the procedure

The Procedure

During the procedure:

  • The skin over the affected area in the foot is cleansed with alcohol or another sterilizing solution.
  • A numbing cream or solution is applied to the skin to reduce discomfort from the injection.
  • If pain or discomfort is severe, additional sedation may be used.
  • Using a thin needle, the irritant solution is injected into the target area or areas as necessary.
  • More than one injection may be performed at the session
  • Following the injection, a heat pack may be placed over the injection sites for about 10-15 minutes

Frequency of Prolotherapy

Prolotherapy usually requires multiple sessions for the best results. The number and frequency of the shots vary depending on the:

  • Foot condition being treated
  • Type of irritant being used
  • Severity of the injury or pain

Your physician will discuss the number of shots per session and the total number of sessions you require.

After-Care and Recovery

You can resume your regular activities as tolerated as this encourages healing. Physical therapy may be recommended. It may take about 6 weeks for significant connective tissue healing.

Benefits of Prolotherapy

Key benefits of the procedure include:

  • Reduced risk compared to surgery
  • Regenerates tissue to stabilize the foot joints
  • Long-lasting pain relief in the foot
  • Improved foot movement and function

Side Effects

Immediately after the procedure, the affected foot may feel worse before beginning to feel better. You will often experience some swelling, soreness and stiffness. These effects are usually mild and usually last for only a few days. Other side-effects experienced occasionally include:

  • Severe pain
  • Bleeding at the injection site
  • Infection at the injection site
  • Mild fever that can be easily treated with antibiotics