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Prolotherapy for Chronic Shoulder Tendinopathy

Dextrose injection therapy for refractory tendon and ligament pain

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Geleneksel ve Tamamlayıcı Tıp department. Book Appointment →

What is Prolotherapy for Chronic Shoulder Tendinopathy?

Prolotherapy uses injection of hyperosmolar dextrose (typically 10–25%) at sites of chronic tendon, ligament, or joint pain.

The proposed mechanism involves localized inflammation, fibroblast activation, and collagen deposition leading to tissue strengthening.

It is administered under ultrasound guidance for accuracy, particularly in deep structures such as rotator cuff insertions.

Treatment typically requires 3–6 sessions spaced 2–4 weeks apart.

Within Turkey's GETAT regulations, prolotherapy is recognized as a complementary technique requiring physician administration.

Comparative trials show benefit similar to or exceeding corticosteroid injections without the catabolic risk.

Symptoms

Chronic shoulder pain lasting >3 months
Painful arc with overhead activities
Tenderness over rotator cuff insertion or biceps tendon
Failed response to physical therapy and NSAIDs
Persistent pain after corticosteroid injection
Imaging confirming tendinosis without complete tear

Risk Factors

Repetitive overhead activities (sports, occupational)
Age over 40 years
Diabetes mellitus (impaired tendon healing)
Obesity
Smoking (delayed tissue repair)
Previous corticosteroid injections without lasting benefit

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Persistent shoulder pain >6 weeks unresponsive to conservative measures warrants specialist evaluation.
  • Acute trauma with sudden weakness suggests possible rotator cuff tear—surgical evaluation required.
  • Night pain awakening the patient or limiting activities of daily living needs comprehensive assessment.
  • Diabetic patients should be counseled about higher complication rates and slower response.
  • Bleeding disorders, anticoagulation, or active local infection are contraindications.

Treatment Methods

01
Comprehensive shoulder examination and ultrasound or MRI imaging.
02
Trial of structured physical therapy and NSAIDs as first-line treatment.
03
Ultrasound-guided dextrose prolotherapy injections at sites of tendon pathology.
04
Series of 3–6 sessions every 2–4 weeks under physician supervision.
05
Concurrent rehabilitation with rotator cuff strengthening and scapular stabilization.
06
Avoidance of NSAIDs around injection time to allow inflammatory healing response.
07
Reassessment with functional outcomes and patient-reported pain scores.
08
Surgical consultation if no response after adequate trial.

Which Department to Visit?

You can visit our Geleneksel ve Tamamlayıcı Tıp department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Geleneksel ve Tamamlayıcı Tıp Department

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You can make an appointment with our specialists or contact us for your concerns.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.