Prolotherapy in Carlsbad and Laguna Hills
A non-surgical injection treatment for joints, ligaments, and tendons that have not healed on their own
You have probably been told to wait it out.
Rest it, ice it, take the anti-inflammatories, come back in six weeks. Then the cortisone, which worked for a while and then did not. Then the conversation about surgery, scheduled a few months out, framed as the only thing left.
Most people who find this page are somewhere in that sequence, and they are looking for what sits between doing nothing and having a joint operated on. Prolotherapy is one of the treatments that lives in that space, and it has been used in the United States for more than seventy years.
70+ years
Prolotherapy has been used in the United States for more than seventy years.
3–6 treatments
A typical course, spaced two to four weeks apart, depending on the structure being treated.
2 offices
Derrington Orthopedics is the largest Regenexx provider in Southern California, with offices in Carlsbad and Laguna Hills.
What prolotherapy actually is
Prolotherapy is a series of injections placed directly into damaged ligament, tendon, or joint tissue using a solution of concentrated dextrose, preservative-free saline, and a local anesthetic called ropivacaine. No steroids, no synthetic filler.
The injection creates a controlled, localized healing response at the site of the injection. Your body responds the way it responds to any fresh injury, by sending platelets, growth factors, and repair proteins into the area. Over a course of treatments, that repeated signal builds tissue back toward its original strength.
Cortisone and prolotherapy are opposite strategies
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Cortisone quiets the inflammation.
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Prolotherapy uses a controlled inflammatory response as the mechanism of repair.
The difference between this and an anti-inflammatory approach is worth sitting with. That is why we ask patients to stay off anti-inflammatory medications early in treatment, because those medications suppress the exact response we are trying to create.
Who this is for
Prolotherapy is most often used for:
Ligament laxity
In the spine, sacroiliac joint, or peripheral joints.
Tendinopathy
That has not resolved with rest, therapy, or bracing.
Osteoarthritic joints
Where the structural damage is mild to moderate.
Nerve irritation
Where an injured structure is the source of the irritation.
It tends to be a fit for people who are still active and intend to stay that way, who have a specific structure that is not holding up, and who want to know whether the tissue can be strengthened before anyone talks about replacing or repairing it surgically.
It is not a fit for everyone.
Part of the evaluation is finding out which category you are in. Dr. Steve Derrington will tell you directly if prolotherapy is not the right treatment for your problem.
What treatment is actually like
Does it hurt?
It depends on the joint and on you. Most patients describe it as mildly uncomfortable but tolerable. You should expect the treated area to feel more sore and stiff for two to three days afterward, because that soreness is the healing response doing its job. Tylenol is fine during that window. Anti-inflammatories are not, for the reason described above.
How many treatments?
Typically three to six, spaced two to four weeks apart. The exact number depends on the structure being treated and how your tissue responds. You will know after the first two whether your body is responding.
What happens at the first visit?
A comprehensive evaluation. Dr. Derrington reviews your imaging, examines the joint, and determines whether the structure is a candidate for prolotherapy, for another non-surgical treatment, or for neither. You leave with an actual answer about your specific joint, not a general education about the field.
Prolotherapy, Regenexx SCP, or Regenexx-SD. Which one is right for your joint?
Most people arrive at this page knowing they want to avoid surgery but not knowing which non-surgical treatment fits their situation. The procedures work on the same principle, which is stimulating repair in tissue that has not healed on its own, and they differ in what gets injected and how much biological signal that material carries.
Prolotherapy
Uses a dextrose solution to create a controlled healing response. There is no blood draw, which makes it the most straightforward of the three, and it can be the right starting point for ligament laxity, early tendinopathy, and joints where the structural damage is mild.
Regenexx SCP
A proprietary version of PRP, or platelet rich plasma. This platelet formulation is processed in the Regenexx lab, and it is not the same as the platelet injections offered at most clinics. The process concentrates platelets and growth factors well beyond what standard bedside centrifuge systems produce, and it removes the red and white blood cells that can work against healing in certain tissues. For many patients with arthritis, tendon, or ligament problems that have not improved with appropriate rehabilitation, SCP is often the appropriate procedure.
Regenexx-SD
Uses your own bone marrow, which contains stem cells, processed through the Regenexx protocol, and placed into the damaged tissue under precise image guidance. It is generally reserved for more advanced joint damage, larger tissue injuries, and situations where a platelet-based approach has not produced enough change.
Everything Regenexx does is tracked in a patient outcomes registry that now holds data on more than 100,000 procedures. That registry is part of the reason we can tell you what tends to happen with your specific joint, your specific injury, and your specific imaging findings, instead of offering a general impression. Dr. Derrington’s decade of experience caring for patients using these treatment options is another.
None of this is a ladder you have to climb in order. Some joints respond fully to prolotherapy and never need anything more. Others are better served by starting with a Regenexx procedure because the damage is beyond what dextrose can address, and starting low would only cost you months. The decision depends on which structure is injured, how much of it is left, your imaging, your age, your activity level, and what you are trying to get back to doing.
That determination happens during your comprehensive evaluation, when Dr. Derrington examines you and reviews your imaging.
You will leave knowing which procedure fits your specific problem, or knowing that none of them do, which is an answer we give when it is the honest one.
Why patients come here specifically
Precision placement is a large factor in the outcome in prolotherapy. A well-formulated solution in the wrong tissue plane does very little.
Derrington Orthopedics is a Regenexx affiliated practice and the largest Regenexx provider in Southern California, with offices in Carlsbad and Laguna Hills.
You can read what patients have said about their treatment, including video from people who were facing the same decision you are facing now.
Dr. Steve Derrington
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Instructor with the Interventional Orthopedics Foundation, and part of the Hands-On Training and Curriculum Committee.
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Teaches with OrthoSono, the longest running private MSK Ultrasound and Regenerative Medicine course in the United States.
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Trains other physicians in the precise, image-guided injection techniques these treatments depend on.
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Practices at a Regenexx affiliated clinic — the largest Regenexx provider in Southern California.
Get an answer about your specific joint
Call us to schedule a comprehensive evaluation. Our patient coordinator will answer your questions about the process, timing, and cost on the phone, before you commit to anything.
If prolotherapy is not the right treatment for your joint, we will tell you that during your evaluation, and we will tell you what is.
Send your imaging ahead
If you already have an MRI or X-ray, upload it before your visit and Dr. Derrington will review it in advance.
Two offices
Carlsbad and Laguna Hills, serving San Diego and Orange County.
Or call us directly at (760) 721-4000 - Carlsbad Office or (760) 721-4000 - Laguna Hills Office
Ready to find out if prolotherapy fits your joint?
Call us to schedule an in-office or telehealth appointment, or fill out the form and our team will reach out. We will ask about your condition, explain which options may apply, and tell you honestly whether an evaluation makes sense.
If we are not the right fit for your condition, we will tell you — and try to point you in the right direction.
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