Harnessing the body's own biological healing mechanisms to repair damaged tissue, reduce inflammation, and restore function — without surgery or long-term medication.
Regenerative medicine represents a fundamental shift in how we approach chronic pain and musculoskeletal injury. Rather than masking pain with medications or removing tissue surgically, regenerative treatments leverage the body's own biological systems — platelets, growth factors, and the inflammatory cascade — to stimulate genuine tissue repair and long-lasting healing.
At Epione Pain Center, we offer two evidence-informed regenerative treatments: Platelet-Rich Plasma (PRP) therapy and Prolotherapy. Both are minimally invasive, use natural substances, and are well-suited to patients seeking alternatives to surgery or long-term anti-inflammatory medication.
Platelets are blood cells best known for their role in clotting, but they also carry a rich payload of growth factors — proteins that orchestrate tissue repair, stimulate cell proliferation, and promote new blood vessel formation. In PRP therapy, a sample of your own blood is drawn and placed into a centrifuge, which spins at high speed to separate and concentrate the platelets. The resulting platelet-rich plasma — containing 3 to 5 times the normal concentration of platelets and their associated growth factors — is then injected precisely into the damaged tissue under ultrasound guidance.
The concentrated growth factors trigger a controlled healing response in the area, accelerating repair processes that have stalled in chronically injured or degenerated tissue.
The entire PRP procedure takes approximately 45 to 60 minutes from blood draw to injection. Because PRP uses your own blood, there is no risk of allergic reaction or disease transmission. Ultrasound guidance is used to ensure the PRP is delivered directly to the affected tissue.
Most conditions respond best to a series of 1 to 3 injections, spaced 4 to 6 weeks apart. Some patients notice improvement within the first few weeks; for others, the full benefit develops over 3 to 6 months as the healing process unfolds.
PRP therapy has minimal downtime. You may experience mild soreness and swelling at the injection site for 2 to 5 days after the procedure — this is a normal sign that the healing response has been initiated. Most patients can return to light activity within 24 to 48 hours. Anti-inflammatory medications (NSAIDs such as ibuprofen) should be avoided for several weeks after PRP, as they can suppress the inflammatory healing cascade that makes PRP effective.
Important: Avoid anti-inflammatory medications (ibuprofen, naproxen, diclofenac) for at least 2 weeks before and 4–6 weeks after PRP injections, as they interfere with the treatment's healing mechanism.
Clinical evidence: A 2019 BMJ meta-analysis of 14 randomized controlled trials found PRP superior to both hyaluronic acid and placebo for knee osteoarthritis at 12 months. Systematic reviews report 60–80% of patients achieve clinically meaningful improvement. For lateral epicondylitis (tennis elbow), an RCT published in the American Journal of Sports Medicine (Mishra et al., 2014) showed 84% improvement in the PRP group at 24 weeks. Duration of relief typically ranges from 6 to 12 months, with some studies reporting sustained benefit at 24 months for knee OA.
Prolotherapy — short for "proliferative therapy" — uses a precise injection of a dextrose (sugar) solution into damaged or lax ligaments, tendons, and joint structures. The dextrose solution acts as an irritant at a cellular level, deliberately triggering a localized inflammatory response in tissue that has become chronically weakened and unable to heal on its own.
This controlled inflammatory response recruits fibroblasts — the cells responsible for building collagen — to the injection site. Over the following weeks, new collagen fibres are laid down, strengthening and tightening the treated tissue. The result is not just pain relief, but genuine structural repair of ligaments and tendons that have become loose, torn, or degenerated.
Prolotherapy is one of the few pain treatments that addresses the underlying structural cause of joint instability rather than simply managing symptoms.
A typical prolotherapy session involves multiple small injections into the affected ligament or tendon insertions, guided by anatomical landmarks and ultrasound where appropriate. Sessions last 20 to 45 minutes depending on the number of areas treated.
Prolotherapy is a cumulative treatment. A series of 3 to 6 sessions spaced 4 to 6 weeks apart is typically required to achieve lasting results, as each session builds on the collagen remodelling initiated by the previous one. Some patients with significant instability may benefit from additional sessions.
After prolotherapy, it is normal to experience localized soreness and mild swelling for 3 to 7 days. This is an expected and necessary part of the healing process. Light activity is encouraged, but strenuous exercise should be avoided for 48 to 72 hours after each session.
As with PRP, anti-inflammatory medications should be avoided around the time of prolotherapy, as they suppress the inflammatory process that drives the treatment's benefit.
A natural approach: Prolotherapy uses a simple dextrose solution — no steroids, no biologics, and no foreign substances. It works entirely by stimulating your body's own repair systems.
Clinical evidence: An RCT published in the Annals of Family Medicine (Rabago et al., 2013) demonstrated clinically significant improvement in knee osteoarthritis outcomes at 52 weeks compared to both saline injection and exercise controls. A 2016 systematic review in the Journal of Alternative and Complementary Medicine found moderate evidence supporting dextrose prolotherapy for knee OA. For chronic low back pain, a study in Spine (Yelland et al., 2004) showed benefit comparable to exercise at 2 years. Relief can persist 12 or more months after a completed treatment series, with some studies showing durable benefit at 2–3 years.
Both PRP and Prolotherapy stimulate healing, but they work through different mechanisms and are suited to different conditions. At your consultation, your specialist will review your diagnosis, imaging, and treatment history to recommend the most appropriate option — or a combination of both.
| Feature | PRP Therapy | Prolotherapy |
|---|---|---|
| Mechanism | Growth factors from concentrated platelets | Dextrose-triggered collagen proliferation |
| Best for | Tendon injuries, osteoarthritis, acute-to-subacute tissue damage | Ligament laxity, joint instability, chronic tendinopathy |
| Sessions | 1–3 injections | 3–6 injections |
| Source | Your own blood | Dextrose solution |
| Downtime | Minimal (2–5 days soreness) | Minimal (3–7 days soreness) |
Our specialists will assess your condition and determine whether PRP therapy, prolotherapy, or a combination approach is the most appropriate path to healing.
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