Prolotherapy for Osteoarthritis: What Does the Data Say?


Traditional treatments for osteoarthritis include over the counter (OTC) pain medications and anti-inflammatories, prescription pain medications, physical therapy, and surgery. Prolotherapy is another option, although it is considered non-traditional. Does it work?

Data demonstrating the efficacy of prolotherapy as an osteoarthritis treatment is limited. Although prolotherapy has been effectively utilized to treat soft-tissue injuries for generations, treating osteoarthritis is something different altogether. Yet a 2016 meta-analysis concluded that some osteoarthritis patients respond very well to prolotherapy.

A Brief Description of Prolotherapy

Lone Star Pain Medicine in Weatherford, TX includes prolotherapy on its list of services. Lone Star clinicians normally recommend prolotherapy for soft-tissue injuries and diseases involving the muscles, ligaments, and tendons. But they do acknowledge that the treatment is sometimes recommended for osteoarthritis.

A video on the Lone Star website explains that prolotherapy’s main mechanism is tricking the body into believing a new injury has occurred. This subsequently triggers the natural healing response including sending cells and growth factors to the affected area.

It is accomplished by injecting a dextrose and anesthetic mixture into the affected site. The anesthesia provides temporary pain relief while the dextrose actually encourages inflammation. It is the inflammation that triggers the body’s natural healing response.

More About the 2016 Study

Getting back to the previously mentioned study from 2016, a group of researchers hailing from Taiwan looked at one single-arm study and five randomized, controlled trials covering a total of 326 patients. Other trials and studies were considered but disqualified for a variety of reasons.

Researchers looked at reported pain relief, measured against baseline, when comparing prolotherapy against other treatment options including local anesthetics, corticosteroid injections, and exercise.

What was the conclusion? After extrapolating and analyzing the data, researchers concluded that prolotherapy offered pain relief to those osteoarthritis patients who tried it. Researchers also discovered no direct correlation between pain relief and dosage from serial injections. In other words, larger volumes of dextrose did not appear to offer more pain relief for patients who received multiple injections.

Treating Osteoarthritis Is Challenging

The 2016 study is by no means conclusive. The same can be said for the studies and trials researchers analyzed for their meta-analysis. Still, the fact that some patients responded positively to prolotherapy is good news. It gives doctors and patients yet another option to choose from.

Unfortunately, not everyone will respond to prolotherapy the same way. But that is true for all osteoarthritis treatments. The fact remains that treating osteoarthritis is challenging even under the best circumstances. Osteoarthritis is a painful and degenerative disease for which there is no cure.

Osteoarthritis is the result of cartilage loss in the joints. In younger, healthy people, sufficient cartilage provides cushioning and lubrication between two bones of a joint. Osteoarthritis patients are dealing with the loss of cartilage in the affected joints. The bones in those joints make direct contact, often grinding on one another. This is what causes osteoarthritis pain.

Patients Should Have Access to Choices

Osteoarthritis is normally associated with age. However, it can be the result of traumatic injury to a joint. Either way, patients should have access to as many treatment choices as possible. Telling a patient his only option is to take prescription medications is both inappropriate and unhelpful.

Prolotherapy may be considered a non-traditional treatment. However, limited data suggests that some patients respond positively to it. As a minimally invasive procedure with very little associated risk, there is no logical reason to not give osteoarthritis patients the opportunity to give it a try. Pain relief comes in many forms. If prolotherapy can provide it, so be it.

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