Pain that keeps coming back is a different problem than pain that's new.

Most foot and ankle pain resolves. You rest it, you change your shoes, maybe you get an injection or a pair of orthotics, and within a few weeks it's behind you.

Then there's the other kind. We all know it, the pain that's been with you for months. It quiets down when you're careful and comes right back when you're not. You've already tried the obvious things. You may have already been told there isn't much left to do short of surgery. That's the pain prolotherapy is for.

What prolotherapy is

Prolotherapy is a series of small injections placed directly into damaged ligament or tendon tissue. The solution is a  concentrated dextrose formulation — not a steroid, not a numbing agent, and not something that masks pain.

The purpose is different from a cortisone shot. Cortisone suppresses inflammation, which can feel excellent in the short term   but does nothing to change the underlying tissue — and repeated cortisone in a tendon can weaken it. Prolotherapy works the other direction: the injection is intended to provoke a controlled healing response in tissue that has stopped healing on its own.

That's why the timeline is different, too. Cortisone often feels better within days. Prolotherapy is a slower process, with change measured over weeks as the tissue responds.

Conditions we treat with prolotherapy

• Chronic plantar fasciitis that hasn't responded to orthotics, stretching, or injections
• Chronic Achilles tendinopathy
• Peroneal and posterior tibial tendon pain
• Chronic ankle instability from old, repeated sprains
• Ligament laxity following an injury that never fully recovered
• Persistent midfoot and arch pain with a clear tissue source

The common thread is a specific, identifiable structure that is damaged and hasn't healed. Not general soreness, and not pain without a findable source.

How we decide whether you're a candidate

This is the part that matters most, and it's the part most clinics skip.

We don't treat prolotherapy as a product you can order. Before any injection, we image the area with diagnostic ultrasound — in the office, at the visit, with you watching the screen. Ultrasound shows tendon and ligament tissue in real time in a way an X-ray simply cannot. You see the thickening, the disorganized fibers, the specific structure that's actually generating your pain.

 From there, you get the full picture, including the options that cost you nothing and the options your insurance already   covers. If bracing, physical therapy, or a change in your orthotic is the right first step, we'll tell you that. If your   ultrasound shows a problem prolotherapy doesn't address, we'll tell you that too.

 Then you get a clear recommendation and the reasoning behind it. Not a menu, a recommendation that is your   personalized prescription.

 If prolotherapy isn't the right fit, you've still gotten a real diagnosis out of the visit. That's not a wasted appointment.

 Prolotherapy, PRP, or shockwave — how they're different

 These three get grouped together as "regenerative" treatments, but they do different jobs, and the right one depends   on what your ultrasound shows.

Prolotherapy — $499 per treatment Best suited to neuromas, ligament laxity, chronic instability, and tissue that needs a stimulus to restart a stalled healing process. The most direct option when the problem is a loose or poorly healed ligament.

PRP (Platelet-Rich Plasma) — $1,195 Uses concentrated platelets drawn from your own blood, prepared in-office. Better suited to substantial tendon damage where there's a real structural defect to address. Higher cost reflects a considerably more involved preparation process. This isn't a premium version of the same treatment, it's a different treatment for a different finding.

Shockwave therapy (ESWT) — from $895 for a series Non-injection. Delivered as a series rather than a single session. Often the right choice for chronic tendon pain, and frequently the right companion to an injection rather than an alternative to one.

Shockwave + prolotherapy combined — $1,395-$1,595 For chronic cases where the tissue needs both a healing stimulus and sustained mechanical loading. We recommend this pairing when the ultrasound supports it.

Which of these you need is a clinical decision made from your imaging and assessment, not a budget decision made from a price list.

What the visit is like

The injection itself is performed under ultrasound guidance, so the solution goes exactly where the damaged tissue is rather than approximately near it. Local anesthetic is used first.

Expect the treated area to feel sore and stiff for a few days afterward. Most people state that it is gone after one day and its very tolerable. That soreness is an expected part of the process, not a complication. Most patients walk out and drive themselves home. We'll give you specific activity guidance before you leave.

Many patients need more than one treatment. We'll discuss the likely number for your case up front rather than after the first one.

Who prolotherapy isn't for

We'd rather say this plainly than have you find out after you've paid:

• Acute injuries, where the tissue is still in its normal healing window
• Pain with no identifiable structural source on examination and imaging
• Advanced arthritis, where the problem is joint surface rather than soft tissue
• Structural deformity that needs to be corrected mechanically or surgically
• Active infection or open wounds at the injection site

If you're in one of these categories, prolotherapy is unlikely to help you, and we'll say so.

About the evidence

We think you should have an accurate picture. Prolotherapy has a substantial body of research behind it, with the strongest support in chronic tendon and ligament conditions. That said, the studies do vary in quality, and it is not as thoroughly established as something like a cortisone injection. Insurance carriers generally consider it investigational, which is why it's a self-pay service.

We won't quote you a success rate. What we will do is confirm the tissue problem on ultrasound before recommending treatment, tell you honestly what we expect in your specific case, and lay out what your alternatives are — including doing nothing.

Pricing

Prolotherapy — $499 per treatment Shockwave + prolotherapy — $1,595

Prices are transparent and posted. See our full self-pay price list for all services.

IF ACCEPTED IN 14 DAYS OF INITIAL VISIT: Your self-pay evaluation fee is credited toward your treatment.

Start with a diagnostic evaluation

The evaluation comes first, and it stands on its own — a real examination, diagnostic ultrasound, and a clear answer about what's actually wrong. Whether or not prolotherapy turns out to be the answer, you'll leave knowing what you're dealing with.

Schedule your evaluation — Bayshore Podiatry Center, South Tampa: 813-877-6636 or Book Online Here

FAQ 

Does prolotherapy hurt? We use local anesthetic before the injection. Expect soreness and stiffness in the treated area for a few days afterward — that's an expected part of how the treatment works, not a sign something went wrong.

How many treatments will I need? It depends on the tissue and how long the problem has been there. Many patients need more than one. We'll give you an expected number for your specific case before you start, not after.

Is prolotherapy covered by insurance? Generally no. Most carriers classify it as investigational, so it's offered as a self-pay service at a posted price of $499 per treatment.

How is this different from a cortisone shot? Cortisone suppresses inflammation and can provide fast relief, but it doesn't change the underlying tissue, and repeated cortisone can weaken a tendon. Prolotherapy is intended to stimulate a healing response in the tissue itself. Different mechanism, different timeline.

How soon will I feel better? Slower than cortisone. Changes are typically measured over weeks rather than days as the tissue responds.

Do I need a referral? No. You can schedule directly.

Can I go back to work or exercise afterward? Most patients drive themselves home and return to work the same or next day. Exercise and activity guidance is specific to what we treated — we'll give you clear instructions before you leave.