Dextrose & Fascial Prolotherapy · Beverly Hills

Dextrose & Fascial Prolotherapy

We don’t just treat the joint — we treat the fascia that moves it.

At The Fascia Institute and Treatment Center of LA, we use ultrasound-guided dextrose prolotherapy to rebuild the tissue behind stubborn pain — ligaments, tendons, muscle, and joint instability. We are one of the few clinics in the country, and one of the first, to take prolotherapy further with fascial prolotherapy and Hydrofascia Release™, restoring healthy fascial flow instead of just quieting symptoms.

Why It Works

Pain that keeps coming back is usually a tissue problem

When an injury keeps flaring, the joint is rarely the whole story. The supporting tissue — the ligaments, tendons, and fascia that hold you together and let you move — often hasn’t fully healed. Cortisone and painkillers can quiet the signal, but they don’t rebuild the structure.

Prolotherapy takes the opposite approach: a small injection of dextrose stimulates your body’s own repair response so the tissue grows back stronger. And because we place every injection under real-time ultrasound — and pair it with Hydrofascia Release™ when fascia has stopped gliding — we treat the exact structure driving your pain, not a best guess.

90+ years
dextrose prolotherapy in clinical use
100% guided
every injection placed under ultrasound
4–6 sessions
typical course to rebuild tissue

What Prolotherapy Treats

Built for instability, ligaments, tendons & muscle

If pain keeps returning, one of these structures usually needs to heal. We treat, from head to toe:

Instability
Chronic ankle instability, recurrent sprains, and joint laxity — including hypermobility and Ehlers-Danlos.
Ligaments
Sprains and overstretched ligaments that never fully tightened back up after injury.
Tendons
Tennis and golfer’s elbow, rotator cuff, patellar and Achilles, and other stubborn tendinopathy.
Muscle
Chronic hamstring, groin, and muscle injuries that don’t resolve with rest and therapy alone.
Fascia & nerve
Adhesions, scar tissue, and nerve entrapment released with ultrasound-guided Hydrofascia Release™ (hydrodissection).
Joints
Knee, hip, shoulder, and finger osteoarthritis and everyday joint pain.

Not sure if you’re a candidate? Request a consultation →

How It Works

Dextrose: “weed and feed” for your fascia

Dr. Courseault explains dextrose prolotherapy the way a gardener thinks about weed and feed. Dextrose is simply concentrated sugar — the same fuel your cells already run on — so it works with your biology: clear out worn, pain-generating tissue, and nourish the healthy tissue that rebuilds it.

The “weed”
A concentrated dose creates a brief osmotic shift that stresses fragile, unhealthy cells and signals the body to clear them — starting a fresh, natural repair cascade (the classic osmotic-inflammatory model; Reeves, Sit & Rabago, 2016).
The “feed”
Healthy cells take dextrose up as fuel and respond by multiplying and laying down new collagen. In lab studies, dextrose raises the growth factors that drive tendon, ligament, and cartilage repair — without harming healthy cells (Han, 1999; Johnston, 2021).
Calms nerves
Low-concentration dextrose also quiets over-firing pain nerves (the TRPV1 pathway) — one reason relief can begin quickly, before tissue has fully rebuilt (Bertrand, 2015; Wu, 2017).

“We’re not masking pain. We’re weeding out the worn tissue and feeding the healthy tissue — so your fascia can flow, and your body can heal itself.”

— DR. JACQUES COURSEAULT, MD, FOUNDER

The Evidence

What the research shows

We read the literature closely — and we publish in it. A sample of the peer-reviewed evidence for dextrose and fascial prolotherapy, grouped by what we treat. Our added advantage: ultrasound guidance, which many of these studies did not use.

Instability & ligaments
A 2025 triple-blind RCT: dextrose to the ankle ligament improved balance and produced fewer recurrent sprains in chronic ankle instability (Sit et al., 2025).
Tendons
An RCT showed benefit in tennis elbow (Rabago, 2013); a 2022 meta-analysis of 8 trials confirmed it (Zhu, 2022).
Muscle
In elite athletes with chronic groin pain, prolotherapy sharply reduced pain and returned most to sport (case series; Topol, 2005).
Fascia & nerve
A double-blind RCT found ultrasound-guided dextrose hydrodissection relieved carpal tunnel to 6 months (Wu, 2017); a meta-analysis supports plantar fasciitis (Chutumstid, 2023).
Knee osteoarthritis
An RCT (Rabago, 2013) and a meta-analysis (Sit, 2016) report improved pain and function.
The big picture
A systematic review supports dextrose prolotherapy for tendinopathies, knee and finger OA, and spinal/pelvic ligament pain (Hauser, 2016).

Evidence quality varies by condition, and results differ from person to person. These studies describe outcomes in research populations, not a promise of individual results.

Published By Our Founder

Fascial prolotherapy, pioneered and published

We don’t just perform these techniques — we’ve helped define them. Dr. Jacques Courseault, MD has published on the fascial hydrodissection and prolotherapy methods we use every day:

What To Expect

Your visit, step by step

01
Evaluate
We review your history and use ultrasound — and, when helpful, Fascial Mapping® — to find the tissue actually driving your pain.
02
Treat
Under live ultrasound, we inject dextrose (with lidocaine for comfort) into the fascia, tendon, ligament, or joint. Most sessions take 10–15 minutes.
03
Recover
Mild soreness for a few days is normal — a sign the healing cascade has started. Take it easy for about 2 days, then ease back into activity.
04
Rebuild
We retrain the tissue to grow strong through rehab and our Fascia Performance Program. Most people need 4–6 sessions.

Frequently Asked Questions

Dextrose & fascial prolotherapy, answered

Does prolotherapy work?

Yes, for the right conditions. Randomized trials and systematic reviews support dextrose prolotherapy for tendon pain, knee and finger osteoarthritis, joint instability, and ligament-related pain. Our ultrasound guidance lets us see and treat the damaged tissue precisely — something many published studies did not do.

What exactly is dextrose prolotherapy?

It’s the injection of dextrose (a concentrated sugar) into the fascia, ligaments, tendons, or joints that generate pain, to stimulate your body to rebuild tissue. It’s the same sugar the FDA approves for injection into veins — but we inject small volumes into damaged tissue, not blood vessels.

Are the injections painful?

Most people find them uncomfortable rather than painful. We use the smallest needle possible and mix in lidocaine for numbing. When we also break up scar tissue with Hydrofascia Release™, soreness can last a little longer. Eat a full meal and hydrate beforehand.

Is it the same as a cortisone shot?

No. Cortisone is an anti-inflammatory that can weaken tissue over time, so we limit it. Prolotherapy does the opposite — it stimulates your body to rebuild tissue. We sometimes use one cortisone injection first to calm severe inflammation, then move to prolotherapy.

How many treatments will I need?

Most patients need 4–6 sessions; some need more. Many notice improvement after the first or second treatment, with gains often appearing by the third or fourth. Because we rebuild tissue rather than mask pain, real healing takes time — but relief tends to last.

Is it safe?

It has an excellent safety record; serious complications are very rare. We inject small amounts into tissue (not blood vessels) under ultrasound guidance. Some bruising, stiffness, or swelling for 1–7 days is expected, because the treatment works through a healing inflammatory response. If pain is severe, especially with a fever, call (424) 378-3488 and seek urgent care if needed.

Will insurance cover it, and what does it cost?

Most insurers don’t yet cover dextrose prolotherapy, so it’s typically self-pay; you may use FSA/HSA funds and can submit receipts for possible reimbursement. For current per-session pricing, see our pricing page or contact us.

Treat The Cause, Not Just The Pain

Ready to rebuild the tissue behind your pain?

Book a consultation at our Beverly Hills clinic with Dr. Jacques Courseault, MD and find out whether dextrose or fascial prolotherapy is right for you.

The Fascia Institute and Treatment Center® of LA · 415 North Crescent Drive, Suite 130, Beverly Hills, CA 90210 · (424) 378-3488 · fit@fasciala.com

References & Further Reading
  1. Reeves KD, Sit RW, Rabago DP. Dextrose prolotherapy: a narrative review of basic science, clinical research, and best treatment recommendations. Phys Med Rehabil Clin N Am. 2016;27(4):783–823. PMID 27788902.
  2. Hauser RA, Lackner JB, Steilen-Matias D, Harris DK. A systematic review of dextrose prolotherapy for chronic musculoskeletal pain. Clin Med Insights Arthritis Musculoskelet Disord. 2016;9:139–159. PMID 27429562.
  3. Sit RW, Wu RW, Reeves KD, et al. Dextrose prolotherapy improves dynamic postural balance and reduces recurrent sprains in chronic ankle instability: a 1-year RCT. Arch Phys Med Rehabil. 2025. PMID 41391614.
  4. Rabago D, Lee KS, Ryan M, et al. Hypertonic dextrose and morrhuate sodium injections (prolotherapy) for lateral epicondylosis: a RCT. Am J Phys Med Rehabil. 2013;92(7):587–596. PMID 23291605.
  5. Zhu M, Rabago D, Chung VC, et al. Effects of hypertonic dextrose injection (prolotherapy) in lateral elbow tendinosis: a systematic review and meta-analysis. Arch Phys Med Rehabil. 2022;103(11):2209–2218. PMID 35240122.
  6. Topol GA, Reeves KD, Hassanein KM. Efficacy of dextrose prolotherapy in elite male kicking-sport athletes with chronic groin pain. Arch Phys Med Rehabil. 2005;86(4):697–702. PMID 15827920.
  7. Rabago D, Patterson JJ, Mundt M, et al. Dextrose prolotherapy for knee osteoarthritis: a randomized controlled trial. Ann Fam Med. 2013;11(3):229–237. PMID 23690322.
  8. Sit RW, Chung VC, Reeves KD, et al. Hypertonic dextrose injections (prolotherapy) for symptomatic knee osteoarthritis: a systematic review and meta-analysis. Sci Rep. 2016;6:25247. PMID 27146849.
  9. Wu YT, Ho TY, Chou YC, et al. Six-month efficacy of perineural dextrose for carpal tunnel syndrome: a RCT. Mayo Clin Proc. 2017;92(8):1179–1189. PMID 28778254.
  10. Chutumstid T, Susantitaphong P, Koonalinthip N. Effectiveness of dextrose prolotherapy for chronic plantar fasciitis: a systematic review and meta-analysis of RCTs. PM R. 2023;15(3):380–391. PMID 35338597.
  11. Han DC, Isono M, Hoffman BB, Ziyadeh FN. High glucose stimulates proliferation and collagen type I synthesis in renal cortical fibroblasts: mediation by autocrine activation of TGF-beta. J Am Soc Nephrol. 1999;10(9):1891–1899. PMID 10477140.
  12. Johnston E, Kou Y, Junge J, et al. Hypertonic dextrose stimulates chondrogenic cells to deposit collagen and proliferate. Cartilage. 2021;13(2_suppl):213S–224S. PMID 34109827.
  13. Courseault J, Kessler E, Moran A, Labbe A. Fascial hydrodissection for chronic hamstring injury. Curr Sports Med Rep. 2019;18(11):416–420. PMID 31702723.
  14. Gerard NO, Mortell TM, Kingry C, Couture C, Courseault J. Hydrodissection of an ulnar nerve fascial adhesion in a baseball pitcher. JSES Rev Rep Tech. 2022;3(2):252–255. PMC10426644.
Across The Fascia Institute Network

The Fascia Institute and Treatment Center® of LA is part of a wider network. Visit our New Orleans flagship at fasciainstitute.org and Dr. Courseault’s research and publications; explore our dedicated Hypermobility & EDS Clinic and its EDS blog. Within this site, see Hydrofascia Release™, Fascial Mapping®, and ProloBoost Dual PRP.

This article is for general education and is not a substitute for individualized medical advice, diagnosis, or treatment. Prolotherapy outcomes vary from person to person, and an evaluation does not guarantee a specific result. Dextrose prolotherapy, Fascial Mapping®, and Hydrofascia Release™ are performed by Jacques Courseault, MD, at The Fascia Institute and Treatment Center® of LA.