Prolotherapy for low back pain

Prolotherapy involves injecting a substance into the body to promote the growth of normal cells, tissues, or organs. There are 3 types of prolotherapy. The type used to treat joint pain is called inflammatory prolotherapy.

In inflammatory prolotherapy, a sugar water solution (dextrose) is injected into a weakened ligament near where the ligament attaches to the bone. The injection is intended to cause inflammation. The body responds to the inflammation by increasing blood flow to the area and stimulating the ligament to repair itself. Usually, a person would have a series of 4 to 6 treatments, each about 2 weeks apart.

A review of several studies suggests that prolotherapy injections alone may not be helpful for chronic low back pain, but they may reduce pain and help you be more active if they are used in addition to other treatment such as exercise and spinal manipulation.1 But a separate review concludes that prolotherapy may not work.2

The most significant risk in prolotherapy treatment is nerve damage from an injection placed too close to a nerve. There are also no established guidelines for the procedure at this time.3

Citations

  1. Dagenais S, et al. (2007). Prolotherapy injections for chronic low-back pain. Cochrane Database of Systematic Reviews (2).
  2. Chou R, et al. (2009). Interventional therapies, surgery and interdisciplinary rehabilitation for low back pain: An evidence-based clinical practice guideline from the American Pain Society. Spine, 34(10): 1066–1077.
  3. Schnirring L (2000). Are your patients asking about prolotherapy? Physician and Sportsmedicine, 28(8): 15–17.

Last Updated: February 3, 2010

Author: Shannon Erstad, MBA/MPH

Medical Review: William M. Green, MD - Emergency Medicine & Robert B. Keller, MD - Orthopedics

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