Regenerative Injection Therapy · New Orleans
Prolotherapy & Fascial Prolotherapy — rebuilding the tissue, not masking the pain
We use ultrasound-guided prolotherapy to treat instability, ligaments, tendons, and muscle — and we are one of the few clinics in the country, and one of the original, to perform fascial prolotherapy and Hydrofascia Release™. Our focus is deeper than a single joint: we work to restore healthy fascial flow throughout the body.
Jacques Courseault, MD, CAQSM, FAAPMR · The Fascia Institute and Treatment Center®
· Instability · Ligaments · Tendons · Muscle · Fascia
01 · What Prolotherapy Treats
From instability to stubborn muscle pain — the tissue that holds you together
Prolotherapy is a regenerative injection that prompts your body to repair the connective tissue that has been quietly failing. We use it to treat joint instability, injured ligaments and tendons, and muscle strains that never fully heal — the structures that keep you stable and let you move without pain.
Clinically, that covers a wide map of the body. We commonly treat headaches and neck pain, shoulder pain, back and abdominal-wall pain, hip and knee pain, and ankle and foot pain — along with hamstring and other muscle injuries that simply won’t resolve on their own. If a pain has outlasted rest, therapy, and time, it is often a connective-tissue problem that prolotherapy is built to address.
Stability
Joint Instability
Lax or over-stretched ligaments that let a joint shift, catch, or give way — common in hypermobility and after injury.
Structure
Ligaments & Tendons
Sprains, chronic tendinopathy, and partial tears that keep flaring because the tissue never fully knit back together.
Movement
Muscle & Fascia
Recurring strains, adhesions, and fascial restrictions — including hamstring injuries that resist standard care.
02 · How It Works
Dextrose is the “weed & feed” of the fascial system
The proliferant we use most is dextrose — simple sugar, the same glucose your cells run on. When a concentrated dextrose solution is placed precisely into damaged tissue, two things happen at once.
The weed. Briefly, the tissue sits in a high-concentration, hyperosmolar environment. The weakest, unhealthy cells — the ones already failing and driving your pain — can’t tolerate it and are cleared out through a natural, controlled process of programmed cell death. Published mechanism reviews describe exactly this: hypertonic dextrose can trigger apoptosis in stressed local cells and quiet inflammatory signaling around them.
The feed. The healthy cells that remain experience the same dextrose very differently — as fuel and fertilizer. Glucose is the body’s most basic cellular nourishment, and the mild, controlled healing response prolotherapy creates recruits the growth factors (PDGF, TGF-β, IGF) that tell fibroblasts to divide, lay down fresh collagen, and rebuild strong connective tissue.
In plain terms
Think of a lawn treatment. The same application that clears the weeds also feeds the grass — so what grows back is healthier and denser than what was there before. Dextrose prolotherapy works on tissue the same way: it clears out what’s failing and nourishes what’s healthy, so your body rebuilds itself instead of simply numbing the signal.
The precise mechanism is still being studied, and no single model captures all of it — but both the “weed” (osmotic, apoptotic clearing) and the “feed” (glucose as fuel plus growth-factor–driven repair) are described in the peer-reviewed literature cited below.
03 · What Makes Us Different
Among the first — and few — to treat the fascia itself
Most clinics that offer prolotherapy inject a joint or a single tendon. We go further. The Fascia Institute is one of the few centers in the country, and one of the original, to perform fascial prolotherapy — treating the connective-tissue web that links muscles, nerves, and joints into one continuous system. When that web becomes stiff, adhered, or restricted, pain and dysfunction travel along it. Our goal is to restore healthy fascial flow so the whole system moves freely again.
The technique at the center of this work is Hydrofascia Release™ — Dr. Courseault’s ultrasound-guided fascial hydrodissection. Using a dextrose or fluid solution, we gently separate fascial layers that have bound together and free the planes where nerves and muscles glide. It reaches deep fascial restrictions that hands-on therapy and standard injections can’t, and it’s the procedure Dr. Courseault first published on in Current Sports Medicine Reports in 2019.
Why it matters
Numb a joint and the joint feels better for a while. Restore fascial flow and the source of the strain changes — which is why fascial prolotherapy and Hydrofascia Release™ so often help people who have already “tried everything.” Learn more about Hydrofascia Release™ →
04 · Precision
We treat what we can see — every injection is ultrasound-guided
Every prolotherapy and Hydrofascia Release™ treatment in our clinic is performed under live ultrasound. We use imaging first to find the exact ligaments, tendons, muscles, joints, and fascial planes generating your pain — then to guide the needle precisely into them.
This is a real clinical advantage. Much of the older prolotherapy research was done with landmark-based (blind) injections, which may explain weaker results in some studies. Seeing the target as we treat it makes the treatment more accurate and safer — and it lets us confirm, in real time, that we’ve reached the tissue that’s actually the problem.
05 · The Evidence
Backed by our own published work — and a growing body of research
Dextrose prolotherapy has been used for over 90 years, and the modern, ultrasound-guided evidence base keeps strengthening. Here is a curated starting point — our work and others’.
Our Published Work
Fascial hydrodissection, first described here
Dr. Courseault’s 2019 paper in Current Sports Medicine Reports was the first published description of ultrasound-guided fascial hydrodissection for chronic hamstring injury — the foundation of Hydrofascia Release™.
Courseault J, et al. Curr Sports Med Rep, 2019 →
Our review: upper-extremity injuries →
Our review: lower-extremity injuries →
The Broader Evidence
Independent research points the same way
A 2025 international group — including renowned fascia scientist Carla Stecco — reported fascial hydrorelease dropping post-hamstring pain from 10 to under 1, independently echoing the technique we pioneered.
Shiwaku K, et al. J Funct Morphol Kinesiol, 2025 →
Hauser RA, et al. Systematic review, 2016 →
Rabago D, et al. RCT, knee OA, 2013 →
What the numbers show
In Hauser and colleagues’ systematic review, roughly 85–90% of patients treated with dextrose prolotherapy reported at least a 50% improvement when treated across a typical course, with no evidence of a condition becoming permanently worse. See the review →
06 · What To Expect
Straightforward visits, then your body does the healing
Your first visit runs a bit longer — often an hour or more — so we can review your history, images, and labs, examine you, and confirm that prolotherapy is the right option. Follow-up treatments are quick: the injection itself usually takes less than 10–15 minutes, and there’s no recovery period, so you can leave right after. Eat a light meal and hydrate beforehand to avoid lightheadedness.
During the treatment
We use the smallest needle possible and mix lidocaine with the dextrose, so most people find it uncomfortable rather than painful. The numbing lasts 3–4 hours and also helps confirm we reached the right spot. If we’re also performing a Hydrofascia Release™ to break up adhesions, expect a little more soreness afterward.
The days after
Mild to moderate soreness for a few days — occasionally longer — is normal and expected. A brief flare of inflammation is actually a good sign: it means the healing cascade has started. Take it easy for two days, then ease back into light activity. If something hurts during an activity, back off it.
How healing unfolds
Unlike a steroid shot that offers quick, temporary relief, prolotherapy relies on your body rebuilding tissue — so it takes time. Many people notice change after the first or second treatment, though improvement more often shows by the third or fourth. Because real tissue repair is occurring, relief can be long-lasting or even permanent.
Just treated? Here are your post-prolotherapy injection instructions.
07 · Safety
A 90-year track record — proven, not experimental
Dextrose prolotherapy has been performed for over 90 years. Dextrose is FDA-approved to be injected into the bloodstream in far larger volumes than we ever use; we inject much smaller amounts into tissue — never into vessels — so there is no systemic side effect from the dextrose itself. Other than expected soreness, serious complications are extremely rare, and ultrasound guidance further protects against them by keeping every needle precisely placed.
As with any injection through the skin, small risks like bruising, bleeding, or infection exist, and we’ll review anything specific to your case at your visit. Insurers still label prolotherapy “experimental,” but that reflects funding and research economics — not the decades of safe, beneficial use behind it. This is not the same as a cortisone shot: cortisone calms inflammation but can work against long-term tissue healing, so we use it sparingly, if at all, and often before starting a prolotherapy course.
08 · Sessions, Cost & Coverage
Clear pricing, and ways to make it work
Most patients need 4–6 sessions, though some conditions require more. Each session at The Fascia Institute is $500, and that covers the entire visit — exam, ultrasound evaluation, ultrasound-guided injection, and any additional assessment or treatment needed that day. Elsewhere, prolotherapy typically runs $400–$1,000 per treatment.
Most insurers don’t yet cover prolotherapy, but you can submit your receipt for possible reimbursement or toward your deductible, and you can pay tax-free using an HSA or FSA. We’re also working to fund the research needed to change that coverage picture.
Make it more affordable
There are several smart ways to lower your out-of-pocket cost. Read our guide to paying for prolotherapy and saving money →
Your Path With Us
How a fascial prolotherapy plan comes together
Start Here · Diagnostic
Fascial Mapping
High-resolution ultrasound to pinpoint the exact planes, adhesions, and restrictions driving your pain — so treatment is aimed, not guessed.
Signature Procedure
Hydrofascia Release™
Ultrasound-guided fascial hydrodissection — the technique Dr. Courseault first published — to free restricted fascia and restore healthy flow at depth.
Regenerative
Prolotherapy & ProloBoost™
Dextrose prolotherapy to rebuild ligaments, tendons, and muscle — with the option to step up to concentrated PRP for tougher cases.
References & Further Reading
1. Courseault J, et al. Fascial Hydrodissection for Chronic Hamstring Injury. Curr Sports Med Rep. 2019;18(11):416–420. — PubMed
2. Shiwaku K, Otsubo H, … Stecco C, Teramoto A. Ultrasound-Guided Fascial Hydrorelease for Persistent Pain After Hamstring Injury. J Funct Morphol Kinesiol. 2025;10(3):318. — MDPI
3. 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. — PMC
4. Rabago D, et al. Dextrose Prolotherapy for Knee Osteoarthritis: A Randomized Controlled Trial. Ann Fam Med. 2013;11(3):229–237. — Annals of Family Medicine
5. Hypertonic Dextrose Prolotherapy in Osteoarthritis: Mechanisms, Efficacy, and Future Research Directions. Front Endocrinol. 2025. — Frontiers
6. The Fascia Institute — What is a Fascial Hydrodissection / Hydrorelease? · Research & publications
This page is for general education and is not medical advice, nor does it create a physician–patient relationship. Prolotherapy outcomes vary by individual, and no result is guaranteed. Talk with a qualified physician about your specific condition. The Fascia Institute and Treatment Center® · 2520 Harvard Ave, Ste 2B, Metairie, LA 70001 · (504) 704-1254.
