Prolotherapy is a technique that involves the injection of an
irritant, usually a hyperosmolar
dextrose solution, typically in the treatment of chronic painful musculoskeletal conditions. Despite its long history and widespread use as a form of complementary
therapy, there still are disparities over its optimal indications and injection preparations. There are, however, numerous studies available regarding the use and efficacy of
prolotherapy for various musculoskeletal conditions. The most frequently published indication is in the treatment of chronic
low back pain, but there are recent studies that examined its use in the management of refractory
tendinopathies as well as
osteoarthritis. There is growing evidence to suggest that
prolotherapy may be helpful in treating chronic
low back pain when coupled with adjunctive
therapies, such as
spinal manipulation or
corticosteroid injections. There is also evidence to suggest that
prolotherapy is effective in treating refractory
tendinopathies, particularly for lateral epicondylosis and Achilles
tendinopathy. Additional larger, randomized controlled trials are needed to make specific recommendations regarding ideal protocols and indications. There is emerging evidence for the use of
prolotherapy as a treatment option for
osteoarthritis; however, further studies are needed to conclusively demonstrate its efficacy. Overall,
prolotherapy remains a promising option for the treatment of painful musculoskeletal conditions, particularly when other standard treatments have proved ineffective.