Prolotherapy 3

State of the Art Prolotherapy Theatre

Prolotherapy 1

Sclerosant Injections to Ligaments

Prolotherapy 2

Reduces the Risk of Recurring Back Pain

Prolotherapy 4

Neural Prolotherapy

Prolotherapy Research

‘Adverse Effect’ Survey

Conclusions
Side effects related to prolotherapy for back and neck pain, such as temporary post injection pain, stiffness, and bruising, are common and benign. Adverse events related to prolotherapy for back and neck pain are similar in nature to other widely used spinal injection procedures. Further study is needed to fully describe the adverse event profile of prolotherapy for back and neck pain.

Comment
A study investigating the adverse effects of prolotherapy found a similar profile to other injection therapies of the spine which include pain, stiffness and bruising post-injection. Some more serious side effects were noted such as pneumothorax and nerve damage but, again, no more common than other similar procedures. (Dagenais 2006) This is excluding the early published case reports in the late 50s in the USA of death, paralysis, paraplegia etc with the use of stronger, more toxic sclerosants, as opposed to the current proliferants. No serious complication since 1960 and since the use of dextrose/phenol/glycerol and dextrose alone. The side effect profile is likely to be lower in the UK than other spinal injections due to a more targeted approach to prolotherapy with fewer insertions than that used in the USA. It is also carried out under image guidance by some practitioners.

Source
Dagenais S, Ogunseitan O, Haldeman S, Wooley J, Newcomb R. Side effects and adverse events related to intraligamentous injection of sclerosing solutions (prolotherapy) for back and neck pain: A survey of practitioners. Arch Phys Med Rehabil. 2006; 87(7): 909-913.

Other References
Dagenais S, Mayer J, Haldeman S, Borg-Stein J. Evidence-informed management of chronic low back pain with prolotherapy. Spine J. 2008; 8(1):203-12.
Rabago D, Best T, Beamsley M, Patterson J. A systematic review of prolotherapy for chronic musculoskeletal pain. Clin J Sport Med. 2005; 15(5):376-80.
Rabago D. Prolotherapy for treatment of lateral epicondylosis. Am Fam Physician, 2009; 80(5):441.
Tsatsos G, Mandal R. Prolotherapy in the treatment of foot problems. J Am Podiatr Med Assoc. 2002; 92(6):366-8.
Yelland M, Sweeting K, Lyftogt J, Ng S, Scuffham P, Evans K. Prolotherapy injections and eccentric loading exercises for painful achilles tendinosis: a randomised trial. Br J Sports Med. 2009.
Mooney V. Prolotherapy at the fringe of medical care, or is it the frontier? Spine J. 2003; 3(4):253-4.
Hooper, et al. Case series on chronic whiplash related neck pain treated with intra-articular zygapophyseal joint regeneration injection therapy. Pain Physician, 2007; 10(2):313-318.
Christopher J. Centeno, MD Prolotherapy Under C-Arm Fluoroscopy. Journal of Prolotherapy, 2009; 1(4).
Royal Society of Medicine Library Search Services Team “Prolotherapy/Sclerotherapy for the Spine and Lower Back” Database(s) Searched: Medline (MEZZ): 1966 – December 2010.