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local anesthetic applied Injection Points: Typically include the AC joint capsule and coracoclavicular ligament attachments Solution Used: 15-25% dextrose + 1% lidocaine or procaine Guidance: Can be done freehand or under ultrasound guidance for precision Post-Injection Care Mild soreness or swelling is expected for 13 days Avoid anti-inflammatory medications (they may blunt the desired response) Gentle range of motion exercises encouraged Physical therapy may be added at any time Treatment Frequency Prolotherapy is typically performed every 34 weeks 36 sessions are usually recommended depending on severity and how you are progressing Clinical Evidence Supporting Prolotherapy for AC Joint Injury While large randomized controlled trials are limited for AC separation specifically, prolotherapy has demonstrated efficacy in multiple musculoskeletal conditions involving ligament and joint instability: Rabago et al

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Moreover, the upregulation of cyclins (cyclin D1, cyclin-dependent kinase 2 (CDK2), and cyclin-dependent kinase 4 (CDK4)) and downregulation of P21 in WECP-treated cell assays have been evaluated

Emerging evidence further indicates that MTs particularly MT1 and MT2A constitute a critical cytoplasmic defense layer against cuproptosis by acting as effective copper sponges that sequester excess Cu + and restrict its aberrant interaction with mitochondrial targets 170,173,174