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Document Title: Kim-AJPMR-May04.shtml
Article Title: Critical Review of Prolotherapy for Osteoarthritis, Low Back Pain, and other Musculoskeletal Conditions: A Physiatric Perspective
Authors: Kim, Sunny R. MD; Stitik, Todd P. MD; Foye, Patrick M. MD; Greenwald, Brian D. MD; Campagnolo, Denise I. MD, MS
Publication: American Journal of Physical Medicine and Rehabilitation, Lippincott Williams and Wilkins.
Date: May 2004
Volume 83(5), May 2004, pp 379-389
Keywords: Prolotherapy, Sclerotherapy, Growth Factors, Osteoarthritis, Chronic Pain, Low Back Pain
(Reference-denoting numbers appear in the same font and point size as the document text. As with all Knee Library documents, this article is provided in full-text form. This article contains no tables nor figures.)
Comments: Prolotherapy, also known as sclerotherapy, essentially entails injecting irritating substances with the intent of causing cell proliferation. Serious concerns arise, especially in the context of dealing with knee-ligament injuries. These issues have been discussed in considerable detail on Bob's ACL WWWBoard. Sue Barber-Westin, an experienced clinical knee researcher of international renown, has commented on this article in posting 215494.
Abstract
ABSTRACT
Kim SR, Stitik TP, Foye PM, Greenwald BD, Campagnolo DI: Critical review of prolotherapy for osteoarthritis, low back pain, and other musculoskeletal conditions: A physiatric perspective. Am J Phys Med Rehabil 2004;83:379–389.
The current scientific literature relevant to the use of prolotherapy for osteoarthritis, low back pain, and other musculoskeletal conditions was reviewed and critically analyzed to determine a clinical effect. Three randomized, controlled studies were found studying the use of dextrose/glycerine/phenol prolotherapy for chronic low back pain; however, they were inconclusive due to the lack of adequate controls, heterogeneity in patient diagnoses, and variations in solutions injected. Two randomized, controlled studies were found that provide some evidence supporting the use of 10% dextrose prolotherapy for osteoarthritis. The sample size of the study (n = 13) involving osteoarthritic thumbs and fingers may have been too small to be strongly conclusive; however, it provides preliminary data to support future studies. Two studies involving osteoarthritic knees report an improvement in anterior cruciate ligament laxity; however, they did not have control groups for comparison. Only case reports were found supporting the pursuit of controlled clinical studies of prolotherapy for chronic neck pain. On the basis of the scarce body of literature critically reviewed to date, the clinical efficacy of prolotherapy in treating osteoarthritis, low back pain, and other musculoskeletal conditions remains inconclusive.
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