Prolotherapy may be considered for selected ligament, tendon, joint, SI joint, pelvic, TMJ, foot, or hypermobility-related pain patterns.
Learn how Dr. Siefferman uses prolotherapy to stimulate the body's natural healing response and help treat chronic joint, ligament, and tendon pain.
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Hi, I’m Dr. Jason Siefferman, medical director at 91视频. Prolotherapy, or proliferation therapy, is a treatment that we will use for injured or stretched or sprained or hypermobile joints, tendons, or ligaments. Generally, any soft tissue where we want to make that tissue stronger, more robust, we will discuss prolotherapy as a treatment option.
What prolotherapy is is actually sugar. We use dextrose injected with local anesthetic into the tissue which causes a chemical irritation. This chemical irritation stimulates the fibroblasts to produce more collagen, which makes that connective tissue stronger and more robust. The general idea is that the type of injuries we’re treating with prolotherapies are overuse, strain, sprain injuries where that tissue is too weak or where it’s overused.
The prolotherapy will make that tissue stronger, more robust, so that it can better sustain the forces that are being placed upon it. For hypermobile joints specifically, it actually helps contract the connective tissue, stabilizing the joint. So we actually improve the intrinsic stability of the joint so there’s less pain from the strain and overuse of that joint.
For tendon issues, for ligamentous attachment issues, it’s making those insertion points stronger so that whatever strain is being put there is better tolerated. How much prolotherapy each patient needs depends on their response. And generally, the goal of the treatment is to make the tissue strong enough.
We use pain as a marker, but we also use ultrasound diagnostics at the same time. Each time we are treating with prolotherapy, we’re performing diagnostic ultrasound as well as using the ultrasound to guide the injection. We can actually see the results of the prolotherapy with each successive visit. So we can see if the tissue is healing appropriately or not. In addition to hearing from the patient how the pain is responding, we filter this into our understanding of the body’s response and we use it to guide our treatments.
And a next-step treatment, if there’s inadequate response, maybe something like platelet-rich plasma, or PRP. These are all things that we discuss in a stepwise motion. We don’t engage in prolotherapy as a prescribed set series of injections. It’s always try one, see how the body responds, and then decide what the next step will be.”
Prolotherapy is a regenerative injection technique that may be considered for selected musculoskeletal pain patterns involving ligaments, tendons, joints, chronic sprains, SI joint dysfunction, pelvic mechanics, TMJ symptoms, foot pain, or hypermobility-related instability. It is not a cure-all, a guaranteed surgery alternative, or a treatment for every pain generator.
At 91视频, prolotherapy NYC care begins with diagnosis-first evaluation. The goal is to determine whether symptoms are related to ligament, tendon, joint, or instability-related pain and whether prolotherapy fits safely within a broader care plan.
MPM specialists evaluate whether prolotherapy may be appropriate by first identifying the likely source of pain. Joint instability, chronic sprains, tendon pain, ligament pain, SI joint dysfunction, pelvic-region symptoms, TMJ dysfunction, foot pain, and hypermobility-related pain may require different treatment strategies.
MPM reviews the diagnosis, exam findings, imaging, movement patterns, prior injections, physical therapy response, bracing response, nerve symptoms, inflammatory contributors, and functional goals. This helps determine whether prolotherapy, PRP, BMAC, ultrasound-guided injections, rehabilitation, medication management, pelvic specialty care, or another pathway is more appropriate.
Patients often search for prolotherapy in Manhattan after persistent pain has not improved enough with physical therapy, bracing, rest, medications, steroid injections, or orthopedic care. Some have been told their pain may be related to ligament laxity, joint instability, hypermobility, EDS, SI joint dysfunction, pelvic mechanics, recurrent sprains, or TMJ-related instability.
MPM approaches prolotherapy with careful, medically grounded expectations. Prolotherapy may be considered when a specific ligament, tendon, joint, or instability-related target appears clinically relevant. However, it should not be described as guaranteed ligament tightening, permanent healing, cartilage regrowth, disc regeneration, or a universal alternative to surgery. Evidence varies by condition, and some patients may not respond. MPM focuses on accurate diagnosis, appropriate patient selection, ultrasound guidance when appropriate, informed consent, and follow-up rehabilitation when clinically needed.
Prolotherapy may fit within MPM鈥檚 Hypermobility, Musculoskeletal issues, and Pelvic Pain expertise when a specific ligament, tendon, joint, or instability-related target is identified. Patients with EDS, hypermobility spectrum disorder, chronic sprains, SI joint dysfunction, pelvic mechanics, TMJ dysfunction, foot and ankle instability, or recurrent musculoskeletal pain often need a plan that accounts for biomechanics, tissue tolerance, nerve sensitivity, and functional goals.
Prolotherapy is not a cure for EDS, hypermobility, joint instability, pelvic pain, TMJ dysfunction, spine pain, or complex chronic pain. For selected patients, it may be considered alongside bracing, stabilization work, physical therapy, pacing, medication management, diagnostic ultrasound, ultrasound-guided injections, or other regenerative treatments. MPM evaluates whether prolotherapy fits the diagnosis and broader care plan before recommending treatment.
Before prolotherapy, MPM reviews the diagnosis, target structure, treatment goal, expected recovery, risks, alternatives, and follow-up plan. Depending on the case, the procedure may involve dextrose prolotherapy or another regenerative injection approach directed at selected ligament, tendon, joint, SI joint, pelvic-region, TMJ, foot, or spine-adjacent targets. Ultrasound guidance may be used when appropriate.
Patients may feel pressure, soreness, or temporary pain flare after treatment. Recovery varies depending on the treated area, diagnosis, activity level, and broader care plan. Some patients may need to modify activity, use bracing, avoid certain medications, or follow a gradual rehabilitation program. Relief, if it occurs, may be gradual and is not guaranteed. MPM monitors response and determines whether continued treatment, rehabilitation, imaging, or another care pathway is appropriate.
I cannot say enough good things about 91视频. From the moment I walked in, I felt truly cared for and taken seriously. Dr. Nino Mikaberidze, Director of Rheumatology, is exceptional 鈥� knowledgeable, compassionate, and incredibly thorough. She takes the time to listen, explains every...
The best care I've received as a chronic pain patient. I traveled from out of state to visit 91视频 because I could not find knowledgeable doctors in my hometown for my hypermobility, and Ehlers-Danlos syndrome symptoms and comorbidities. Let me tell you, it was worth every travel e...
I was injured in a bicycle accident over 8 years ago. I鈥檝e suffered throughout the years since my accident with nothing seeming to work. PT, Yoga, lifestyle changes, NOTHNG! I finally made an appointment with Dr Kane and I鈥檓 feeling an improvement in my life. I no longer stay up all night in pain, a...
One of the best experiences, if not the best, I have ever had at the doctor鈥檚 office. From the front desk to the nurses to the PA assisting the doctor this was a great experience. Dr.Nino actually listened to me and came up with a game plan. Would recommend this practice to as many people as I could...
I have very unique & severe nerve pain from CRPS which has no known specific cure. Dr. Siefferman has a huge tool box, far greater than the other 23 Drs. I have seen. He saved me from jumping off a bridge and continues to help me with both treatments and advice. Dr. S. is in a different league!
After two years of searching and feeling lost and let down, I finally found real help at 91视频. With Dr. Siefferman, Adam Rosenberg, Dr. Mikaberidze, and the whole team, I feel heard, supported and understood. Every symptom is being considered and I鈥檓 finally getting answers with m...
Why is Dr Dr. Tayyaba Ahmed one of the top pevic Floor specialists - 1- She wants to know a full history of what led the patient to get to this point. 2 - She listens intensley to the patient 3- She does not rush you 4- Extremely skilled at giving pelvic floor injections 5- I thank my luck stars she...
The staff was friendly and helpful. Dr. Siefferman was thoughtful, listened, asked questions and proposed simple safe ways to come to further conclusions regarding my pain and discomfort. The office staff including Dr. Siefferman is responsive even after the initial in-person visit. Very pleased.
Dr. Siefferman is a brilliant provider. While my pain is still a work in progress, Dr Siefferman always gives me options and explains his reasoning behind things. He listens to my feedback and concerns. I never feel rushed; and am grateful he works to meet me where I am. I highly recommend him.
What a great find! They listen to me, I listen to them and the diagnosis is made and a plan developed to develop an approach to treat all of my chronic pain. I wish I could have discovered this type of treatment sooner. This doctor and group give me hope.
Prolotherapy is a regenerative injection technique that may be considered for selected ligament, tendon, joint, chronic sprain, SI joint, pelvic-region, TMJ, foot, or hypermobility-related pain patterns. It typically involves injecting a solution into a targeted area to stimulate a local tissue response. Prolotherapy is not a cure-all and is not appropriate for every pain condition. At MPM, prolotherapy treatment NYC care begins with diagnosis-first evaluation, target selection, safety review, and realistic expectations.
Dextrose prolotherapy is a form of prolotherapy that uses a dextrose-based solution injected into selected ligament, tendon, joint, or soft tissue targets when clinically appropriate. It is often discussed in the context of chronic sprains, ligament pain, joint instability, SI joint dysfunction, or hypermobility-related pain. Dextrose prolotherapy is not the same as PRP, BMAC, steroid injections, or stem cell therapy. MPM determines whether this approach fits the diagnosis and tissue target.
Prolotherapy is intended to create a controlled local tissue response in a targeted area. The goal may be to support healing, reduce pain, or improve function in selected ligament, tendon, joint, or instability-related conditions. The exact response varies by patient, target, and diagnosis. Prolotherapy should not be described as guaranteed ligament tightening, permanent repair, or tissue regeneration. MPM evaluates whether the patient鈥檚 symptoms and anatomy support a reasonable treatment rationale.
Prolotherapy may be considered for selected patients with chronic sprains, ligament pain, tendon pain, joint instability, SI joint dysfunction, hypermobility-related pain, EDS-related pain, foot and ankle instability, shoulder or hip pain, spine-adjacent pain, pelvic-region pain, or TMJ-related symptoms. It is not appropriate for every condition. Pain may also come from nerve irritation, inflammatory disease, structural spine disease, vascular issues, central sensitization, or pelvic floor dysfunction, which may require a different treatment pathway.
Prolotherapy may be considered when joint instability or ligament-related pain appears to be a meaningful contributor to symptoms. This may occur in selected patients with chronic sprains, recurrent joint irritation, SI joint dysfunction, hypermobility, or EDS-related pain. It does not guarantee joint stabilization or replace strengthening, bracing, movement retraining, or rehabilitation. MPM evaluates whether the instability pattern, tissue target, and broader clinical picture support prolotherapy before recommending treatment.
Prolotherapy may be considered for selected patients with hypermobility or EDS-related pain when a specific ligament, tendon, joint, or instability-related target is identified. It does not cure EDS, hypermobility spectrum disorder, joint instability, or complex chronic pain. Patients with hypermobility often need coordinated care that may include stabilization, bracing, physical therapy, pacing, medication management, and evaluation for overlapping nerve or centralized pain. MPM evaluates candidacy carefully.
Prolotherapy may be considered for selected chronic sprains when symptoms appear related to persistent ligament irritation, laxity, or instability. The right plan depends on the joint involved, injury history, imaging, exam findings, activity demands, and prior rehabilitation response. Some chronic sprains may need bracing, physical therapy, diagnostic ultrasound, PRP, additional imaging, or surgical evaluation instead. MPM determines whether prolotherapy fits the pain generator and recovery goals.
Prolotherapy may be considered for selected SI joint pain patterns, especially when ligament-related pain, instability, or hypermobility-related mechanics appear to contribute. SI joint pain can also be inflammatory, degenerative, traumatic, spine-referred, or related to pelvic mechanics. MPM evaluates whether the SI joint or surrounding ligaments are likely pain generators before recommending prolotherapy. Other options may include diagnostic injections, rehabilitation, bracing, rheumatology care, or additional imaging.
Prolotherapy may be considered for selected pelvic-region pain patterns when symptoms appear related to ligament, joint, or instability-related structures. Pelvic pain can also involve pelvic floor dysfunction, pudendal neuralgia, pelvic dystonia, PGAD, endometriosis, nerve pain, urologic issues, GI issues, or gynecologic conditions. MPM evaluates the full pelvic pain pattern before considering prolotherapy and may coordinate with pelvic floor therapy, gynecology, urology, pain psychology, or other specialists when needed.
Prolotherapy may be considered for selected tendon or ligament pain patterns, including chronic strain, ligament irritation, tendinopathy, or instability-related symptoms. The clinical target must be clear. Tendon or ligament pain may also be caused by inflammatory disease, overuse, nerve irritation, mechanical overload, or poor movement mechanics. MPM reviews exam findings, imaging, prior treatments, and functional goals before recommending prolotherapy or another regenerative or rehabilitation-based option.
Prolotherapy and PRP are different regenerative injection approaches. Prolotherapy typically uses an injected solution, often dextrose-based, to stimulate a local tissue response. PRP is made from the patient鈥檚 own blood and processed to concentrate platelets before injection. Each has different preparation steps, possible targets, evidence limits, recovery expectations, and cost considerations. MPM determines which option, if either, fits the diagnosis, tissue target, and treatment goals.
Steroid injections are typically used to reduce inflammation and pain in a targeted area. Prolotherapy has a different goal and is intended to stimulate a local tissue response in selected ligament, tendon, joint, or instability-related pain patterns. Steroids may work faster for certain inflammatory conditions, while prolotherapy may involve a slower and more variable response. MPM determines which approach fits the diagnosis, safety profile, tissue target, and goals.
No. Prolotherapy is not the same as stem cell therapy. It usually involves injecting a solution, such as dextrose, into selected musculoskeletal targets. Stem cell, exosome, amniotic, cord-derived, Wharton鈥檚 jelly, or adipose-derived products are different and are often marketed with broad claims. Many of these products are not FDA-approved for orthopedic pain or chronic pain conditions. MPM distinguishes prolotherapy from unsupported regenerative claims and discusses realistic expectations before treatment.
The number of treatments depends on the diagnosis, target, severity, response, recovery plan, and patient goals. Some patients may not need repeated treatment, while others may be considered for a series only if early response, safety, and clinical reasoning support it. Prolotherapy should not be repeated automatically. MPM reassesses symptoms, function, side effects, and whether the broader plan should include rehabilitation, bracing, medication management, imaging, or another treatment.
Risks may include post-procedure pain flare, soreness, bruising, bleeding, infection, allergic reaction, nerve irritation, vascular injury, temporary worsening, and incomplete relief. Risk depends on the target, technique, patient health, and diagnosis. Prolotherapy does not guarantee pain relief or tissue repair. Urgent evaluation is needed for fever, spreading redness, severe swelling, new weakness, new numbness, loss of pulses, limb discoloration, bowel or bladder dysfunction, or rapidly worsening symptoms.
Before care begins, our team helps patients understand the practical side of treatment, including insurance verification, out-of-network benefits, cost-share estimates, self-pay options, and billing questions. We believe patients should have as much clarity as possible before moving forward.
Prolotherapy is a regenerative injection technique that may be considered for selected musculoskeletal pain patterns involving ligaments, tendons, joints, chronic sprains, SI joint dysfunction, pelvic mechanics, TMJ symptoms, foot pain, or hypermobility-related instability. It is often discussed as dextrose prolotherapy or regenerative injection therapy.
At 91视频 (MPM), prolotherapy NYC care begins with diagnosis-first evaluation. The goal is to determine whether symptoms are related to a specific ligament, tendon, joint, or instability-related pain generator. Prolotherapy is not a cure-all, a guaranteed alternative to surgery, or a replacement for rehabilitation, medical management, or specialist care when those are needed.
Prolotherapy is intended to stimulate a local tissue response in a targeted area. It may be considered for selected patients with chronic sprains, ligament pain, tendon pain, joint instability, SI joint pain, foot and ankle instability, shoulder or hip pain, spine-adjacent pain, pelvic-region pain, or TMJ-related symptoms.
The target matters. A patient with ligament-related pain may need a different plan than a patient with nerve irritation, inflammatory arthritis, disc-related pain, pelvic floor dysfunction, or central sensitization. MPM evaluates where the pain is coming from before deciding whether prolotherapy is reasonable.
Patients with EDS, hypermobility spectrum disorder, recurrent sprains, joint instability, or ligament laxity often ask whether prolotherapy can help. Prolotherapy may be considered when a specific ligament, tendon, joint, or instability-related target is clinically relevant. However, it does not cure EDS or hypermobility and should not be described as guaranteed ligament tightening or permanent stabilization.
Hypermobility-related pain often requires a coordinated plan that may include bracing, stabilization, physical therapy, pacing, activity modification, medication management, and evaluation for overlapping nerve or central pain contributors. Prolotherapy may be one part of care for selected patients, but the broader plan remains important.
Prolotherapy may be considered for selected SI joint pain patterns when ligament-related pain, instability, or hypermobility-related mechanics appear to contribute. SI joint pain can also be inflammatory, degenerative, traumatic, spine-referred, or related to pelvic mechanics.
For pelvic-region pain, prolotherapy may be considered only when a specific ligament, joint, or instability-related structure appears clinically relevant. Pelvic pain may also involve pelvic floor dysfunction, pudendal neuralgia, pelvic dystonia, PGAD, endometriosis, urologic conditions, GI conditions, or nerve pain.
For foot and ankle symptoms, prolotherapy may be considered in selected instability or ligament-related patterns, but pain may also come from Morton鈥檚 neuroma, tarsal tunnel syndrome, metatarsalgia, tendon dysfunction, arthritis, or nerve irritation. TMJ symptoms may involve joint mechanics, muscle overactivity, dental factors, headache overlap, or orofacial nerve pain, so careful evaluation is needed before considering prolotherapy.
Prolotherapy, PRP, BMAC, and steroid injections are different treatments. Steroid injections are typically used to reduce inflammation and pain. PRP uses platelet-rich plasma prepared from the patient鈥檚 blood. BMAC uses bone marrow aspirate concentrate. Prolotherapy typically uses an injected solution, often dextrose-based, to stimulate a local response.
No single option is best for every patient. MPM determines which treatment, if any, fits the diagnosis, tissue target, evidence, safety profile, and recovery goals.
Evidence for prolotherapy varies by condition. Some studies suggest possible benefit for selected musculoskeletal pain patterns, while evidence quality and outcomes differ across diagnoses. MPM avoids unsupported claims about ligament tightening, cartilage regrowth, ligament reconstruction, disc regeneration, nerve regeneration, or permanent healing.
Risks may include post-procedure pain flare, bruising, bleeding, infection, allergic reaction, nerve irritation, vascular injury, temporary worsening, and incomplete relief. Patients should seek urgent evaluation for fever, spreading redness, severe swelling, new weakness, new numbness, bowel or bladder dysfunction, saddle anesthesia, chest pain, shortness of breath, sudden severe headache, severe abdominal or pelvic pain, major trauma, suspected infection, loss of pulses, limb discoloration, or rapidly worsening symptoms.
For selected patients, prolotherapy may be one part of a targeted pain care plan. MPM鈥檚 role is to determine whether the diagnosis, tissue target, safety profile, and recovery plan support treatment within a coordinated, medically responsible framework.
