Prolotherapy is a non-surgical treatment for joint pain and dysfunction. It works by stimulating healing and reconstruction of connective tissue (ligaments) that surround and stabilize joints. “Prolo” is short forproliferation. Ligaments lack a blood supply which makes healing of these tissues a slow and inefficient process.

Prolotherapy delivers an injection into damaged or weak connective tissue surrounding joints. The injected solution contains dextrose (sugar) and a local anesthetic (procaine or lidocaine). The injection results in local inflammation which triggers a healing response and promotes reconstruction of the affected tissue. In time, with each subsequent treatment, the new connective tissue continues to grow, thicken and strengthen, restoring stability to joints and providing relief from pain associated with unstable joints.



By means of injection, Prolotherapy accomplishes two things:

  1. Physical disruption of the ligaments as well as the periosteum, which is the outer most layer of bone where ligaments attach.
  2. Delivery of a solution of dextrose and local anesthetic to the damaged area.

The combination of these two things causes a local and acute inflammatory response in the affected tissue. Acute inflammation is necessary for the healing response to occur, which involves the flow of nutrients and growth factors to the area. Under these conditions, new collagen can form and connective tissue begins to rebuild. As the new collagen matures it also shrinks resulting in tighter and stronger ligaments giving more stability to joints which, in turn, can often relieve joint pain.



Whether you’ve had a single injury, multiple injuries or an overuse type of injury, the lingering pain you’re feeling may be due to instability of the affected joint(s). If this is the case, Prolotherapy has good potential to get you moving again with a lot less pain. Ligaments are the connective tissue that surround and stabilize joints. When they become damaged or weak, the immune system attempts to repair them. But since these structures have a poor blood supply, incomplete healing is common after injury–even years later. Without complete healing, the once taut and strong bands of connective tissue are now relaxed and weak and the joint they’re meant to hold together becomes unstable. Joint instability can often be a source of joint pain.



Using an ultrasound image to guide the prolotherapy injection significantly increases accuracy in hitting the target area of treatment. This is especially important when treating deeper areas such as the lumbar spine and the hip or delicate areas such as the cervical spine.


  • Joint Pain (hip, knee, ankle, shoulder, elbow, wrist, hands and feet)
  • Joint Injury
  • Back and SI Pain
  • Shoulder problems
  • Rotator cuff tears
  • Labrum tears
  • Tendinitis
  • AC injuries
  • Frequent dislocations
  • Frozen shoulder/Adhesive capsulitis
  • Plantar Fasciitis
  • Ankle instability (frequent ankle sprains)
  • Knee problems, ACL/PCL and meniscus injuries
  • Hyperextension injuries
  • Pain from Osteoarthritis of the knee

Prolotherapy services at Evoke Integrative Medicine are performed by Dr. Angèle Besner ND.



Come in for a complimentary info session and preliminary assessment. Have your questions answered and determine if prolotherapy is an appropriate option for you, or visit vancouverprolotherapy.com