Prolotherapy for Foot & Toe Pain

Foot and toe pain can range from slightly annoying to completely disabling. Whether the pain is aggravated by sports, working on your feet, or just standing while you cook dinner, Prolotherapy is an excellent non-surgical option for progressive and chronic foot and toe pain. Our team has treated and published the most patient success cases using Prolotherapy for a variety of foot pain including bunions, Morton’s neuroma, plantar fasciitis, osteoarthritis, turf toe, and more. What these conditions all have in common is that they are most often the result of ligament laxity and joint instability. Prolotherapy is the regenerative injection treatment that specifically targets weakened ligaments in the foot. When the ligaments are strengthened, the joints become stabilized, and the symptoms are alleviated. Since 1993, our team has helped patients avoid foot surgery and treat post-surgical pain with Prolotherapy, Platelet Rich Plasma, and Stem Cell therapy. Navigate through the sections below for lots of foot pain information or get help from our medical staff now.

Symptoms caused by Foot Instability

  • Arch cramping
  • Burning sensation
  • Feels like stepping on a pebble
  • Gait abnormality
  • Loss of motion
  • Mild aching to sharp pain
  • Numbness and tingling sensations
  • Popping

These symptoms can be signs of the following foot pain conditions caused by foot and toe instability that we commonly treat with Prolotherapy.

Chronic Conditions caused by Foot & Toe Instability

Foot & Toe
Flat feet
Subtalar joint
Turf toe

Prolotherapy Treatment for Foot Pain

Chronic foot pain is relatively common and almost expected, as the feet bear tons of force every day just from the process of walking. Often, chronic foot pain begins from a collapse of the medial arch. This occurs because the spring ligaments and plantar fascia can no longer support the arch. Treatments, such as arch supports, may provide temporary benefit but unless the ligament strength is restored, most patients find that they circle through various orthotics, cortisone injections, pain pills and dozens of new shoes trying to cushion the foot. However, Prolotherapy injections to strengthen the arch can provide more permanent results. Another common long-term issue that arises from ligament laxity is heel spurs. Remember, bone spurs are the long-term reaction to joint instability. Heel spurs are due to the weakened ligamentous support of the plantar fascia. Prolotherapy injections, which may include cellular solutions such as Platelet Rich Plasma, to strengthen the plantar fascia will eliminate chronic heel pain. There is generally not a need for heel spurs to be surgically removed after the supportive ligaments and plantar fascia have been repaired.

Heel Spur Formation

Weakness in the plantar fascia (called plantar fasciitis) causes inflammation to occur at the calcaneal attachment, cuasing a heel spur.

heel spur formation

Big toe pain, including bunion pain, is due to weakness of the metatarsal ligaments. Prolotherapy is superior at eliminating the pain of bunions, but does not correct the deformity. Whether looking for an alternative to bunion surgery or patients experience chronic pain after bunion surgery, Prolotherapy is an excellent option to consider.

Big Toe Pain Levels Before & After Prolotherapy

Survey responses before and after Prolotherapy on levels of big toe pain with various activities.

big toe pain chart

In our clinic, we often utilize Nerve Release and Regeration Injection Therapy to provide instant relief for entrapped nerves, in addition to Prolotherapy to repair the underlying joint instability to restore joint stability and prevent recurrences of nerve entrapment. This is especially helpful for nerve pain from conditions like Morton’s neuroma. However, even without NRRIT, Prolotherapy results are fantastic.

Morton’s Neuroma Pain Levels Before & After Prolotherapy

Survey responses before and after Prolotherapy on levels of pain from Morton’s Neuroma with various activities.

mortons neuroma pain chart

Cortisone injections, NSAIDs, and surgery work against a patient’s best long-term interest because they are degenerative by nature. Patients with chronic foot pain need regenerative options to stop the degenerative process. This is also true for athletes with acute foot problems, as well as anyone who wishes to stay active without taking extended time off for surgical recovery. Most patients need approximately 3-6 total Prolotherapy treatments for the desired long-lasting effects, as the treatments build upon each other to restore the stability of the foot and toe joints.

Cortisone Versus Prolotherapy

There really is no comparison.

Prolotherapy Cortisone
Capillary dilation Increased Decreased
Blood flow Increased Decreased
Migration of immune cells to area Increased Decreased
Phagocytic activity (clean up) Increased Decreased
Leukocyte numbers in area Increased Decreased
Capillary proliferation (new blodd vessels) Increased Decreased
Fibroblast proliferation Increased Decreased
Deposition of collagen Increased Decreased
Collagen strength Increased Decreased
Protein synthesis Increased Decreased
Tissue strength Increased Decreased

Our Research on the use of Prolotherapy for Foot Pain

In our retrospective observational study, Hackett-Hemwall dextrose Prolotherapy helped cause large decreases in pain and stiffness and improved clinically relevant quality of life parameters in people with unresolved foot and toe pain. The complete study and results can be read here: Hauser R, et al. A Retrospective Observational Study on Hackett-Hemwall Dextrose Prolotherapy for Unresolved Foot and Toe Pain at an Outpatient Charity Clinic in Rural Illinois. Journal of Prolotherapy. 2011;3(1):543-551.

Average pain level BEFORE Prolotherapy
Average pain level AFTER Prolotherapy

Pain scale is 1-10 where 1 = no pain & 10 = unrelenting pain.

We get patient satisfaction results. 100% of patients in this study felt that Prolotherapy changed their life for the better and 100% have since recommended Prolotherapy to someone else.

Our Research on the use of Prolotherapy for Morton’s Neuroma

Hackett-Hemwall dextrose Prolotherapy was extremely effective at long-term quality of life and pain level improvement in our study on patients diagnosed with Morton’s Neuroma. The complete study and results can be read here: Hauser R, et al. Dextrose Prolotherapy Treatment for Unresolved “Morton’s Neuroma” Pain. The Foot and Ankle Online Journal. 2012;5(6):1.

Average pain level BEFORE Prolotherapy
Average pain level AFTER Prolotherapy

Pain scale is 0-10 where 0 = no pain & 10 = unrelenting pain.

Our Research on the use of Prolotherapy for Big Toe and Bunion Pain

Patients suffering from big toe and bunion pain showed excellent improvement after Prolotherapy. The complete study and results can be read here: Hauser R, et al. Dextrose Prolotherapy Treatment for Unresolved “Morton’s Neuroma” Pain. The Foot and Ankle Online Journal. 2012;5(9):1.

Average pain level BEFORE Prolotherapy
Average pain level AFTER Prolotherapy

Pain scale is 0-10 where 0 = no pain & 10 = unrelenting pain.

Our other studies on regenerative treatment outcomes for foot pain

Patient Success Stories using Prolotherapy for Foot Pain

Toe Pain After Bunionectomy

Nicole was a 21 year old with chronic big toe pain after a bunionectomy she had at the age of 13. The surgery left her with pain and sensitivity along the scar as well which made almost all footwear uncomfortable. Being on her feet for longer than an hour or walking more than a mile became increasingly painful and discouraging. She was treated twice with traditional dextrose Prolotherapy into and around the metatarsophalangeal joint along with Neural therapy to the surgical scar which helps to stop the pain and tingling from sensitive scars. After treatment, she was able to wear whatever shoes she wanted and being on her feet for hours was no longer an agonizing ordeal. Eventually, Nicole ended up back in our office for Prolotherapy to a knee injury she incurred years later while training for a triathlon. She said the bunion pain was such a distant memory that she often forgets she ever had any problem. The surgical scar is the only reminder.


When pain is addressed with Prolotherapy earlier in younger people, usually only a couple treatments are needed to change the course of their lives for the better. Patients are able to participate in athletics and obtain a higher level of overall health and fitness without being hindered by pain, being prescribed pain pills, or undergoing additional surgeries.

Marathon Foot Pain Resolved

AS was a 58-year-old athlete who developed pain, numbness, and swelling in her feet. She would experience sharp pain while running which greatly affected her ability to train for marathons. Before coming to Caring Medical, she received cortisone injections and laser therapy to her feet prior to each race which only offered temporary relief. She tried Prolotherapy, but was inconsistent with the recommended treatment course. Upon her decision to complete the recommended treatment, we performed 3 rounds of comprehensive Prolotherapy with Platelet Rich Plasma to both feet. After her last Prolotherapy session, AS reported she was able to run an entire half marathon without foot pain and her constant numbness had resolved!


Many athletes are looking for the quick fix to get them through an event. While Prolotherapy can be done while the athlete continues to train, it is not often that only 1 treatment can stimulate enough repair of tissue that has been damaged by corticosteroids and continuous marathon training. It is ideal to complete the recommended treatment series because the treatments build upon each other. Most patients only need between 3-6 treatments for a complete series, and feel it was “worth it” in the end to get the improved long-term results.

Big Toe Pain Resolved without Surgery

Virginia was 65 years old and had already dealt with big toe pain for a year before reaching out to Caring Medical. She had been diagnosed with osteoarthritis and told there “was not much that could be done” by a local orthopedic surgeon. She experienced sharp pains in her toe which became severe when she walked. As someone who spent all day on her feet for work, she needed a second opinion. She was seen at Caring Medical for a dextrose Prolotherapy series consisting of 4 treatments. Afterward, she reported 100% pain relief!


Many people believe that any pain complaint warrants a visit to an orthopedic surgeon. However, there are many other options before consulting with a surgeon. A referral to a surgeon can always be made in appropriate cases. But generally surgeons are going to conduct a surgical candidate evaluation. If you do not want surgery, exploring other options earlier, especially regenerative options, is a good idea.

Abnormal Gait Kinetic Chain

Brett came to Caring Medical at age 41 after dealing with constant foot pain for many years. He had been diagnosed with plantar fasciitis and tarsal tunnel syndrome. Brett attended 30 sessions of physical therapy with no improvement. The pain worsened to the point of causing him to limp. This abnormal gait began to affect other joints as well. He felt the pain was greatly affecting his daily life. After 4 rounds of Comprehensive Prolotherapy, Brett was able to regain quality of life and return to exercise pain-free!


Understanding the kinetic chain-joint instability is important in cases where people notice that once pain started in one area that their gait changed and a new pain started elsewhere.

Basketball Plantar Fasciitis

JK was an athletic 32 year-old who developed heel pain after playing basketball. After being diagnosed with plantar fasciitis, he tried many therapies, including rest, NSAIDs, oral steroids, physical therapy, active release therapy, cortisone injection, and orthotics. Despite his efforts, he experienced constant pain for 8 months before consulting with Caring Medical. JK received 4 treatments of comprehensive Prolotherapy which alleviated his pain and allowed him to return to full activity!


Plantar fasciitis is a misnomer (not typically a tissue inflammation, rather a mechanical heel problem). Until regenerative treatments are utilized along the heel, the soft tissue is continuing to degenerate and cause continued pain, even to the point of the fascia tearing. While most athletes do not learn about it until after trying more old-fashioned methods, Prolotherapy makes an ideal first-line therapy for plantar fasciitis and heel pain.

Plantar Fasciitis Misdiagnosis

PF began experiencing foot pain in her late 60’s. By the time she came to Caring Medical she had been dealing with what was diagnosed as plantar fasciitis for more than 5 years. She tried many conservative treatments to stop the pain from preventing her from having an active lifestyle, including physical therapy, orthotics, icing, stretching, and NSAIDs, which could only offer temporary relief, and did not resolve the pain. Unfortunately, PF had to stop playing pickle ball due to foot pain. When we saw PF, physical examination clearly showed ankle instability that was never addressed. PF received a total of four dextrose prolotherapy treatments to comprehensively treat both the medial and lateral ankle. We were thrilled to learn upon follow-up that PF had been able to walk all around while vacationing overseas as well as return to pain-free pickle ball! It is awesome to see how Prolotherapy can help people achieve functional goals that greatly improve their quality of life and ability to exercise!


Plantar fasciitis is a common misdiagnosis. The “itis” indicates an inflammatory condition but chronic pain is degenerative in nature. It means that plantar fasciosis is a more appropriate term. But upon physical exam, there can be more. The pain can be coming from structures further up the ankle or leg and referring pain into the foot. Finding the underlying joint instability will lead to resolution of symptoms and pain. As the tissue continues to repair even weeks after the last treatment, the patient should notice increased strength and endurance of the joint again, eventually returning to full physical activity.

Return to Running and CrossFit

KD, an active 54-year-old, had lived with foot pain due to neuroma for over a decade, until it was no longer tolerable. She would experience intense pain in her toes when walking without shoes. After consulting with one of our Prolotherapists, KD was advised to limit running and jumping for a few weeks and that a few Prolotherapy treatments should resolve the issue that had caused more than a decade of pain. As she improved more after each treatment, she was cleared to slowly return to full activity with the condition that she tape her toes while getting back to running. After her third treatment of Prolotherapy, she had returned to running and CrossFit with minimal pain. A fourth and final treatment was performed which led to KD graduating from her Prolotherapy series!


People often live with pain for years, yet do not always appreciate the rebuilding process for tissue that has been continually overused and abused for years can also take some time. Just like healing a broken bone happens over weeks/months, same goes for ligament repair. Most patients begin to feel better after the first treatment, and incrementally after subsequent treatments. But returning to full athletic activity is safest once the new tissue has had some time to strengthen. Working with the natural timing of the body can have outstanding long-term rewards.

Ankle Instability Misdiagnosed as Plantar Fasciitis

After PH was diagnosed with plantar fasciitis, she followed the route of traditional medicine in hopes of a cure for about 6 years. She tried physical therapy, wearing a boot, stretching, ice, orthotics, and NSAIDs. Nothing provided complete relief and every podiatrist she consulted with had a different opinion. PH was in her early 70s and suffering from constant pain along the bottom of her foot when she came to Caring Medical. She was an avid golfer and loved playing pickleball, but had to stop both activities due to her foot pain. Upon physical exam, it was determined her foot pain was due to ankle instability. She received 4 rounds of comprehensive [H3] Prolotherapy to her ankle over a period of 5 months. Her immediate goal was to be able to enjoy an upcoming vacation which would require daily walking on varying terrain. After her 4th treatment, she spent 19 days traveling and walking Europe without foot pain! She also returned to playing golf and pickleball pain-free!


It is common for referral pain into the foot to be coming from further up the leg, including the ankle, knee, hip, or low back. Consulting specialists who only examine or order imaging for the foot may have limited success. In these cases, a more comprehensive approach is needed to assess for joint instability referral patterns. 

Bilateral Toe Pain, Different Response to Treatment 

JD suffered from chronic pain for many years in her big toes. For several years she repeated cortisone injections every 6 months and acupuncture every few weeks. By age 60, her big toes became “frozen” and quite painful whenever she would wear shoes. This was not ideal for someone who normally enjoyed running 4 days each week. Surgery was recommended for hallux rigidus. Knowing she was seeking a surgical alternative, one of her doctors recommended consulting with Caring Medical. After her first Prolotherapy treatment, JD reported 100% pain relief and improved range of motion in her left big toe. The right big toe still felt inflamed constantly and was not progressing as well after the first treatment. The decision was then made to try a more aggressive treatment for the right big toe using Platelet Rich Plasma Prolotherapy, which improved her pain significantly. In total, JD underwent a total of 4 treatments to her right toe which alleviated her pain 100%. When following-up 18 months later, she confirmed that she was able to avoid surgery for both toes and is now living a pain-free life! 


Even with bilateral pain, the response may not be uniform. Sometimes one side needs more treatments and/or a more aggressive solution. Seeing a Prolotherapist who understands this and can offer various proliferants, instead of only one-shot PRP or only dextrose Prolotherapy, etc, is important. 

Plantar Fasciitis

Rachel developed constant heel pain from plantar fasciitis at age 53. The burning and sharp pains were severe enough to cause her to limp and would wake her up at night. She had tried stretching and rolling it out, which did not resolve the pain. After 5 treatments of comprehensive Prolotherapy, her foot pain was 100% alleviated! She can now take long walks as often as she pleases.


Stretching is one of the most common recommendations people with plantar fasciitis try first. It can become an endless cycle of stretching, massage, rest, repeat. However, plantar fasciitis is more commonly a “fasciosis,” because there is no inflammation. It is actually a chronic, degenerative condition. Stretching does nothing to repair degenerated tissue. Instead, regenerative treatments are a more effective approach.

More Information about Prolotherapy for Foot Pain

How well do you understand the cause of your foot pain?

Take the Joint Instability Quiz! This quiz covers how musculoskeletal pain develops and which important diagnosis is often missing when people are suffering from chronic pain.

Articles about Prolotherapy for Foot Pain

Videos about Prolotherapy for Foot Pain

More Foot Prolotherapy Videos

Books about Prolotherapy for Foot Pain

Prolo Your Pain Away!Read about treating foot pain with Prolotherapy in our free E-book, Prolo Your Pain Away! Curing Chronic Pain with Prolotherapy, 4th Edition. This edition explains all about Prolotherapy and how it is used to permanently alleviate pain from arthritis, sports injuries, and all types of chronic pain conditions! Plus, it takes an expanded look at the medical literature and patient studies on Regenerative Medicine: Prolotherapy, Platelet Rich Plasma, Stem Cell Therapy, and more!

Caring Medical: Utilizing dynamic testing to properly diagnose and identify the structures causing symptoms and degenerative conditions, and treating with comprehensive regenerative injection therapy, H3 Prolotherapy, and individualized joint rehabilitation protocols

You deserve the best possible results from your foot & toe pain treatments. Let’s make this happen! Talk to our team about your case to find out if you are a good candidate.

For example, resume marathon training, return to college, walk my children to/from school, be able to perform my manual labor job full-time, etc… Functional goals would not be “to feel NORMAL” or “to feel BETTER” as these feelings differ greatly for each person who is suffering from a chronic condition. You could also list some objective ways by which you are measuring the success of the treatments you have already received or are looking to receive.

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