Prolotherapy vs. PRP vs. Steroid Injections
Summary
The article explains why prolotherapy, platelet-rich plasma, and steroid injections are not interchangeable options for musculoskeletal pain. Dr. Siefferman divides these interventions into three distinct mechanisms: tightening loose structures, healing damaged tissue, and calming active inflammation. Dextrose prolotherapy encourages collagen growth to support unstable joints, while platelet-rich plasma delivers growth factors to repair injured tendons or ligaments. Steroids reduce acute inflammatory flares but do not rebuild tissue. Choosing the appropriate procedure requires identifying whether joint laxity, structural tearing, or inflammation is the primary driver of the pain.
Conditions and treatments discussed
- Prolotherapy. Dextrose prolotherapy acts to tighten loose or unstable joint structures by stimulating a controlled local collagen response.
- Platelet-Rich Plasma (PRP). Platelet-rich plasma concentrates growth factors from a patient's blood to promote tissue repair in injured tendons or ligaments.
- Steroid Injections. Steroid injections calm acute inflammatory flares and nerve irritation but do not repair structural tissue damage or fix joint instability.
- Hypermobility Spectrum Disorder. Joint instability and ligament laxity can trigger muscle spasms as surrounding muscles attempt to stabilize loose joints.
What this shows about Manhattan Pain Medicine
In this post, Dr. Siefferman outlines how Manhattan Pain Medicine categorizes treatments by their underlying mechanism rather than treating injections as generic options. The practice reports using prolotherapy combined with local anesthetic as both a therapeutic intervention and a diagnostic test to confirm the pain generator. Manhattan Pain Medicine describes a diagnostic model where interventions target the specific driver, whether joint laxity, tissue damage, or inflammation. This structured evaluation guides the sequence of care to address the root cause of symptoms.