Prolotherapy

Prolotherapy, also called proliferation therapy is an injection-based treatment used in chronic musculoskeletal conditions. It has been characterised as an alternative medicine practice.

Medical uses

A 2015 review found limited evidence that prolotherapy is safe and effective for Achilles tendinopathy, plantar fasciosis, and Osgood Schlatter disease. The quality of the studies was also poor. Another 2015 review assigned a strength of recommendation level A for Achilles tendinopathy, knee osteoarthritis and level B for lateral epicondylosis, Osgood Schlatter disease, and plantar fasciosis. Level A recommendations are based on consistent and good-quality patient-oriented evidence while level B are based on inconsistent or limited-quality patient-oriented evidence. Two 2016 review articles expanded level B strength of recommendations to include low back/sacroiliac pain and rotator cuff tendinopathy. As of 2016 evidence to support the use of prolotherapy in acute pain, myofascial pain or as first-line therapy, could not be determined.

History

The concept of creating irritation or injury to stimulate healing has been recorded as early as Roman times when hot needles were poked into the shoulders of injured gladiators. Prolotherapy use began in the 1930s and was originally used in the treatment of ligamentous laxity. In the 1950s, George S. Hackett, a general surgeon in the United States, began performing injections of irritant solutions in an effort to repair joints and hernias. This practice is what would eventually evolve into modern-day prolotherapy. In 1955, Gustav Anders Hemwall became acquainted with George Hackett at an American Medical Association meeting and started practicing prolotherapy.