Dr. Attaman offers prolotherapy treatment at his Bellevue, WA office. Feel free to call our office at 425-247-3359 (Bellevue) or schedule an appointment online.


This non-surgical procedure relieves chronic pain with an injection that promotes the natural healing of injured tissues and joints. The limited blood supply and poor healing properties of ligaments, cartilage and tendons may make treatment necessary after injury. Prolotherapy is not a treatment for all issues; a careful pre operative consultation is required to determine if a patient will benefit from prolotherapy versus one of many dozens of other treatment options available from Dr. Attaman.

Beware of practitioners (many are not even physicians) who suggest you need 5-20 sessions of prolotherapy; these are universally people with no training in the usage of image guidance, and most have no other tools available to treat you. In general, prolotherapy properly performed under image guidance should require no more than 1-3 treatments.

Can It Help Me?

Conditions aided by prolotherapy include whiplash, chronic lower back pain, sacroiliac joint pain, joint problems such as chronic tendonitis and sprained ligaments and tendons.

Injecting the Solution

A mixture of concentrated dextrose, glycerin, and low concentration phenol (PDG solution) is injected into and around the injured tissues. PDG is the strongest of the prolotherapy injection solutions in common use. It creates a stronger and more efficacious inflammatory reaction than using dextrose alone. The injection tricks the body into responding as if a new injury has occurred.


This injection is performed by Dr. Attaman using image guidance such as ultrasound or X-ray. This enhances safety, accuracy, and efficacy many times over prolotherapy done without image guidance. It is particularly critical that x-ray image guidance be used for prolotherapy injections performed in the spine; a misplaced needle in the spine may result in nerve injury, paralysis, and even death. Dr. Attaman is one of the few board certified Interventional Pain Management physicians in the country who performs prolotherapy injections in the spine using fluoroscopic X-ray guidance.

Dr. Attaman received extensive training under the late renaissance man Dr. Thomas Dorman, a leader of the “West Coast” school of prolotherapy. This school of prolotherapy was developed by Dr. Milne Ongley after completing his training with the late James Cyriax. This is considered the most advanced and efficacious school of prolotherapy, in which a very detailed biomechanical evaluation is carried out prior to prolotherapy; it is not enough to identify the damaged tissue, rather the entire “kinetic chain” of the patient must be evaluated prior to identifying which structures need to be treated to optimize function. One may think of this as an engineer evaluating problems with a suspension bridge; while only a few cables may be damaged, those few cables can propagate fault along the entire structure. This was labeled as “tensegrity” by architect Buckminster Fuller.

The second vital component to the “West Coast” school of prolotherapy is the integration of manual therapy into the Prolotherapy session prior to injection. As a board certified Osteopathic Physician, Dr. Attaman applies hands on Osteopathic Manipulative Medicine of the structures in poor alignment immediately prior to Prolotherapy. This is particularly important when performing Prolotherapy in the spine to ensure normal “alignment” prior to injection.

This detailed pre-operative biomechanical assessment of the patient’s kinetic chain and pre-operative manipulative medicine is unique to the “West Coast” school of Prolotherapy and not an integral part of the form of Prolotherapy taught by Drs. Hemwall and Hackett. It is Dr. Attaman’s experience that the “West Coast” school of prolotherapy is much more efficacious.

How It Works


This attracts cells that specialize in repairing damaged tissue. These cells include fibroblasts, which create the collagen used to strengthen and rebuild any damaged tissue.

Long-term Outcome


Prolotherapy patients are able to go home the same day, and should avoid taking any anti-inflammatory pain medications (aspirin, ibuprofen and naproxen). Full recovery from inflammation usually occurs within one week of the procedure. Additional treatments may be required to ensure complete healing of the injured tissues.

Dr. Attaman is board certified and Anesthesiology-fellowship trained in the medical subspecialty of Pain Medicine and Interventional Pain Management. He is also residency trained and board certified in the specialty of Physical Medicine and Rehabilitation. He is one of only a few with such extensive qualifications in the state of Washington. Connect with Dr. Attaman on Google+ | LinkedIn | Facebook If you are in pain, call Dr. Attaman's Seattle office (206-395-4422) or Bellevue, WA (425-247-3359) office.


  1. Janine R 04/25/2017 at 5:55 AM - Reply

    My husband is a c8 quad he was injured in 1983 for the last 5 years or more he has had terrible low back pain radiating into his hips he has had several injections and they do help but not complete pain relief and only for a short time He also has hip arthiritis on both sides but pain only on left side and more on the lower left side of back Do you think there is anything that will help his pain Thank you Janine Roberts

    • Jason G. Attaman, DO, FAAPMR 06/08/2017 at 7:16 PM - Reply

      Dear Janine,

      This is too complex to answer over the internet. I’d suggest scheduling a consultation. Best of luck, Dr. Attaman

  2. Lynn K 05/25/2017 at 1:02 PM - Reply

    I’m wondering if your practice is strictly for treating an already diagnosed injury, or do you assist in diagnosis? Based on what Dr. Google has told me :) I believe I have ischial bursitis, or possibly some other injury to the ischial tuberosity. I’m seeing my PCP in a few weeks but thinking they are not experts in this and will probably either send me right for physical therapy or to someone else for diagnosis of exactly why I have a lot of pain in my sitz bone (both sides, but worse in one) when sitting for any length of time. So basically I’m just trying to set myself up for the next step. Thank you.

  3. Jason G. Attaman, DO, FAAPMR 06/08/2017 at 7:22 PM - Reply

    I cannot answer this unless I evaluate you in clinic or review your records. I’d be happy to see you in my clinic and review your MRIs and perform a physical exam. I can also evaluate you via a video conference here:


    Kind Regards, Dr. Attaman

  4. Sharon Graham 01/07/2019 at 11:37 AM - Reply

    I have just been diagnosed with CPPD (chondrocalcinosis) in my right knee. There is a possibility that the same condition may be affecting the joints in my feet.
    Does prolotherapy help with this condition?

    My doctor is suggesting I do cortisol injections to relieve the pain and stiffness, and I am leary of cortisol.

  5. Michele A Rabey 03/05/2020 at 7:14 AM - Reply

    I’m wondering if you also utilize autologous PRP in place of the traditional prolotherapy mixture. If not, will you offer your thoughts regarding why? Thanks,

  6. Jeremias R. Duarte, D.O. 03/11/2023 at 10:56 AM - Reply

    Thank you for sharing this informative article on prolotherapy treatment. It’s great to know that there are non-surgical options available to relieve chronic pain and promote natural healing of injured tissues and joints. It’s also reassuring to hear about the careful pre-operative consultation required to determine if a patient will benefit from prolotherapy, and to beware of practitioners who suggest unnecessary sessions. Dr. Attaman’s use of image guidance for prolotherapy injections is impressive and highlights the importance of safety and accuracy in the procedure. The integration of manual therapy prior to injection as part of the “West Coast” school of prolotherapy is also intriguing and shows a dedication to optimizing function and overall biomechanical assessment. Overall, this article is a great resource for anyone considering prolotherapy treatment and seeking a qualified practitioner like Dr. Attaman.

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