Prolotherapy vs PRP – Which Gives Better Results for Joint Pain?
If you have been researching regenerative treatments for joint pain you have almost certainly come across both Prolotherapy and PRP – Platelet Rich Plasma therapy. Both are positioned as alternatives to steroid injections and surgery. Both use the body’s own biology to stimulate repair. And both are increasingly popular in the regenerative medicine space.
But they work very differently, they have different evidence bases and for most patients one is a significantly better choice than the other. In this post we explain exactly how each works, what the evidence shows and why at Proback we use Prolotherapy and Prolozone rather than PRP as our primary regenerative injection treatments.
What Is PRP?
PRP – Platelet Rich Plasma – is produced by taking a sample of the patient’s own blood, spinning it in a centrifuge to concentrate the platelets and growth factors, and injecting the resulting platelet-rich solution into the affected joint or tissue. The growth factors contained in the platelets are intended to stimulate the body’s own healing response in the damaged tissue.
PRP has been used in orthopaedics and sports medicine for over two decades and has attracted significant research interest. It sounds compelling in theory – using the patient’s own concentrated healing factors to repair damaged tissue.
What Is Prolotherapy?
Prolotherapy uses a natural dextrose solution – typically 15% dextrose – injected precisely into damaged ligaments, tendons and soft tissue to trigger a controlled inflammatory healing response. The body recognises the dextrose injection, lays down new collagen fibres at the injection site and progressively strengthens and repairs the damaged structures. Unlike PRP there is no blood draw required – the solution is entirely natural and the mechanism is well understood.
At Proback we combine Prolotherapy with Prolozone – medical grade ozone injected alongside the dextrose – which adds a powerful anti-inflammatory and tissue oxygenating effect to the structural repair stimulus. This combination consistently produces better outcomes than either treatment alone.
How Does the Evidence Compare?
PRP has a large and growing body of research behind it – but the results are notably inconsistent. Multiple systematic reviews have found that PRP produces variable outcomes depending on the preparation method, the concentration used, the condition being treated and the injection technique. A Cochrane review of PRP for knee osteoarthritis found that while some studies showed benefit, the quality of evidence was low to moderate and results were highly inconsistent between studies.
Part of the problem is that PRP is not a standardised treatment. The concentration of platelets, the activation method and the volume injected all vary significantly between practitioners and clinics – meaning two patients receiving “PRP” may be receiving very different treatments.
Prolotherapy has a more consistent and in some respects more robust evidence base for musculoskeletal pain. Rabago et al 2013 demonstrated significant and sustained improvement in knee osteoarthritis pain and function with dextrose Prolotherapy compared to controls at 52 weeks. Reeves and Hassanein 2000 showed significant improvements in a double blind randomised controlled trial. The mechanism of action is well understood and the dextrose solution is standardised – 15% dextrose across all properly performed Prolotherapy.
Cost – A Significant Difference
PRP typically costs between £300 and £600 per injection in London private clinics – and most conditions require multiple injections. The cost of centrifuge equipment, blood processing and the additional clinical time involved makes PRP inherently more expensive than Prolotherapy.
Prolotherapy at Proback is £275 for the first area and £85 for each additional area in the same session – making it significantly more accessible, particularly for patients requiring multiple sessions or multiple treatment areas.
Note: Proback currently does not offer PRP. We plan to introduce PRP in 2027 as a complementary option for specific presentations. Until then we offer Prolotherapy and Prolozone as our primary regenerative injection treatments.
Which Is Better for Specific Conditions?
For knee osteoarthritis the published evidence slightly favours Prolotherapy for structural ligamentous repair and long term stability, while PRP may have an advantage for the inflammatory and cartilaginous component. At Proback we address both components simultaneously with our Prolotherapy and Prolozone combination – the ozone component specifically addresses the articular cartilage and inflammatory environment while the dextrose addresses the structural ligamentous component.
For tendinopathy PRP has reasonable evidence particularly for rotator cuff and Achilles tendinopathy, but Prolotherapy combined with Shockwave Therapy – our preferred approach – has a comparable evidence base and is significantly more cost effective.
For ligament injuries and joint instability Prolotherapy is the more established and better evidenced treatment. PRP for ligament laxity has limited published evidence compared to the extensive Prolotherapy literature.
Why We Use Prolotherapy and Prolozone Rather Than PRP
At Proback our clinical experience across nearly 20 years of treating musculoskeletal pain leads us to consistently choose Prolotherapy and Prolozone as our primary regenerative injection approach for several reasons. The mechanism is well understood and reproducible. The solution is standardised. The evidence base is consistent. The cost is significantly lower. And the combination with Prolozone addresses components that PRP alone cannot – particularly the oxygenation and anti-inflammatory environment within arthritic and degenerated joints.
When we introduce PRP in 2027 it will be as a complementary tool for specific presentations – not as a replacement for our current approach.
Pricing and Next Steps
Our initial consultation is currently on special offer at £110 – reduced from £270 – and includes a full clinical examination, imaging where required and a dedicated results appointment where your findings and a personalised treatment plan are explained in full before you commit to anything further.
Treatment: first area £275 per session, each additional area £85. 15% discount when prepaying for a full course upfront.
Give us a call on 0207 976 6648 or email victoria@proback.co.uk.
Proback Clinic, 4 Evelyn Mansions, Carlisle Place, Victoria, London SW1P 1NH. Five minutes from Victoria station.
