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Treatment Protocol Initial Evaluation Before beginning prolotherapy, a thorough evaluation is necessary to: Confirm the diagnosis of instability Identify affected structures Rule out complete tears requiring surgery Use imaging (ultrasound or MRI) as needed Injection Sessions Injections are administered every 3 to 4 weeks A typical course involves 3 to 6 treatments , depending on severity Each session may involve 4 to 8 injections around the shoulder Performed with local anesthetic