Prolotherapy for Chronic Musculoskeletal Pain

This chapter describes prolotherapy as an effective therapy for chronic musculoskeletal pain, including low back pain, osteoarthritis and several tendinopathies. Prolotherapy is an injection technique which involves injecting irritant or sclerosing solutions known as proliferants that initiate a local healing reaction favoring anabolic processes, though its mechanism of action is not well established. It gives a brief account of the current prolotherapy use, in vitro and animal model studies and a series of case studies among others. The efficacy of prolotherapy for tendinopathies from clinical trials is investigated and includes treatment for three tendon disorders: eral epicondylosis (tennis elbow), hip adductor and Achilles tendinopathies. Prolotherapy for osteoarthritis of the knee and finger is described with patients reporting significant improvement. A brief account of the adverse effects of the therapy is given due to the safety issue of the technique especially when performed for perispinal or rib indications. These complications were mostly reported in perispinal prolotherapy for back and neck pain including cases of neurological impairment from spinal cord irritation.