There are a number of different types of injections which have proven to be successful in Prolotherapy. Although they work in different ways, motivating the body to heal itself through a variety of natural responses, the end result is the same: to cure pain by building new tissue and stabilizing the joints.
 

All of the solutions used in Prolotherapy are designed to have a double-edged" effect: a combination of anesthetic and proliferant qualities.
 

The anesthetic agent alleviates the "pain trigger" while at the same time the proliferant agent begins to strengthen the ligament and tendons at the trigger or tender point.

Some Prolotherapy doctors use mild chemical irritants, such as phenol, guaiacol or tannic acid, to trigger the healing process. These substances attach themselves to the walls of the cells wherever they are injected, causing irritation that stimulates the body’s reactive healing process. Others prefer to use chemotactic agents, primarily morrhuate sodium, a fatty acid derived from cod liver oil. Most closely aligned to the compound Sylnasol used by Dr. Hackett in his pioneering efforts, these proliferants attract immune cells directly to the injected area.
 

The dramatic sounding "osmotic shock agents" are actually simple compounds like dextrose and glycerine. These are the most commonly used ingredients in the arsenal of Prolotherapy. Extremely safe and water-soluble, they are easily excreted from the body after having their initial desired effect. They work by causing cells to lose water, which leads to Inflammation and the subsequent stimulation of the healing response.
 

Particulates such as pumice flour are microscopic particles that attract macrophages, tiny organisms which gobble them up, in turn secreting polypetide growth factors that result in collagen production.
 

Besides these general differences, the specific combinations of chemicals and substances used are as varied as the schools" of Prolotherapy using them.
 

Some practitioners add co-factors, such as the anti-oxidant mineral manganese, or a combination of glucosamine sulfate and condroitin sulfate which is believed to aid in the repair of arthritic joints, or other co-factors believed to increase the efficacy of the compounds they are used with.
 

The most important variable of all, however, as in all medical practices, is the ability and experience of the therapist one chooses. Besides being a licensed medical doctor, it is important that the Prolotherapy doctor also be in tune with the underlying premise of homeopathy. It is not our duty to cure, but rather to entice the body into curing itself.