Prolotherapy in Greenville, SC
Prolotherapy at IHP Greenville. Dr. Hendry, DAOM — NCBAHM-certified, 25+ yrs experience, hospital-credentialed. Call (864) 365-6156.
"I was struggling with adductor and hamstring issues for years, stopping me from running. I tried this place as a last ditch effort and am glad I did. After a consultation it was decided to try a 'wet needling' therapy — it saved my running career."
— Corey Coll · April 2022 · Google Review
Tendons and ligaments are structurally different from muscle. Muscle heals because it has a generous blood supply — cut a muscle and the repair system responds quickly. Tendons and ligaments are relatively avascular by comparison. Their healing is slower, less complete, and far more dependent on conditions that chronic pain patients often don't have: adequate circulation, nutrient availability, low systemic inflammation, and a healing stimulus strong enough to re-engage a repair process that has gone quiet.
When a ligament or tendon is repeatedly stressed without fully healing — a sprained ankle that's "almost fine," a lower back that goes out every six months, a knee that never quite regained stability after an old injury — the tissue isn't inflamed. Inflammation would actually be productive. The tissue has become chronically lax: structurally compromised, poorly vascularized, and no longer generating the cellular signals needed to rebuild.
Prolotherapy interrupts that pattern. A precisely placed injection of hypertonic dextrose solution into the injured tendon or ligament insertion triggers a controlled, localized inflammatory response. Not inflammation for its own sake — a targeted biological signal that recruits fibroblasts, platelets, and growth factors to a site that has gone metabolically quiet. The result is new collagen synthesis, increased tissue thickness, and restored tensile strength at the exact structure that has been generating your pain.
I use prolotherapy for patients where the problem is mechanical stability, not inflammation management. If your MRI shows "mild degenerative changes" and your cortisone injection worked for three months before wearing off, that's not an inflammation problem. That's a structural problem. We offer both standard dextrose prolotherapy and Prolozone — a combination of dextrose with medical-grade ozone — for cases where enhanced tissue oxygenation and faster collagen turnover are indicated.
How Prolotherapy Works
Each prolotherapy session begins with a thorough assessment of the target joints and connective tissues — identifying specific ligament and tendon insertion sites that are tender to palpation and correlate with your pain pattern. Dr. Hendry uses both Western orthopedic examination and Chinese medicine palpation to map the structural landscape before a single injection is placed.
The treatment area is cleaned and a local anesthetic is applied to minimize discomfort. The prolotherapy solution — hypertonic dextrose, typically 15–25% concentration — is then injected directly into the affected tendon or ligament insertions and the surrounding joint capsule using fine-gauge needles. Multiple sites are typically treated in a single session. Sessions run 30–45 minutes.
For Prolozone, a small volume of medical-grade ozone gas is added to the injection protocol. Ozone enhances cellular metabolism, improves local tissue oxygenation, reduces inflammatory byproducts, and accelerates collagen synthesis — often producing faster results with fewer total sessions than dextrose prolotherapy alone.
After treatment, mild soreness, swelling, and warmth at the injection sites are expected and desirable — they confirm the proliferant response has been activated. Anti-inflammatory medications (NSAIDs) must be avoided for at least 48–72 hours after each session, as they suppress the inflammatory cascade that prolotherapy is designed to stimulate. Treatments are typically spaced 2–4 weeks apart to allow each round of collagen remodeling to consolidate before the next stimulus.
Conditions Treated with Prolotherapy
Prolotherapy vs. Cortisone Injection
Cortisone and prolotherapy treat the same presentation — painful, unstable joints and tendons — through opposite biological mechanisms. Cortisone is a corticosteroid that suppresses the inflammatory response. It works quickly, often producing meaningful pain relief within days. But the tissue that was generating pain remains structurally unchanged. The ligament is still lax, the tendon is still degenerated, the joint capsule is still loose. Worse, corticosteroids are catabolic at the injection site: repeated cortisone injections are associated with collagen fiber disruption, tendon weakening, and cartilage degradation. The Hinman et al. randomized clinical trial in JAMA (2014) found that intra-articular cortisone for knee osteoarthritis produced no significant benefit over saline injection at two years and was associated with greater cartilage volume loss. A patient who has received three or four cortisone injections into the same knee — each one working less than the last — is experiencing what the pharmacology predicts: transient symptom suppression with progressive structural deterioration. Prolotherapy operates in the opposite direction. It introduces a controlled pro-anabolic stimulus — recruiting the fibroblasts and growth factors that build tissue rather than suppress it. The first two sessions may be less comfortable than a cortisone injection because the therapeutic mechanism is not suppression. But the outcome trajectory is different: patients who complete a full prolotherapy protocol typically report durable improvements in stability and pain that do not require repeat treatment indefinitely. For a patient who has had meaningful but short-lived relief from cortisone, prolotherapy offers the structural repair that the cortisone never provided.
Research & Evidence
Prolotherapy's mechanism is well-characterized: the injection of a hyperosmolar dextrose solution into a tendon or ligament insertion creates transient osmotic disruption of local cells, triggering an inflammatory cascade that recruits fibroblasts, platelets, and growth factors to the treated site. The result is new collagen synthesis — Type I collagen deposition that thickens and strengthens the injured structure rather than simply suppressing the pain signal it generates. This is not a theoretical model. The histological evidence is direct: post-prolotherapy biopsies consistently show increased collagen fiber density and improved organizational alignment at treated entheses compared to controls. The landmark randomized controlled trial by Rabago et al. (Annals of Family Medicine, 2013) enrolled 90 patients with knee osteoarthritis in a blinded comparison of dextrose prolotherapy versus saline injection versus at-home exercise. The prolotherapy group demonstrated statistically significant improvements in pain (VAS), function (WOMAC), and composite knee scores at 52 weeks — outperforming both control conditions with an effect size that remained clinically meaningful at one-year follow-up. A subsequent systematic review by Rabago et al. (Clinical Journal of Pain, 2015) evaluated prolotherapy across chronic musculoskeletal conditions including low back pain, lateral epicondylosis, finger osteoarthritis, and knee OA, concluding that dextrose prolotherapy consistently produces functional improvement beyond control conditions. For spinal applications, Hauser et al. (Journal of Prolotherapy, 2009) provided the mechanistic framework for ligament-targeted injection in spondylolisthesis: by strengthening the supraspinous, interspinous, and iliolumbar ligaments that maintain vertebral alignment, prolotherapy addresses the structural instability driving both pain and slippage rather than treating the pain signal downstream of it. Prolozone — the combination of dextrose with medical-grade ozone — adds an oxidative stimulus that enhances mitochondrial ATP production in hypoxic connective tissue, increases local oxygen availability (ozone decomposes to O2 in the joint environment), and modulates the inflammatory resolution phase to accelerate collagen maturation.
Your First Appointment
Bring any prior imaging (X-ray, MRI) and a list of current medications — particularly blood thinners or anti-inflammatory drugs. Wear loose, comfortable clothing that allows easy access to the joints being treated. Eat a light meal beforehand. Plan to avoid NSAIDs (ibuprofen, aspirin, naproxen, Aleve) for at least 48 hours before and after each session — these directly suppress the healing response prolotherapy is designed to trigger. Some post-injection soreness and swelling is normal and expected for 24–72 hours; this is the proliferant response working. Most patients resume normal daily activity the same day, with high-impact activity delayed 48–72 hours.
Why Dr. Hendry for Prolotherapy
Dr. Hendry's Injection Therapy certification, combined with 25+ years of precision needle work across acupuncture, dry needling, and biopuncture, means his injection placement is anatomically exact — not approximate. Prolotherapy outcomes are highly technique-dependent: the therapeutic response happens at the ligament and tendon insertion points, not in the general vicinity. His hospital privileges at Prisma Health and five peer-reviewed publications on needle-based therapy reflect a clinical standard that most injection practitioners do not operate at. He also integrates prolotherapy with the broader functional medicine framework when indicated — addressing the nutritional and metabolic factors (vitamin C, collagen precursors, systemic inflammation) that determine how well connective tissue heals between sessions.