Julbirdy

| url = http://www.nytimes.com/2007/08/07/health/07brod.html

| publisher = [[New York Times]]

 

 

As of April 2005, doctors at the [[Mayo Clinic]] began supporting prolotherapy. Robert D. Sheeler, MD (Medical Editor, ''Mayo Clinic Health letter'') first learned of prolotherapy through [[C. Everett Koop]]’s interest in the treatment. Mayo Clinic doctors list the areas that are most likely to benefit from prolotherapy treatment: ankles, knees, elbows, and the [[sacroiliac joint]] located in the lower back. They report that "unlike [[corticosteroid]] injections — which may provide temporary relief — prolotherapy involves improving the injected tissue by stimulating tissue growth."<ref name="Mayo">{{cite journal| journal = Mayo Clinic Health Letter| volume = 23| issue = 4| year = 2005| pages = | title = Alternative treatments: Dealing with chronic pain| last = Mayo Clinic | first = | url = | format = | accessdate = }}</ref>

 

Injections of irritant solutions were performed in the late 1800’s to repair hernias and in the early 1900’s for jaw pain due to temporomandibular (jaw) joint laxity. George S. Hackett developed the technique of prolotherapy in the 1940’s. [[Gustav Hemwall]] was a pioneer, beginning his studies and treatments in the 1950s and continuing until the mid 1990s. In his study of almost 10,000 prolotherapy cases, Dr. Hackett found that over 99 percent of the patients found relief from their chronic pain. <ref name=history>{{cite news |first=Ross | last=Hauser |url=http://getprolo.com/the_history_of_prolotherapy.htm |title=The History of Prolotherapy. |accessdate=2007-08-26 |quote=In 1955, at an American Medical Association meeting, Dr. Gustav Hemwall was astonished to see so many doctors at one particular exhibit. The presenter was talking about a very successful treatment for chronic low back pain. Nothing was worse at the time for Dr. Hemwall than having a chronic low back pain patient come to him, because the treatments he was able to offer were not very successful. The doctor doing the presentation was [[George S. Hackett]], M.D., and he was discussing the technique of Prolotherapy. Once the crowd diminished, Dr. Hemwall asked Dr. Hackett how he could learn the treatment described in his book, Ligament and Tendon Relaxation Treated by Prolotherapy. Dr. Hemwall went to Dr. Hackett's office in Canton, Ohio, to learn the technique. Dr. Hemwall became so proficient at administering the technique that Dr. Hackett would later refer patients to him. Prolotherapy owes a great debt to Dr. Hemwall. Between 1955 until his retirement in 1996, he was the main instructor and proponent of Prolotherapy in the United States. He was not a researcher but a clinician, and perhaps the world's greatest Prolotherapist. He treated more than 10,000 patients world wide and collected data on 8,000 of these patients. In 1974, Dr. Hemwall presented his largest survey of 2,007 Prolotherapy patients to the Prolotherapy Association. |publisher= }}</ref>

 

Prolotherapy involves the injection of an irritant solution into the area where connective tissue has been weakened or damaged through injury or strain. Many solutions are used, including [[dextrose]], [[lidocaine]] (a commonly used local anesthetic), [[phenol]], [[glycerine]], or [[cod liver oil]] extract. The injection is given into joint capsules or where [[tendon]] connects to bone. Many points may require injection. The Injected solution causes the body to heal itself through the process of [[inflammation]] and repair. In the case of weakened or torn connective tissue, induced inflammation and release of growth factor at the site of injury may result in a 30-40% strengthening of the attachment points, although strong scientific evidence supporting this is lacking.

 

Allen R Banks, Ph.D., has described in detail the theory behind prolotherapy in "A Rationale for Prolotherapy".<ref name="RationalForProlotherapy"/>

 

* Recurrent swelling or fullness involving a joint or muscular region

* Popping, clicking, grinding, or catching sensations with movement

Prolotherapy is often used as an alternative to invasive [[arthroscopic surgery]].

 

A [[Cochrane Collaboration|Cochrane review]] of the medical literature as of January 2004 on the efficacy of prolotherapy injections in adults with chronic low-back pain<ref name="CochraneCollaboration">{{cite doi|10.1002/14651858.CD004059.pub3}}[http://www.cochrane.org/reviews/en/ab004059.html] Cochrane collaboration</ref> found four [[controlled trials]], all measuring pain and disability levels at six months. The review concluded:

 

More recently, Rabago et al. [A systematic review of prolotherapy for chronic musculoskeletal pain. Clin J Sport Med. 2005 Sep;15(5):376-80] noted: "Two [randomized controlled trials] on osteoarthritis reported decreased pain, increased range of motion, and increased patellofemoral cartilage thickness after prolotherapy."

 

Most major [[medical insurance]] policies do not cover the treatment. After a 1999 review of the medical evidence, Medicare declined to cover prolotherapy for chronic low back pain citing that prolotherapy "was last examined for coverage by the Health Care Financing Administration (HCFA) in September 1992".<ref>{{cite web |url=http://www.quackwatch.org/01QuackeryRelatedTopics/prolo.html |title=HCFA Decision Memorandum |accessdate=2008-07-24 |quote= |publisher=[[Quackwatch]] }}</ref>

 

A randomized, [[double-blind]], [[placebo]] control study is currently recruiting patients to determine whether prolotherapy can decrease pain and disability from knee [[osteoarthritis]]. This study is Sponsored by the National Center for Complementary and Alternative Medicine ([[NCCAM]]).<ref>[http://clinicaltrials.gov/show/NCT00085722] Clinicaltrials.Gov, Joint Injections for Osteoarthritic Knee Pain, web page last updated October 16, 2006</ref>

 

A randomized, [[double-blind]], [[placebo]] control study is currently recruiting patients to determine whether prolotherapy can be an effective treatment for lateral epicondylitis (tennis elbow).<ref>http://clinicaltrials.gov/ct2/show?cond=%22Tennis+Elbow%22&rank=3 Clinicaltrials.Gov, Efficacy Study of Prolotherapy vs Corticosteroid for Tennis Elbow</ref>

 

A randomized, [[double-blind]], [[placebo]] control study is currently recruiting patients to compare prolotherapy to injection of [[corticosteroids]] in treating carpo-metacarpal joint arthritis of the thumb.<ref>[http://clinicaltrials.gov/ct2/show/NCT00685880 Prolotherapy Versus Steroids for Thumb Carpo-Metacarpal Joint Arthritis]</ref>

 

{{Reflist}}

 

* [http://www.prolotherapy.org Prolotherapy.org] is a source for extensive articles, diagrams and other resources related to prolotherapy.

* [http://prolotherapy.com/ Prolotherapy.com] - a source for information on nonsurgical ligament reconstruction

[[es:Proloterapia]]

[[it:Proloterapia]]