Reaching into the back seat hurts. So does putting on a jacket. You can’t sleep on that side anymore. What started as a minor strain has lingered for months, and physical therapy helped only so much.
Chronic shoulder pain, especially from rotator cuff tendinopathy, is one of the common reasons people look into prolotherapy.
How prolotherapy is used in the shoulder
The rotator cuff is a group of four muscles and tendons that stabilize the shoulder. With repetitive use, aging, or injury, those tendons can become irritated and degenerated. This is called tendinopathy. Tendons have limited blood supply, which is part of why they heal slowly.
Prolotherapy injects a solution at or near the painful tendon and its attachment to bone, aiming to stimulate the body’s repair response. At Venturis Clinic, this may use dextrose or an oxygen-ozone mixture, depending on your situation.
What the research shows
- A randomized controlled trial (Bertrand et al., Archives of Physical Medicine and Rehabilitation, 2016) studied adults with painful rotator cuff tendinopathy who were also doing physical therapy. Those who received dextrose prolotherapy at the tendon attachments reported greater pain improvement and satisfaction at nine months than those who received superficial control injections.
- Evidence for other shoulder conditions, like frozen shoulder or shoulder osteoarthritis, is more limited.
Prolotherapy generally works best as part of a plan that includes appropriate strengthening and movement, not as a stand-alone fix.
Who may be a candidate
- Rotator cuff tendinopathy or partial-thickness tendon irritation
- Chronic shoulder pain lasting months despite physical therapy
- Pain with overhead reaching, lifting, or sleeping on the affected side
- Recurring shoulder strain from work or sports
Who may not be a candidate
- A suspected full-thickness rotator cuff tear with major weakness, which needs orthopedic evaluation
- A dislocated or fractured shoulder
- Active infection, certain bleeding disorders, or uncontrolled diabetes
- Shoulder pain that may be referred from the neck or elsewhere and hasn’t been evaluated
What to expect
- Evaluation: a shoulder and neck exam, your history, and review of any imaging.
- Plan: the injection sites, the approach, and a realistic number of sessions.
- Injection visit: usually brief.
- Afterward: soreness for a few days is common. You’ll get guidance on activity and returning to your exercises.
Risks
- Common: post-injection soreness and stiffness.
- Uncommon: bruising, infection, or nerve irritation.
- Rare with ozone: serious complications if gas enters a blood vessel.
When to get emergency care
Call 911 for shoulder or arm pain together with chest pressure, shortness of breath, or sweating. These can be signs of a heart problem.
Seek prompt care for sudden inability to lift your arm after an injury, or a hot, red, swollen joint after any injection.
Serving Oklahoma City, Tulsa, and all of Oklahoma
Venturis Clinic sees patients from Oklahoma City and surrounding areas, including Tulsa, and from across Oklahoma. Learn more on our Prolotherapy in Oklahoma City page.
Frequently asked questions
Does prolotherapy work for rotator cuff problems? A randomized trial found improved pain and satisfaction for rotator cuff tendinopathy when prolotherapy was added to physical therapy. Individual results vary.
Can prolotherapy fix a torn rotator cuff? It isn’t used to repair full-thickness tears. Suspected complete tears should be evaluated for surgical options.
Should I stop physical therapy? No. Research on the shoulder studied prolotherapy alongside physical therapy, and strengthening remains important.
How long before I notice a difference? It varies. Improvement, when it happens, tends to be gradual over a series of sessions.
Ready to talk about your shoulder? Book a free 15-minute discovery call, or learn more about prolotherapy in Oklahoma City.
Individual results vary. This page is for educational purposes and is not a guarantee of outcome.
By Alvin Philipose, DC, ICCP
Sources
- Bertrand H, et al. Dextrose prolotherapy versus control injections in painful rotator cuff tendinopathy. Archives of Physical Medicine and Rehabilitation. 2016;97(1):17–25.