Saturday, July 18, 2009

Prolotherapy

A patient of mine asked about prolotherapy so I did some information gathering. In my blog reader which is actually a useful adjunct to more formal types of literature I found 7 entries dating back to 2007. There was a NYTimes article from 08/07/07 that touted the promises of this intervention. An entry in the CAM report from 01/06/08 had an interesting review/summary of the following article: The Spine Journal, Volume 8, Issue 1, January-February 2008, Pages 203-212 Simon Dagenais, John Mayer, Scott Haldeman and Joanne Borg-Stein.
the authors concluded, it’s not possible to separate the benefits of prolotherapy from the other treatments because “there is no evidence of efficacy for prolotherapy injections alone without cointerventions.”

The best was this youtube video, the part on prolotherapy is towards the end:
Nothing too concrete... so I went to pubmed where there were 59 search results to the term "prolotherapy" including a Cochrane review article from 2007 (highest level of research) that 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.

I doubt I will (within the confines of my practice act) recommend it to others based on the current literature out there but do any of you have any experiences with this form of treatment, please share in the comments and have a nice day, it is gorgeous here in NYC.

Addendum: Platelet-rich plasma injections seem to be the wave of the future here. We are seeing a lot more of them in NY. I am sure there will be posts coming soon on this topic.

1 comment:

decreemack said...

That doctor was speaking out his ass. There is a difference between crushing someone's knee with a bat and making a fake injury with sugar water. It's basic osmosis; the cells dry out and crenate because the sugar water has a higher concentration of solute. This signals the body to come in and repair the damaged cells. Or you could crush someone's knee with a bat...ridiculous. A large stimulus in the body is harmful, while small stimuli are productive. When you weight train, you create micro tears in the muscles and tendons, which the body repairs and consequently, the muscles hypertrophy. Using his same logic, why don't you just get under a bar weighing 500 pounds and let it rip your muscles apart? There's a method to the madness.