Is Prolotherapy a Scam? How Injections Help Some Beat Chronic Pain
By September 19, 2011 12,492 5
In general, we think of scarring as bad. But in prolotherapy, it heals.
A promising alternative treatment for chronic musculoskeletal pain like arthritis and back pain, prolotherapy has been flirting with a move from the muddy realm of complementary medicine into the mainstream.
The treatment’s supporters say it does more than relieve pain: It actually causes the body to heal itself in areas crippled by joint pain caused by injury to tendons and ligaments, which hold muscles and bones together. Some doctors have had excellent results, while others are waiting for more conclusive research.
The idea is not a new one: The concept of creating irritation or injury to stimulate healing has been recorded as early the fifth century B.C. where hot needles were poked into the shoulders of injured gladiators and javelin and discus throwers.
To be sure, prolotherapy has evolved and been refined since Roman times. But the modernized version still mimics its precursor, utilizing the body's own resources and the inflammatory response to heal itself.
Instead of hot needles, doctors today inject a concentrated sugar solution in and around the injured area, as close to the tendons and ligaments as possible. The injection irritates the area and leads to localized inflammation, which rushes blood, nutrients and cells to the area. The result is an increase in repair fibers – mostly collagen, the material that tendons and ligaments and scar tissue are made of.
Prolotherapy allows the patient to move after injections, allowing collagen fibers to follow the forces of movement. New collagen is directed toward the most-used areas and shrinks as it matures, tightening the ligament that was injected and making it stronger.
So, why hasn’t your doctor already prescribed prolotherapy? A lack of substantial research has prevented prolotherapy from being widely used – much less accepted by insurance providers.
New research that attempts to better pin down how prolotherapy works may help move prolotherapy from the nebulous realm of complementary medicine into mainstream medicine.
Most doctors do not deny that prolotherapy can work for some patients. Those who perform the treatments report a high success rate, particularly for those with joint pain, arthritis, bunions and chronic sprains. They tout it as fast acting – effects within months and without the long recovery period of surgery – and have reported it as a permanent fix for about 80 to 90 percent of patients.
But research on prolotherapy is limited and studies have had mixed results on whether it can provide consistent benefits. For example, a recent medical review of five well-designed studies found that prolotherapy is ineffective treating chronic low back pain by itself. However, in those cases, prolotherapy reduced pain and disability when combined with spinal manipulation, exercise and other treatments.
Researchers aimed at testing prolotherapy also face a two-fold challenge: the wide variation of compounds and procedures used for injections, and the presence of other interventions that could influence efficacy.
Until it receives a tried-and-tested stamp of approval, prolotherapy is unlikely to become a mainstream pain relief technique – if for nothing more, because of cost. In general, a treatment requires conclusive scientific evidence and government approval before it can be considered for insurance coverage, leaving many patients to foot the bill for this oft-practiced, but little researched therapy for themselves.