Prolotherapy Can Improve Knee Osteoarthritis

A colleague and someone that I learned directly from, Jeff Patterson DO, co-authored a recent blinded trial of dextrose prolotherapy vs. placebo injection or exercise therapy. The results suggested that prolotherapy is an effective solution for knee osteoarthritis with reductions in pain and stiffness and an increase in range of motion and function. This is not new, but more confirmatory results of the effectiveness of prolotherapy for numerous types of joint pain and musculoskeletal complaints.

 

June 04, 2013

Dextrose Prolotherapy Can Improve Knee Osteoarthritis

(HealthDay News) – For adults with knee osteoarthritis, dextrose prolotherapy is associated with greater improvements in pain, function, and stiffness compared with saline injections or at-home exercise, according to a study published in the May/June issue of the Annals of Family Medicine.

David Rabago, MD, of the University of Wisconsin School of Medicine and Public Health in Madison, and colleagues conducted a three-arm blinded, randomized controlled trial involving 90 adults with ≥3 months of painful knee osteoarthritis. Participants were randomized to receive blinded injection (dextrose prolotherapy or saline) or at-home exercise. Injections were provided at weeks one, five, and nine, with additional treatments at weeks 13 and 17, as needed. An exercise manual and in-person instruction were provided to exercise participants.

The researchers found that all groups reported an improvement in composite Western Ontario McMaster University Osteoarthritis Index (WOMAC) scores from baseline to 52 weeks. The improvement in WOMAC scores at 52 weeks was significantly more for the dextrose prolotherapy group compared with the saline or exercise groups, after adjustment for age, sex, and body mass index. In the prolotherapy group, the individual knee pain scores also improved more. High satisfaction was noted with prolotherapy and there were no adverse events reported.

“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,” the authors write.

The Abstract From the Recent Study:

Dextrose Prolotherapy for Knee Osteoarthritis: A Randomized Controlled Trial

  1. David Rabago, MD1⇑, Jeffrey J. Patterson, DO1, Marlon Mundt, PhD1,Richard Kijowski, MD2, Jessica Grettie, BS1, Neil A. Segal, MD, MS3 andAleksandra Zgierska, MD, PhD1

Author Affiliations:
Department of Family Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
Departments of Orthopaedics & Rehabilitation, Epidemiology, and Radiology, The University of Iowa, Iowa City, Iowa

Corresponding Author:
David Rabago, MD, Department of Family Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI 53715, david.rabago@fammed.wisc.edu

Abstract

PURPOSE
Knee osteoarthritis is a common, debilitating chronic disease. Prolotherapy is an injection therapy for chronic musculoskeletal pain. We conducted a 3-arm, blinded (injector, assessor, injection group participants), randomized controlled trial to assess the efficacy of prolotherapy for knee osteoarthritis.

METHODS
Ninety adults with at least 3 months of painful knee osteoarthritis were randomized to blinded injection (dextrose prolotherapy or saline) or at-home exercise. Extra- and intra-articular injections were done at 1, 5, and 9 weeks with as-needed additional treatments at weeks 13 and 17. Exercise participants received an exercise manual and in-person instruction. Outcome measures included a composite score on the Western Ontario McMaster University Osteoarthritis Index (WOMAC; 100 points); knee pain scale (KPS; individual knee), post-procedure opioid medication use, and participant satisfaction. Intention-to-treat analysis using analysis of variance was used.

RESULTS
No baseline differences existed between groups. All groups reported improved composite WOMAC scores compared with baseline status (P <.01) at 52 weeks. Adjusted for sex, age, and body mass index, WOMAC scores for patients receiving dextrose prolotherapy improved more (P <.05) at 52 weeks than did scores for patients receiving saline and exercise (score change: 15.3 ± 3.5 vs 7.6 ± 3.4, and 8.2 ± 3.3 points, respectively) and exceeded the WOMAC-based minimal clinically important difference. Individual knee pain scores also improved more in the prolotherapy group (P = .05). Use of prescribed postprocedure opioid medication resulted in rapid diminution of injection-related pain. Satisfaction with prolotherapy was high. There were no adverse events.

CONCLUSIONS
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.

For full text of this research study: http://www.annfammed.org/content/11/3/229.full

Dr Glen Jarosz is a skilled practitioner of prolotherapy as well as numerous other regenerative injection therapies. Please contact him for a free consultation to see if you may benefit from prolotherapy.

Fibromyalgia Pain Treated With Prolotherapy

It is interesting to note that the classical tender points of fibromyalgia are over tendon and ligament insertions. These insertion points have the lowest pain threshold of any somatic structure, meaning, even a small stimulus can be interpreted as a large amount of pain. Weak or lax ligaments are potential nociceptors (nerve stimulus receptors) in fibromyalgia, and that this is potentially correctable with prolotherapy.

Treatment of Consecutive Severe Fibromyalgia Patients with Prolotherapy,

  1. Dean Reeves, MD

Abstract: The potential of tendon and ligament triggers as primary nociceptors in fibromyalgia led to treatment of primary fibromyalgia patients with tendon and ligament strengthening injections. The injection of ligaments and tendons with proliferant (Prolotherapy) offers the advantage of creating increased strength of the connective tissue in the region of injection as well as affecting the pain cycle. Reduction in pain levels and increased functional abilities were seen in excess of 75% of patients with severe fibromyalgia in this study.

Journal of Orthopaedic Medicine Vol 16 1994 No 3

 

For full research article go to:

http://www.drreeves.com/sites/default/files/fibromyalgia%20study.pdf