Prolotherapy – Is It a Solution for Lower Back Pain?
Prolotherapy – Is It a Solution for Lower Back Pain?
Lower back pain is an issue that many adults deal with on a daily basis. While lower back pain may develop from an accident or injury, it can also occur because of aging and natural wear and tear on the spine. Other potential causes of lower back pain include structural problems, arthritis and spinal disc injuries.
Lower back pain can range from mild to severe enough to negatively impact a person’s daily life. Fortunately, prolotherapy can be an effective and efficient solution to minimize lower back pain and promote spinal health.
What Is Prolotherapy?
Prolotherapy treatment is an innovative therapy for muscle and joint pain. Also known as proliferation therapy or regenerative injection therapy, prolotherapy involves injecting saline or sugar substances into a sore muscle or joint. This substance acts as an irritant, causing your body to send immune cells to the painful area. These immune cells initiate your body’s natural healing cycle, repairing any soft tissue damage, including muscle tissue, blood vessels and nerves.
Prolotherapy can improve function, mobility, joint stability and biomechanics while minimizing pain and soreness. A physician will inject a prolotherapy solution into a tender or painful tendon or ligament and adjacent joint spaces. This solution, referred to as a proliferant, is thought to cause local irritation and inflammation that initiate tissue healing. As the tissues heal, they help strengthen and enlarge weak or damaged tendons, ligaments and surrounding structures.
Rehabilitation centers, sports medicine doctors and orthopedic physicians often provide prolotherapy treatments to help alleviate painful symptoms associated with tendon injuries, acute or chronic low back pain, sports-related injuries and osteoarthritis. Once the body’s healing process begins, it can repair damaged cells and strengthen a sore joint or muscle. As the ligament strengthens over time, it helps stabilize the joint and minimize pain and soreness.
Doctors often use regenerative injection therapy to alleviate lower back pain and promote healing in patients. When a patient tears, stretches or damages a tendon or ligament, the joint destabilizes, causing discomfort and soreness. Prolotherapy is a unique treatment that addresses this instability and repairs weakened areas by promoting healing for pain and stiffness. Once the body repairs the joint and muscle, the pain and discomfort typically resolve quickly.
Physicians often recommend prolotherapy as a non-surgical solution. Traditional surgical approaches are invasive, leading to significantly more risk. However, as a form of regenerative medicine, prolotherapy can promote natural healing and help repair and strengthen joints, connective tissues and sore muscles. Because prolotherapy offers long-term relief by correcting pain and negative symptoms at the source, it continues to grow in popularity. While traditional pain relief from medicine is only temporary, prolotherapy uses the body’s natural healing process to reduce pain and improve symptoms.
How Do Prolotherapy Injections Work?
Prolotherapy requires several injections of an irritant solution into a sore or damaged joint — typically in the joint’s interior or a supporting ligament or tendon. Researchers believe the irritant solution triggers a reaction in the connective tissues, promoting growth within these tissues and reducing pain levels. This sugar or saline solution may include lidocaine to minimize pain and discomfort and soothe sore joints.
Precision is of the utmost importance when placing an injection into a sore or damaged joint, and your physician may use an ultrasound to locate the best area for injection. Since precision is so important, you should look for a physician who has experience with prolotherapy injections. Each session may require anywhere from four to 15 shots, depending on your symptoms. A physician can help determine the number of injections you may need each session and the number of total sessions.
Prolotherapy can effectively treat conditions including ligament problems, knee and finger osteoarthritis and tendon injuries. It can also help relieve musculoskeletal pain, including lower back pain, for six months to a year.
You should talk with your physician before starting prolotherapy or any other form of treatment to ensure it is the right option for your symptoms. Patients with certain existing health complications such as cellulitis, abscesses, fractures, septic arthritis or gouty arthritis often aren’t eligible for prolotherapy injections.
Is Prolotherapy Safe?
Research shows that prolotherapy should be considered a safe procedure, a conclusion supported by every meta-analysis since 2005. While there are some risks, as there are with any treatment or procedure, these risks are greatly minimized when an experienced physician performs prolotherapy. Generally, receiving your prolotherapy injections from an experienced physician lowers your risk for complications.
Potential adverse side effects include occasional numbness, stiffness, minor pain, swelling and bruising at the injection site or minimal bleeding following treatment. While highly unlikely, some patients may develop an infection or experience an adverse reaction to the prolotherapy solution. Each patient reacts differently, so it’s important to follow all post-procedure instructions to promote proper healing.
Potential side effects and complications depend on the number of injections you receive and the severity of your treated symptoms. Treatment location also plays a fundamental role in potential side effects or post-procedure discomfort.
Where Did Prolotherapy Come From?
While prolotherapy has a long history, modern prolotherapy originated in the 1930s with Dr. Earl Gedney.
When Dr. Gedney caught his thumb in an operating room door, he experienced severe pain and joint instability. After his colleagues said there wasn’t much they could do for his thumb, he began his own research to alleviate his discomfort. At the time, some physicians were using irritant solutions to treat hernias.
Dr. Gedney published an article in 1937, which is considered one of the first known pieces on injection therapy in the modern medical literature. This article detailed preliminary protocols and provided two reports of prolotherapy effectively treating patients’ pain. Dr. Gedney followed this article with a presentation during the 1938 Osteopathic Clinical Society of Philadelphia meeting, detailing the technique.
The 1930s was a revolutionary time for injection treatments and injection therapy. Injection therapy research showed that injection therapy could stimulate collagen production, helping achieve prolotherapy’s positive outcomes.
As physicians have realized its benefits, prolotherapy has become a widely used treatment and effective therapy for various musculoskeletal conditions, including ligament sprains, neck pain, ankle pain, plantar fasciitis, knee pain and more.
Research continues today, with physicians and scientists continuing to publish papers discussing and expanding on the knowledge and effectiveness of prolotherapy. Dr. Kent Pomeroy helped improve scientific research models and fine-tune data in key areas of outcome studies. Other notable figures in the history of prolotherapy include Drs. Faber, Schultz, Dorman, Leedy, Montgomery and Hauser. As research continues, physicians can uncover additional benefits and applications for prolotherapy.
Is Prolotherapy Good for Lower Back Pain?
Patients with lower back pain are ideal candidates for prolotherapy in many cases. Doctors use prolotherapy for lower back pain to reduce discomfort, increase the strength of tendons and joints and restore normal function and mobility to the back. Prolotherapy may also help reduce the likelihood of pain recurrence at the treatment site.
It’s important to receive a proper diagnosis of lower back pain. Understanding the underlying cause of your back discomfort can help ensure you’re a candidate for prolotherapy treatment. While symptoms may vary, acute lower back pain typically resolves within a few weeks without professional treatment. Physicians consider lower back pain chronic if symptoms last 12 weeks or longer.
Prolotherapy is often a complementary treatment along with other solutions for lower back pain like cortisone injections, spinal manipulation or other pain-relieving therapies. However, certain medical conditions may mean prolotherapy might not be the right treatment for them. Before undergoing a prolotherapy treatment, speak with your physician to determine if prolotherapy is right for you.
What Other Conditions Can Prolotherapy Treat?
While prolotherapy is often an effective treatment for lower back pain and discomfort, it’s also a versatile treatment that doctors can use to treat various conditions. Physicians often recommend prolotherapy to treat ligament and joint injuries in other body parts, including shoulders, knees, hips and the neck. A physician may recommend prolotherapy for chronic conditions such as:
- Arthritis: Prolotherapy may be ideal for treating arthritis, the tenderness and swelling of one or more joints. Some of the main symptoms of arthritis include joint stiffness and pain that often worsens with age. Approximately 58.5 million people in the U.S. have arthritis.
- Osteoarthritis: Osteoarthritis, one of the most common types of arthritis, develops when the cartilage between bones wears down. While osteoarthritis can affect any joint, it’s most common in the spine, hips, knees and hands. Approximately 32.5 million adults in the U.S. have osteoarthritis.
- Degenerative disc disease: Degenerative disc disease is one of the most common causes of neck and lower back pain. Degenerative disc disease often occurs in the neck and lower back due to spinal disc wear and tear. Some patients with degenerative disc disease may experience shooting pains or general weakness in the legs and arms.
- Sacroiliac joint dysfunction: Sacroiliac joint dysfunction, also known as SI joint pain, causes pain in the legs or lower back joints. SI joint pain can cause the joint to be either restricted in movement or overly mobile.
- Tendinitis: Tendinitis is a condition in which a tendon, one of the fibrous cords that attach bone to muscle, becomes irritated or inflamed. Tendinitis causes a patient to experience tenderness and pain around the joint. Some of the most common instances of tendinitis include tennis elbow, pitcher’s shoulder, jumper’s knee and swimmer’s shoulder.
- Meniscus tears: A torn meniscus is a common knee injury, which can happen when the knee rotates or twists forcefully. Each year, there are about 1 million meniscus tears in the U.S.
- Iliotibial band syndrome: Iliotibial (IT) band syndrome is a health complication that causes pain to develop around the knee. While IT band syndrome is common in athletes, it can also occur in those new to exercise.
- Spinal stenosis: While spinal stenosis can develop in any portion of the spine, it’s most common in the lower back, also known as the lumbar. The lumbar spine comprises five spinal bones known as vertebrae. In spinal stenosis, the spinal canal narrows, placing pressure on the spinal nerves and cords that connect to your body’s muscles. Prolotherapy can improve spinal stenosis pain and help ease symptoms.
- Bulging disc: Prolotherapy can also help pain from a bulging spinal disc. As the name implies, a bulging disc occurs when the outer ring of cartilage weakens and the disc begins to bulge out past the vertebrae.
What to Expect From Prolotherapy
The physician will begin by preparing the treatment area before the procedure to minimize the risk of infection. The injections use a sugar or saline solution combined with a local anesthetic to initiate a healing response.
In most cases, physicians administer prolotherapy in multiple treatments approximately four to six weeks apart. Each treatment requires four to six injections. For a single part of the body, treatments often last 10 to 15 minutes per session.
A prolotherapy treatment plan typically takes approximately four to six months in total, depending on the number of treatments your physician recommends. While many patients notice an improvement in negative symptoms within one to two treatments, patients usually see the most progress in the third or fourth treatments. Following prolotherapy, you may experience mild aching, swelling, soreness, burning or even muscle spasms for three to seven days after treatment. However, these symptoms often improve within a few days following treatment.
Avoid using anti-inflammatory medicine after prolotherapy, as it can make the treatment less effective. Common non-steroidal anti-inflammatories, or NSAIDs, include Advil, Ibuprofen, aspirin, Alleve, Naprosyn and aspirin-containing products. Instead, opt for Tylenol, Ultram, Hydrocodone or Darvocet with your physician’s approval.
Get Your Back Pain Treated at Metropolitan Pain & Spine Institute
At Metropolitan Pain & Spine Institute, our team of experts and board-certified spine specialists can help you determine the cause of your pain. We treat every patient with the highest level of compassion and understand patients with lower back pain often experience difficulty finding an effective remedy.
Our team offers innovative treatments, including epidurals, medial branch blocks, radiofrequency ablations, kyphoplasty, vertebroplasty and more. We believe all patients deserve to regain their mobility and revive their life.
Contact us online to learn more about prolotherapy and other back pain treatments.