What Is Prolotherapy?
Invented in the 1950s by George Hackett, prolotherapy is based on the theory that chronic pain is often caused by laxness of the ligaments that are responsible for keeping a joint stable. When ligaments and associated tendons are loose, the body is said to compensate by using muscles to stabilize the joint. The net result, according to prolotherapy theory, is muscle spasms and pain.
Prolotherapy treatment involves injections of chemical irritant solutions into the area around such ligaments. These solutions are believed to cause tissue to proliferate (grow), increasing the strength and thickness of ligaments. In turn, this presumably serves to tighten up the joint and relieve the burden on associated muscles, stopping muscle spasms. In the case of arthritic joints, increased ligament strength would allow the joint to function more efficiently, thus reducing pain.
Prolotherapy has not been widely accepted in conventional medicine. The technique is used by prolotherapy practitioners to treat many conditions, including back pain
How Is Prolotherapy Performed?
Prolotherapy is generally administered at intervals of 4 to 6 weeks, although studies have used a more frequent schedule. The treatment involves injection of a mixture containing an irritant and a local anesthetic. A total of 4 to 6 treatments is typical.
When treating back pain, prolotherapy practitioners frequently use a form of manipulation somewhat similar to chiropractic
There are several irritant solutions used in prolotherapy. Concentrated dextrose or glucose has become increasingly popular because it is completely non-toxic. Phenol (a potentially toxic substance) and glycerin are also sometimes used. Other non-irritant substances may be added to the solution, such as vitamin B 12 , corn extracts, cod liver oil extracts, zinc, and manganese; however, there is no evidence that these substances add any benefit.
What Is the Scientific Evidence for Prolotherapy?
Some animal and human studies have found that prolotherapy injections increase strength and thickness of ligaments. 1-4
In a review of five studies, three found prolotherapy to be no more effective than control treatments for
What can one make of this contradictory evidence? When used alone prolotherapy is probably no more effective than a placebo injection for the treatment of low back pain. However, there is some evidence that the technique may be beneficial when combined with other therapies.
A double-blind, placebo-controlled study evaluated the effects of 3 prolotherapy injections (using a 10% dextrose solution) at 2-month intervals in 68 people with
The same research group performed a similar double-blind trial of 27 people with osteoarthritis in the hands.
In studies, prolotherapy has not caused any serious, irreversible injury. There is usually discomfort after each injection that lasts for a few minutes to several days, but this discomfort is seldom severe. 9
Finding a Qualified Prolotherapy Practitioner
Prolotherapy is practiced by a medical doctor (MD) or doctor of osteopathy (DO). Generally, physicians specializing in orthopedics or physical medicine and rehabilitation are most likely to practice prolotherapy. To find a qualified practitioner, contact the following groups:
- American College of Osteopathic Sclerotherapeutic Pain Management, Inc.
- 303 S. Ingram Court, Middletown, DE 19709
- (800) 471-6114
- American Association of Orthopedic Medicine
- 600 Pembrook Drive, Woodland Park, CO 80863
- (888) 687-1920
2. Liu YK, Tipton CM, Matthes RD, et al. An in situ study of the influence of a sclerosing solution in rabbit medial collateral ligaments and its junction strength. Connect Tissue Res. 1983;11:95-102.
4. Klein RG, Dorman TA, Johnson CE. Proliferant injections for low back pain: histologic changes of injected ligaments and objective measures of lumbar spine mobility before and after treatment. J Neurol Orthop Med Surg . 1989;10:141-144.
7. Reeves KD, Hassanein K. Randomized prospective double-blind placebo-controlled study of dextrose prolotherapy for knee osteoarthritis with or without ACL laxity. Altern Ther Health Med. 2000;6:68-70,72-74,77-80.
8. Reeves KD, Hassanein K. Randomized, prospective, placebo-controlled double-blind study of dextrose prolotherapy for osteoarthritic thumb and finger (DIP, PIP, and trapeziometacarpal) joints: evidence of clinical efficacy. J Altern Complement Med. 2000;6:311-320.
13. Dechow E, Davies RK, Carr AJ, et al. A randomized, double-blind, placebo-controlled trial of sclerosing injections in patients with chronic low back pain. Rheumatology (Oxford). 1999;38:1255-1259.
Last reviewed February 2010 by EBSCO CAM Review Board
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