What Is Regenerative Injection Therapy? A Complete Guide to PRP, Prolotherapy, Perineural Injection

If you’ve been dealing with chronic pain, stubborn sports injuries, or joint problems that just won’t heal, you’ve probably heard the term regenerative injection therapy. But what does it actually mean — and which treatments fall under this category?

In this guide, we’ll break down four of the most effective regenerative injection options used in musculoskeletal medicine today:

· Platelet-Rich Plasma (PRP)

· Prolotherapy

· Perineural Injection Therapy (PIT)

· Micro-Fragmented Adipose Tissue (MFAT)

We’ll explain how each works, what conditions they help most, and what the latest research says — so you can make an informed decision about your care.

What Is Regenerative Injection Therapy?

Regenerative injection therapy (RIT) refers to a family of minimally invasive procedures that stimulate the body’s natural ability to repair and restore damaged tissues. Instead of simply masking pain, these treatments target the root cause by improving the health of ligaments, tendons, cartilage, or nerves.

The main goals of RIT are to:

· Reduce inflammation in the long term (not just temporarily)

· Encourage repair of soft tissues and joint structures

· Improve function and mobility

· Delay or prevent the need for surgery

While there are several techniques, all share the same principle: activate the body’s own healing mechanisms through targeted injections.

The Four Main Modalities

Platelet-Rich Plasma (PRP)

Main Ingredient: Concentrated platelets from your own blood

Primary Target: Tendons, ligaments, cartilage, muscle

Best For: Tendinopathies, early arthritis, sports injuries

Typical Healing Mechanism: Growth factors from platelets trigger tissue repair and reduce inflammation

Prolotherapy

Main Ingredient: Dextrose (sugar) solution

Primary Target: Ligaments, tendons, joint capsules

Best For: Chronic instability, lax ligaments, overuse injuries

Typical Healing Mechanism: Mild irritation stimulates local healing and strengthens connective tissue

Perineural Injection Therapy (PIT)

Main Ingredient: Low-concentration dextrose solution

Primary Target: Superficial nerves

Best For: Nerve pain, post-traumatic neuropathy, hypersensitivity

Typical Healing Mechanism: Calms irritated nerves, reduces neurogenic inflammation

Micro-Fragmented Adipose Tissue (MFAT)

Main Ingredient: Your own fat tissue, mechanically processed

Primary Target: Joints, cartilage, tendons

Best For: Advanced arthritis, cartilage loss, large-scale tissue degeneration

Typical Healing Mechanism: Adipose-derived cells support anti-inflammatory and reparative processes

1. Platelet-Rich Plasma (PRP)

PRP involves drawing a small amount of your blood, spinning it in a centrifuge to separate the platelets, and injecting the concentrated platelets directly into the injured area.

Platelets are rich in growth factors — natural signaling proteins that tell your body to send in repair cells and build new tissue.

Research highlights:

· PRP has shown promising results in knee osteoarthritis, with meta-analyses reporting improved pain and function compared to hyaluronic acid and placebo injections [1].

· In tendon injuries (e.g., tennis elbow, Achilles tendinopathy), PRP can accelerate healing and reduce recurrence rates [2].

2. Prolotherapy

Prolotherapy uses a hypertonic dextrose solution injected into ligaments, tendons, or joint capsules. The mild irritation from the solution activates a controlled inflammatory response, kick-starting the repair process.

It is especially effective for ligament laxity, which can lead to joint instability and chronic pain.

Research highlights:

· Systematic reviews suggest prolotherapy is effective for knee osteoarthritis and certain low back pain cases linked to ligament weakness [3].

· A 2019 trial found improved function and pain reduction in chronic tendinopathy patients after prolotherapy compared to exercise alone [4].

3. Perineural Injection Therapy (PIT)

PIT targets small sensory nerves located just under the skin that can become irritated after injury, surgery, or overuse. These irritated nerves can perpetuate pain and inflammation even after the tissue has healed.

A low-concentration dextrose solution is injected along the course of these nerves, calming them down and reducing “neurogenic inflammation.”

Research highlights:

· Clinical studies have reported significant pain reduction and improved mobility in patients with nerve-related pain syndromes following PIT [5].

· Particularly effective for post-traumatic neuropathy, chronic regional pain, and hypersensitivity.

4. Micro-Fragmented Adipose Tissue (MFAT)

MFAT therapy involves harvesting a small amount of your own fat tissue (usually from the abdomen or thigh), processing it mechanically to “micro-fragment” it, and injecting it into the damaged area.

Adipose tissue contains mesenchymal stromal cells, which have anti-inflammatory and reparative properties. The micro-fragmented process preserves the tissue’s structural components and cellular health without enzymes.

Research highlights:

· MFAT has shown promise in reducing pain and improving function in patients with knee osteoarthritis, even in moderate-to-severe cases [6].

· Studies indicate long-lasting benefits up to 2–3 years for some patients.

Ultrasound Guidance: Precision Matters

For all these treatments, ultrasound guidance is key to ensuring accuracy. It allows your clinician to visualize the needle in real-time, confirm placement in the target tissue, and avoid nearby nerves or blood vessels.

Why it matters for outcomes:

· Higher accuracy = more effective results

· Reduced risk of injection-related complications

· Essential for treating small or deep structures (e.g., hip tendons, joint recesses)

Who Can Benefit from Regenerative Injection Therapy?

These treatments are especially suited for:

· Athletes with sports injuries that aren’t healing with rest and rehab

· People with chronic tendon or ligament pain

· Patients with early to moderate arthritis looking to delay surgery

· Those with nerve-related pain from injury or overuse

The Bottom Line

Regenerative injection therapy isn’t a one-size-fits-all approach. Each technique — PRP, prolotherapy, perineural injection therapy, and MFAT — works differently and is best suited to certain conditions.

Working with a provider trained in diagnostic musculoskeletal ultrasound and experienced in multiple regenerative techniques gives you the best chance of getting a treatment plan tailored to your needs.

If you’re struggling with pain or injury and looking for non-surgical, research-supported solutions, regenerative injection therapy could be the right next step.