I had pain in my shoulder and the osteo Doctor that I went to wanted me to travel to his home office for prolotherapy treatment. I did not want to travel that far, as I was already driving an hour to the facility, he worked at one day a week. He had a student with him that day and he proceeded to explain to her that he was going to do a manual type of treatment that brings about the same results as prolotherapy. He then took his thumb and pushed it very hard into my shoulder and rotated it around the joint. It was really painful, and he told me not to hold my breath because tears were rolling out of my eyes. I had my shoulder pain for over 6 months and after he did this to my shoulder it improved quickly. Now when I have a joint pain, I go into the joint with a lot of pressure and irritate it and that works really well for me. I have done it to my elbows and knees and it helped. Not sure why irritating a joint works, but he did tell the student that the prolotherapy shot is just sugar and water to irritate the joint.