Safe, effective, non-surgical treatment for damaged ligaments and tendons


Prolotherapy is a type of regenerative injection therapy, that is primarily used to treat chronic and acute injuries and pain – although it can be used for other therapeutic purposes.

A combination of dextrose and local anesthetic is injected directly into damaged tissue, which stimulates the production of new, strong, healthy tissue. Prolotherapy increases joint stability, ultimately improving function and decreasing pain.

Prolotherapy can be used to treat a wide range of injuries, including but not limited to:

  • Rotator cuff tears
  • Disc herniations
  • Meniscal tears
  • Cartilage degeneration
  • Tendon strains
  • Ligament tears
  • Osteoarthritis



Prolotherapy treats pain and injuries via a few different mechanisms. The main way prolotherapy results in healing is by creating a signal for your immune cells to go to the area that is being injected and initiate a healing response. We are purposely causing inflammation, albeit in a controlled fashion.

Prolotherapy also works by creating a small amount of trauma in the area needing to be healed. This is where the skill of the practitioner really comes into play. With proper needle technique, the practitioner is able to break up knotted collagen, free up tangled nerves, and create microtrauma in the tissue. Microtrauma causes increased blood flow to the area, which is what the damaged tissue needs the most.

A third way in which prolotherapy works its magic is by part of the solution (dextrose) binding to what is called the capsaicin receptor (otherwise known as the TrpV1 receptor for all you physiology nerds out there). This receptor is located on nerves and when it is stimulated, results in decreased neuroinflammation.


Typically 4-6 injections are required for full healing, however, depending on the severity of your injury/pain, your age, activity level, hormone status and healing ability, the number of injects needed can vary greatly.


No referral is required to receive prolotherapy treatment from a licensed naturopathic doctor.


We do not offer direct billing at ProActive Health Group, but your prolotherapy treatments can be reimbursed if your insurance plan includes naturopathic medicine or a health spending account.


Prolotherapy is a bit painful during the actual administration of the solution, but because part of the injectable is an anesthetic, numbing occurs quickly.  Once the numbing wears off, the area that has been injected is usually tender to the touch for a day or two. It is normal to experience swelling and possibly some bruising after a prolotherapy treatment.


The initial prolotherapy appointment is about 40 minutes. Follow up appointments are 20 minutes.

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If you are ready to experience regenerative injection therapy, click below to book your appointment with Dr. Mandy at ProActive Health Group

Want to Know More About Prolotherapy Treatment in Calgary?

When considering receiving any treatment, it’s always best to research the topic and understand the treatment first. I have found that understanding what the treatment entails, what it does and how it works, makes my patients more comfortable when undergoing prolotherapy treatment at my clinic in Calgary.

Here I have compiled very detailed answers to the most common questions I receive from patients. As an expansion to the details on my prolotherapy page, here is a more detailed description of prolotherapy. Of course, there is no substitute to discussing your condition and treatment with your naturopathic doctor so this information is simply to provide you with an insight to the treatment. I hope you find it informative!

Teaching about Prolotherapy

Learn with Dr. Mandy

What is the Mechanism of Action of Prolotherapy?

Prolotherapy is a natural treatment performed on musculoskeletal joints in the body experiencing prolonged or chronic pain in an attempt to improve joint stability and alleviate symptoms. Musculoskeletal pain is typically caused by inadequate support of the joint by its fibrous connective tissue. This is frequently through ligament and tendon weakness due to injury. When the mechanical stability of a joint is reduced, the added motion and load bearing of the joint stimulates mechanoreceptors which provide pain sensation. Naturally, if the stability of the supportive tissue remains weak, continued mechanoreceptor stimulation results in chronic pain. Prolotherapy works by stimulating the generation of new supportive connective tissues to improve joint stability and reduce pain sensation through mechanoreceptor stimulation.

Dr. Mandy Administering Prolotherapy

Administering Prolotherapy

By injecting a natural irritant substance into the targeted region, prolotherapy generates a mild localized inflammatory response around the connective tissue. A localized inflammation causes fibroblast activation. Fibroblasts are the primary cell type involved in the generation of connective tissues in animals. Through their activation, additional supportive connective tissue can be generated to provide tensile reinforcement to the joint. This has been shown in multiple animal models e.g. Rabbit medial collateral ligaments, and human trials (discussed later). By stabilizing the joint, chronic pain can be reduced or eliminated.

vial and a syringe used in prolotherapy

Dextrose used In Prolotherapy Treatment

Why receive Prolotherapy?

In comparison to other body tissues, ligaments and tendons have an inferior blood supply. This is why connective tissue tends to take longer to heal than other tissues. Additionally, it is widely accepted that connective tissue DOES NOT heal to its original condition prior to the injury. This is the reasoning for a weak joint and the propensity for repetitive injury. It is common that post injury, many people will utilize a joint support when being active to provide added joint stability to prevent repetitive injury. Prolotherapy acts under the same theory of providing additional support to the joint but by building new tissue at the joint for PERMENANT support.

What conditions can Prolotherapy treat?

Prolotherapy is an evolving treatment. It is continually being tested as a treatment for an increasing amount of pathologies. Its application thus far is broad. To find out if prolotherapy is a suitable treatment for you needs, contact Dr. Milliquet ND for a discussion.

Here are some of its established uses with links to supportive evidence for their effectiveness:

Acute Joint Injuries

Demonstrated by a variety of injuries to supportive connective tissue where tissue is torn or stretched resulting in laxity of stabilizing tendons or/and ligaments. Published reports support the use of prolotherapy in anterior cruciate (ACL) tear repair, tendinopathies and spinal/pelvic pain due to ligament dysfunction, chondromalacia patella (Runner’s Knee) and more generally chronic musculoskeletal pain.

Temporomandibular Joint Syndrome (TMJ)

Dextrose Prolotherapy has been shown to be significantly effective in the symptomatic treatment of TMJ in a controlled trial study.

Temporomandibular joint prolotherapy image

Whiplash, Neck Pain

In cases of soft tissue damage in the neck, prolotherapy has been shown to be effective in the treatment of Chronic neck pain.

Prolotherapy in Neck Pain

Chronic Headaches

Studies have shown prolotherapy’s effectiveness in treating Chronic Headaches which in some case can be referred pain due to a cervical joint disorder.

Chronic Groin Pain

Testing of prolotherapy on athletes determined positive results for its use in Chronic groin pain.

Rotator Cuff Injuries

Shoulder pain has been shown to be reduced in patients suffering Rotator cuff tendinopathy.

Repetitive Sports Injuries such as Tennis Elbow & Golfer’s Elbow

Epicondylosis or elbow pain have been effectively treated with prolotherapy warranting further examination.

Lower Back Pain, Sciatica & Sacroiliac Joint Pain

The benefits of Prolotherapy have been demonstrated in lower back pain.  In cases where sciatica is caused by referred pain from the sacroiliac joint, sciatica can thus be treated by prolotherapy targeted at the Sacroiliac Joint.

Prolotherapy for back pain

Prolotherapy for treatment of Back Pain

Spine Joint Pain treatment



Osteoarthritis Treatment

A study showed improvements in Knee Osteoarthritis plus another study showing with statistically significant improvements for a variety of measures including anterior cruciate ligament laxity.

Knee area for Prolotherapy treatment

Can anyone with a suitable injury receive Prolotherapy?

There are contraindications to prolotherapy so its application must be done only by experienced professionals and under strict conditions.

Firstly, it is important to understand the cause of the pain/injury to ensure the underlying condition leading to the injury/pain is treated. Otherwise, an underlying illness could prevent healing in the injured area and treatment could fail or simply cover up symptoms.

Next, we need to ensure that your injury is a suitable candidate for prolotherapy. The best method is to discuss this with your naturopathic doctor, as the criteria is beyond the scope of this article.

Finally, certain other criteria can prevent prolotherapy from working. Examples of these include autoimmune conditions, frequent users of anti-inflammatories (such as Advil), complete rupture of a tendon or ligament, allergy to the prolotherapy inflammatory substance, patients not willing to undertake a possible long term treatment or patients not willing to perform complimentary exercises. Obviously, anti-inflammatories will prevent the desired mild inflammation needed for healing. Again, due to a variety of criteria, a discussion with your naturopathic doctor is the best option.

Syring with Prolotherapy solution

What conditions are not treatable using Prolotherapy?

As pain can manifest in various ways, typically painful conditions that are not related to a connective tissue disorder would not be treatable by prolotherapy. However, as referred pain can often require treatment to an area where pain is not present, only an examination by your local naturopathic doctor will give you a conclusive answer.

What are the risks of Prolotherapy?

As with any medical procedure, prolotherapy has some risks associated with it but nothing like those associated with surgery. In fact, as the goal of the treatment is localized inflammation, inflammation itself can be considered a side effect of many other treatments whereas, in prolotherapy, it is intentional. The recovery time is very short and there is minimal chance of infection. There can be some mild irritaion and redness at the injection site.

How can I find out more about Prolotherapy?

As previously mentioned, this article is simply a guide to the background and research findings about Prolotherapy. To find out more, contact Dr. Mandy Milliquet for Prolotherapy in Calgary. A Prolotherapy specialist is the best person to give you advice on Prolotherapy treatment and if it is right for you and your needs.

Prolotherapy consultation

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