T Nation

Prolotherapy - Any Experience Good or Bad?


#1

What's peoples experience been with prolotherapy? Viable alternative to surgery? Snake oil? Depends on the severity of the injury?!

Anyone heard anything good, bad or indifferent about it?!

My shoulder's epically unstable in an overhead snatch grip position and I'm looking at all treatment options.

Cheers :slightly_smiling:


#2

In my personal experience, prolotherapy was a terrible decision for me. These doctors are not very knowledgeable (and I went to one of the best ones in the country for this).

Please don't do it.


#3

What is the purpose for the prolotherapy? What is the underlying issue/injury? It is not a fix all solution for all injuries, and even those that it can help, it won't help all people. I have seen mixed results from people. If you do get the prolo therapy, be prepared to not be able to do any activity for upwards of 48 hours after getting the shot.


#4

Check out my buddy's website: http://www.theforgottenjoint.com/

He has a horribly affected SC joint and has been getting prolotherapy for a while now because surgery is so risky for him. Check out the blog for the full story.


#5

Prolotherapy worked for me.

JHollywood, thanks man. I have exactly the same problem as your buddy.


#6

Can everyone describe their prolotherapy sessions who've gone through Prolotherapy:

Number of sessions:
Number of shots per visit:
Type of solution used:
Area of injection:
Cost:


#7

Here are mine:

Number of sessions: 4
Number of shots per visit: 50+
Type of solution used: Sodium morrhuate
Area of injection: Pelvis and adductor connection points
Cost: Around $1500

Outcome and current status: Treatment caused muscles to tighten up so much that I still deal with this. Followup MRI showed no change (positive or negative) in areas injected.


#8

Number of sessions: 4
Number of shots per visit: no idea
Type of solution used: dextrose
Area of injection: sternoclavicular joint
Cost: I had it done in conjunction with extracorporeal shockwave therapy to kill nasty and deep trigger points. But prolotherapy-only seems to cost about 40 EUR per session.

Outcome: 3 months after the last injection, my SC joint became a lot more stable, pain almost vanished while training poundages increased. Prior to prolotherapy, my SC joint and shoulder didn't improve for 10 months.


#9

Snake oil. Bad. Please don't do it. Works for some, but hey, so does acupuncture even though placebo injections yield the same effect as any traditional spot to target..........and this isn't even talking about the schools that have no set policy on how to teach it as they feel practitioners will learn and develop their own preferred injection sites anyway....uh huh.......that's getting off topic, sorry.

Is your shoulder unstable on both sides or just one?


#10

Ill be going in for PRP, which is a kind of prolotherapy as far as I can tell, on Monday. I'll let you all know how it goes! >:slightly_smiling:


#11

The website that JHollywood posted is mine. GluteusGigantis, what proof do you have that prolotherapy done properly is snake oil? I have to agree that some doctors are terrible at it, but others have developed their techniques to the utmost and they are highly effective. The doctor who treats me with prolotherapy was an orthopedic surgeon for 35 years and said my SC joints were the most unstable he had ever seen. Many treatments later, they are much, much more stable. There is no placebo effect taking place when your collar bone doesn't pop out of your sternum anymore when doing the same movements as before.


#12

I think prolotherapy is highly overused for various injuries or even ailments. I think that's why it's snake oil when used in those cases.

If you look at the first google search on prolotherapy, that doctor claims to cure so many different ailments, but provides no peer reviewed studies on it.


#13

In my opinion, there are very FEW uses for prolotherapy and in those cases when it's appropriate, there are better alternatives.


#14

Oh, really? So what would you suggest for an unstable sternoclavicular joint?


#15

Oh and to the original poster, your options are surgery, physical therapy, and prolotherapy. Start conservative and work your way up.


#16

If I had an unstable joint, I would treat it through physical therapy and mobility exercises. Just because prolotherapy doctors say that there treatment works, it doesn't mean it really does. There are lots of alternative therapies out there that are bunk. The problem with prolotherapy is that there are no peer reviewed articles saying it's successful. This does not mean it doesn't work though, but there is an inherent danger into "blindly" injecting an area with injections without the use of ultrasound for guidance.

Also, why do you think prolotherapy results are permanent?


#17

I agree, but prolotherapy is hardly conservative.


#18

Prolotherapy has been investigated in several articles with next to no conclusive support, with nearly every clinical position stand on treatment saying it doesn't work.

Again, I haven't completely discounted it, as there are SOME individuals who report benefit, but I would argue these are individuals who would respond to just about anything when it comes to a treatment effect. I am yet to work with a clinical rehab client who has received benefit from prolotherapy, and I have over 10 years exp. Maybe practitioners where I am just suck at it, but if a treatment is to be accepted it shouldn't require some sort of voodoo expertise to get it right everytime.


#19

Yes, a hypermobile joint needs to be mobilized with physical therapy. Or in the case of the SC joint, you can mobilize the GH...have fun with that.

http://www.theforgottenjoint.com/wp-content/uploads/2010/08/ACLLaxityStudy.pdf
http://www.theforgottenjoint.com/wp-content/uploads/2010/08/ultrasoundprolo.pdf
http://www.theforgottenjoint.com/wp-content/uploads/2010/08/schwartzsagedylitreview.pdf
http://www.theforgottenjoint.com/wp-content/uploads/2010/08/systematicreviewprolo.pdf
~Discusses methodological errors encountered in past studies.
http://www.theforgottenjoint.com/wp-content/uploads/2010/08/Prolotherapy-For-NeckPain-Instability.pdf
~Uses fluoroscopic guidance.
http://www.theforgottenjoint.com/wp-content/uploads/2010/08/Sports-Medicine-Resource-Manual-2008-Chapter-50.pdf
A textbook chapter for the hell of it.
http://www.theforgottenjoint.com/wp-content/uploads/2010/09/FingerArthritisStudy.pdf
http://www.theforgottenjoint.com/wp-content/uploads/2010/09/Prolotherapy-Athletes-Groin-Pain.pdf
http://www.theforgottenjoint.com/wp-content/uploads/2010/08/Rationale.pdf
~Just an explanation.
http://www.theforgottenjoint.com/wp-content/uploads/2010/09/proloepicondylosis.pdf

Hold on, fingers are tired.

http://www.calgaryprolo.com/Articles/ReevesOAStudy.pdf
~ Knee osteoarthritis with or without laxity.
http://www.prolotherapy.com/articles/ongley.htm
~ Originally published in Manual Medicine (1988) 3:152-154

They're not blindly injecting into your body, there's something called school to teach you where and how to inject. Prolotherapy is conservative compared to surgery. Prolotherapy results are permanent to the extent that you don't reinjure the tissues. Let's say you tore your MCL. Under the best circumstances, your MCL heals back up to the proper length and you're asymptomatic. If you injure the ligament again and tear the scar tissue, then yes, you're going to go through the repair process all over again.

"if a treatment is to be accepted it shouldn't require some sort of voodoo expertise to get it right everytime."
It's called proper technique, proper proliferant selection, proper indications, and a compliant patient. There are a lot of messed up spines from botched back surgeries and spinal surgery is accepted. Some doctors do a great job, some are butchers. Doctors are not created equally.

BackInAction, I have no idea why someone injected your adductors with sodium morrhuate. That's an extremely strong solution and it's used to create microtrauma on ligaments directly. Some people also have allergic reactions to sodium morrhuate, it's not to be taken lightly.


#20

By the way, I completely agree that some doctors indicate it for all kinds of injuries and syndromes. I don't agree with a large amount of what they say it treats. In the best case scenario, it will build up scar tissue that will eventually take the slack out of a lax ligament. Some will argue that it is not scar tissue and histological studies actually support this idea, but I'm not going to get into that. I'm not drinking the prolotherapy kool-aid. It's merely a tool in a large arsenal of potentially helpful treatments. Some joints really have no alternative aside from surgery because physical therapy will only do so much.