Prolotherapy for Pain ReliefJune 12, 2013 Written by JP [Font too small?]
In the Los Angeles area, there’s a popular weekend radio problem hosted by a physician who specializes in a form of treatment known as prolotherapy. After hearing the show for the first time, a client inquired about the science behind this unconventional technique which involves the injection of a “sugar-water” solution into joint, ligament and tendinous spaces. How is it possible that injecting a mixture consisting primarily of dextrose and water can help improve inflammatory conditions such as low back pain, osteoarthritis and tendinopathy, while at the same time promoting a healing reaction? Admittedly, this sounds counterintuitive. Injections, in and of themselves, evoke pain. Dextrose, a high glycemic variety of sugar, is typically associated with ill effects. In prolotherapy, this combination is turned on its head. Research reveals that immediately following each injection, localized inflammation does, in fact, occur. However, as time goes on, this initial inflammation shifts to pain modulation and encourages the proliferation of new tissue via the induction of tissue growth factors
Prolotherapy isn’t exactly a perfect candidate for an “alternative” or “complementary” treatment. In addition to dextrose and water, prolotherapy injections often contain a small amount of lidocaine, a local anesthetic of synthetic origin. What’s more, with the exception of B vitamin shots, injections are rarely employed at all in holistic circles. From an allopathic or conventional medical perspective, prolotherapy hasn’t been taken very seriously due to a paucity of controlled, scientific studies to verify its efficacy and safety. However, over the past several years, some integrative practitioners have begun to consider and recommend prolotherapy thanks to a new batch of promising, well designed clinical trials.
The latest and most high profile examination of prolotherapy appears in the May-June issue of the Annals of Family Medicine. In the randomized study, participants with knee osteoarthritis were administered dextrose prolotherapy, placebo (saline) injections or at-home exercises. Over a 17 week period, up to 5 prolotherapy sessions were given to the experimental and saline groups. All of the study volunteers were followed over a 52 week period. Those receiving the dextrose prolotherapy improved to a greater extent than the exercise and saline comparison groups. The benefits were assessed by using a symptom ranking scale (WOMAC index) and measures of individual pain perception (KPS or knee pain scale). According to the authors of the paper, patient satisfaction was “high” and no adverse reactions were reported. The concluding remarks state, “Prolotherapy resulted in clinically meaningful sustained improvement of pain, function, and stiffness scores for knee osteoarthritis compared with blinded saline injections and at-home exercises”. Previous investigations support the utility of prolotherapy for knee osteroarthritis and go on to describe several other conditions which are also responsive including Achilles tendinosis, lateral epicondylosis or “tennis elbow”, sacroiliac joint pain and TMJ (temporomandibular joint dislocation).
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To learn more about the studies referenced in today’s column, please click on the following links:
Study 1 – American Family Physician: Prolotherapy for Chronic Musculoskeletal … (link)
Study 2 – Dextrose Prolotherapy for Knee Osteoarthritis: A Randomized … (link)
Study 3 – Hypertonic Dextrose Injections (Prolotherapy) for Knee Osteoarthritis … (link)
Study 4 – Prolotherapy Injections and Eccentric Loading Exercises for Painful … (link)
Study 5 – Hypertonic Dextrose and Morrhuate Sodium Injections (Prolotherapy) … (link)
Study 6 – Prolotherapy Versus Corticosteroid Injections for the Treatment of … (link)
Study 7 – The Efficacy of Prolotherapy for Lateral Epicondylosis: A Pilot Study … (link)
Study 8 – A Randomized Controlled Trial of Intra-Articular Prolotherapy Vs Steroid … (link)
Study 9 – Short-term Results of Prolotherapy in the Management of TMJ … (link)
Study 10 – The Efficacy of Dextrose Prolotherapy for Temporomandibular Joint … (link)
Prolotherapy Improves Arthritic Symptoms (WOMAC Score)
Source: Ann Fam Med. 2013 May-Jun;11(3):229-37 (link)
Tags: Arthritis, Pain, Sugar
Posted in Alternative Therapies, Bone and Joint Health, Exercise