4. Another article published in Physical Medicine and Rehabilitation Clinics of North America reported on multiple Randomized Control Studies (Gold Standard Studies) conducted by Dr. Dean Reeves found that prolotherapy shows clinically meaningful pain and function improvements in knee osteoarthritis, spinal pain, and several tendinopathies. The results were sustained benefit at 6–12 months; structural changes (e.g., increased cartilage thickness) have been observed in some knee osteoarthritis trials.
5. An article published in 2016 performed by Dr. Ross Hauser in chronic musculoskeletal conditions (spine, peripheral joints, tendons) found that across multiple Randomized Control (Gold Standard) Studies and prospective studies, dextrose prolotherapy improved pain, function, and patient satisfaction in knee OA, lateral epicondylitis, plantar fasciitis, and rotator cuff pathology. In several studies, prolotherapy outperformed physical therapy, saline injections, or exercise alone on pain and functional scales. The authors argue that dextrose prolotherapy is a promising, low‑cost option for chronic musculoskeletal pain
6. A 2024 article done by the Veteran’s Administration and the National Institute of Health (in the U.S.A.) confirmed that dextrose prolotherapy improves pain and function for musculoskeletal conditions more than saline or exercise. It suggests prolotherapy may be a reasonable option when conservative care fails and surgery is undesirable.
George Hackett, M.D. presented data of the American Medical Association on June 1955 on prolotherapy and neck pain. 563 patients participated. 82% considered themselves cured.
43 patients with chronic low back pain who had been unresponsive to other treatments, including surgery underwent Prolotherapy to the sacroiliac joint area over a period of six weeks. 93% of the patients reported significant improvement. Only three of the patients reported no improvement.
Schwartz R. Prolotherapy: A literature review and retrospective study; Journal of Neurology, Orthopedic Medicine and Surgery 1991: 12:220-223.
A study performed by Merriman compared Prolotherapy versus intra-operative fusion in the treatment of joint instability of the spine and pelvis. The success rate of the prolotherapy was an 80-90% cure rate. The success rate of the fusion was variable.
Journal of the International College of Surgeons, 1964 42:150-159.
656 patients received a total of 18,000 injections. 12 years after prolotherapy was completed, 82% of the patients considered themselves cured.
Hackett M.D. Low back pain British Journal of Physical Medicine 1956 19.25-33
A double-blind study in one of the most prestigious medical journals was conducted on the most difficult patients with continuous low back pain. These patients suffered for 10 years or longer and had surgery, medications, manipulations, exercise, physical therapy and other treatments. These interventions failed to provide adequate relief for 10 or more years. 88% of the group treated with prolotherapy had moderate to marked improvement.
Ongley, M. A new approach to the treatment of low back pain. Lancet July, 1987 2:143-145.
91% of 177 patients with chronic spinal pain had reduced pain, 84% had improvement in work ability and 85% could do self-care more easily. Hooper RA; Ding M Retrospective case series on patients with chronic spinal pain treated with dextrose.
Chronic LBP: Hooper et al 2004.
In the prestigious journal Spine, a randomized study showed the success rate in reducing pain and improving disability are at least as good as those reported for spinal cord stimulation, surgery or multidisciplinary treatment for patients with low back pain. Additionally, they found significant reductions in the chronic low back pain and disability 2 years after injections were performed.
Spine 29(1):9-16, 2004.
57% improved markedly with 72% improvement in disability scores and 76% in pain in patients with degenerative disc disease.
Klein et al 2003.
43.3% of patients with severe degenerative disc disease had sustained improvement, with an average improvement of 71%.
Miller MR, Mathews RS, Reever KD. Treatment of painful advanced internal disc derangement with intradiscal injection of hypertonic dextrose. Pain Physician 2006 9:115-121.
80% of patients with failed back syndrome obtained good to excellent relief of pain following prolotherapy. Patients also reported improvement in work capacity and social functioning.
Wilkinson HA Injection therapy for enthesopathies causing axial spine pain and failed back syndrome: a single-blinded, randomized and cross-over study. Pain Physician, Apr 2005, 8(2) P 167-73.
Prolotherapy performed for knee arthritis by a trained operator resulted in safe, significant and sustained and consistent improvements on validated, quality-of-life, pain, function, and stiffness measures.
After prolotherapy injections, there was an improvement in pain, swelling, knee buckling and flexion by 44%, 63%, 85%, and 14 degrees respectively. There was also an improvement in cartilage thickness on X-ray. Reeves KD, Hassanein K Randomized prospective double-blind placebo-controlled study of dextrose prolotherapy for knee arthritis with or without ACL laxity. Alt Ther Hlth Med 2000;6(2):37-46. Please click here to see the full journal article on the use of prolotherapy for arthritis.
A study conducted of sixty-one patients, representing 94 hips who had been in pain for an average of 63 months found that 89% experienced more than 50% of pain relief with Prolotherapy; more than 84% showed improvements in walking and exercise ability, anxiety, depression and overall disability. 54% were able to completely stop taking pain medications. Included in the study was a subset of patients who were told there were no other treatment options for their pain, and those who were told surgery was their only treatment option.https://www.caringmedical.com/prolotherapy-results/chronic-hip-pain-research/
George Hackett presented data in front of the AMA on June 1958 on prolotherapy and cervical whiplash. 82% of patients considered themselves cured.
Statistically significant correlations between proliferant injections, a reduction of both cervical flexion and extension translation, as well as a reduction in pain score Christopher J Ceteno, MD, James Elliott, MSPT, PhDc Pain Physician 2005; 8:67-72 Fluoroscopically Guided Cervical prolotherapy for instability with blinded pre and post radiographic reading.
92% of career-threatened elite athletes returned to full elite-level performance in a timely and sustainable manner after regenerative therapy using dextrose. Am J. Phys Med Rehabil. 2008;87(11):90-902.
Dextrose prolotherapy showed marked efficacy for chronic groin pain in this group of elite rugby and soccer athletes. Topol GA, Reeves KD, Hassanein K. Efficacy of Dextrose Prolotherapy in Elite Male Kicking-Sport Athletes With Chronic Groin Pain. Archives Phys Med Rehabil, 2005;86:697-702.
Using simple dextrose injection into 16 knees with loose ACL ligament, 10/16 knees were no longer loose by machine measurement at the time of follow-up, and symptoms were improved. Symptoms of osteoarthritis improved even in those who still tested loose. Long term effects of dextrose prolotherapy for anterior cruciate ligament laxity; A prospective and consecutive patient study. Reeves KD Hassanein K Alt Ther Hlth Med 2003;9(2):
Excellent results using prolotherapy for recurring headaches. Dextrose Prolotherapy for Recurring Headaches and Migraine Pain by Ross A. Hauser, MD and Heather McCullough, MA.
Prolotherapy yielded a significant reduction in pain at rest and during tendon-loading activities in patients with chronic tendinosis of the Achilles tendon. Maxwell NL, Ryan MB. Sonographically guided intertendinosus injection of hyperosmolar dextrose to treat chronic tendinosis of the Achilles tendon: A pilot study, JR Am J Roentgenol. 2007 Oct; 189(4): 215-20
Reduction if pain levels and increased functional abilities were seen in 75% of patients with severe fibromyalgia using prolotherapy. Reeves KD, Treatment of Consecutive Severe Fibromyalgia Patients With Prolotherapy. The Journal of Orthopedic Medicine 16(3):84-89.
An in situ study of the influence of sclerosing solutions in a rabbit medial collateral ligaments and its junction strength. He found that after five injections the ligament mass increased by 44%, the thickness by 27% and the strength of the ligament bone junction increased by 28%. This study showed that prolotherapy actually causes tissue growth and strengthening. Liu, Y Connective Tissue Research 1983 2:95-102.
Rabbit tendons treated with sodium morrhuate. Six weeks after treatment the diameter of the tendons increased by 20-25%. Maynard J. Morphological and biomechanical effects of sodium morrhuate on tendons. Journal of Orthopedic Research 1985 3: 236-248.
Hackett G. Joint Ligament Relaxation Treated by Fibro-Osseous Proliferation. First Edition. Charles C. Thomas, publisher, 1956.
Hackett G. Joint stabilization: an experimental, histological study with comments on the clinical application in ligament proliferation. American Journal of Surgery. 1955;89:968-973.
Hackett G. Back pain following trauma and disease – Prolotherapy. Military Medicine. 1961;126:517-525.
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