Is prolotherapy an effective treatment for chronic pain?

Multiple studies of prolotherapy have reported conflicting evidence regarding its effectiveness in treating chronic pain. Some studies have shown a benefit, others have showed none.

Prolotherapy involves injecting painful ligaments and tendons with sugar solutions that are intended to stimulate production of connective tissue. A typical course of treatment is six to 10 sessions, sometimes with multiple injections at each session.

Proponents believe that these treatments restore strength and stability to ligaments and joints, which may relieve pain. Prolotherapy has been used to treat a number of painful musculoskeletal conditions, such as osteoarthritis and chronic back pain.

Prolotherapy is known to cause some pain at the injection site, but this is typically mild and temporary. As with any injection, there is a risk of infection, bruising, bleeding or tissue damage.

A 2007 review of five well-designed studies involving 366 participants concluded that prolotherapy alone was ineffective in treating chronic low back pain. However, when combined with other treatments — such as spinal manipulation and exercise - prolotherapy may improve chronic low back pain.

More research is needed to clarify what role, if any, prolotherapy plays in the treatment of chronic pain.