Prolotherapy
You should get a second opinion if
ANY 'doctor' suggests doing this to you!
Prolotherapy, as the Doctor Skeptic points out, is 'the illusion of effectiveness.'
Some may claim it's a treatment for joint pain that involves injecting substances, often an actual pain killer/blocker combined with saline or sugar water directly into the joint. That should actually induce inflammation, which should cause a cellular reactions into affected tissues.
In theory they are correct, it WILL create a 'reaction.' However, the results they believed would happen are wrong, and the contraindications are clearly not worth 'their cure.'
Some may claim it's a treatment for joint pain that involves injecting substances, often an actual pain killer/blocker combined with saline or sugar water directly into the joint. That should actually induce inflammation, which should cause a cellular reactions into affected tissues.
In theory they are correct, it WILL create a 'reaction.' However, the results they believed would happen are wrong, and the contraindications are clearly not worth 'their cure.'
There have been a number of studies and reviews investigating the use of prolotherapy in humans. Overall, the evidence has a very real leaning toward ineffective, with some even pointing to dangerous.
Most of the actual studies to date have been generally low quality, but enough information has been gathered to determine that it's likely a wrong direction for modern medical treatments to take.
One of the best studies to date, is the 'Cochrane Review' of prolotherapy.
It focused on lower back pain, examining five independent studies involving 366 people. That review concluded, "There is conflicting evidence regarding the efficacy of prolotherapy injections for patients with chronic low-back pain. When used alone, prolotherapy is not an effective treatment for chronic low-back pain. When combined with spinal manipulation, exercise, and other co-interventions, prolotherapy may improve chronic low-back pain and disability. Conclusions are confounded by clinical heterogeneity amongst studies and by the presence of co-interventions."
However, the insurance companies Aetna and Cigna, along with the Veterans Administration, have each published the results of their extensive reviews of the scientific literature on prolotherapy. Each pointing out that it's 'no better than placebo effect, and new evidence from case series would not alter these conclusions.'
There has been limited efforts to assess the risks of prolotherapy, especially in humans.
One survey, of practitioners of this treatment, resulted in the following reported contraindications:
Dagenias et al. (2006) studied the effects and adverse events related to prolotherapy for back and neck pain. Surveys were mailed to members of the American College of Osteopathic Pain Management and Sclerotherapy (ACOPMS) and the American Academy of Orthopaedic Medicine (AAOM), both closely affiliated with prolotherapy conference, in addition to nonmembers attending the 2004 AAOM annual conference.
Almost 98% of the respondents to the survey held MD or DO degrees, and 83% were board certified in related disciplines.
A 50% response rate was obtained.
The authors published that the side effect with the highest estimated median prevalence was:
~ temporary post-injection pain (70%),
~ stiffness (25%),
~ bruising (5%), and
~ temporary numbness (1%).
The most commonly reported adverse events (total of 472) were:
~ spinal headache (n=164),
~ pneumothorax (n=123),
~ temporary systemic reactions (n=73), and
~ nerve damage (n=54).
69 adverse events REQUIRED hospitalization,
~ 5 resulted in PERMANENT INJURY, secondary to nerve damage.
The authors concluded that "to better assess the true risk of adverse events related to prolotherapy, further well-designed clinical trials ... are needed."
Remember, Blood Letting was an accepted, and thought to be effective 'treatment' for centuries, until modern science and a peer reviewed studies proved it was no better than placebo effect, and didn't medically improve or treat anything.
Remember, Blood Letting was an accepted, and thought to be effective 'treatment' for centuries, until modern science and a peer reviewed studies proved it was no better than placebo effect, and didn't medically improve or treat anything.
All information in this article is for educational purposes only. Nothing herein is for the diagnosis, treatment, prescription, or cure of any disease or health condition. If you have medical concerns, please see a real licensed doctor, who can actually see you... run any necessary tests, and focus on your specific needs, symptom(s), and unique situation.
Sources for claims on this page — full abstracts on Research & Citations.
- Dagenais S, Yelland MJ, Del Mar C, Schoene ML. Prolotherapy injections for chronic low-back pain. Cochrane Database Syst Rev. 2007;(2):CD004059. When used alone, prolotherapy was not an effective treatment for chronic low-back pain. Combined with manipulation and exercise, results were mixed and confounded by co-interventions. PMID:17443528
- Dagenais S, et al. Side effects and adverse events related to prolotherapy for back and neck pain. Survey of ACOPMS/AAOM members (2006). Highest estimated median effects: post-injection pain 70%, stiffness 25%. Among 472 reported adverse events: spinal headache 164, pneumothorax 123, temporary systemic reactions 73, nerve damage 54; 69 hospitalizations; 5 permanent injuries.
- Aetna, Cigna, and VA technology assessments have treated prolotherapy as investigational / not proven superior to placebo for coverage decisions. Those are payer reviews, not RCTs, but they summarize the same thin literature.
- Clegg DO et al. Glucosamine, chondroitin sulfate, and the two in combination for painful knee osteoarthritis. N Engl J Med. 2006;354:795–808. A nutrient-adjacent oral product still had to beat placebo in 1,583 patients — and in the overall group it did not. PMID:16495392
- Ang-Lee MK, Moss J, Yuan CS. Herbal medicines and perioperative care. JAMA. 2001;286:208–216. Stop selected herbs before procedures because of bleeding and anesthesia interactions. A joint injection is not an herbal capsule. PMID:11448272