Question

Are prolotherapy injections for chronic low back pain effective?

Bottom Line

The evidence is conflicting. When used alone, prolotherapy is not an effective treatment. When combined with spinal manipulation, exercise, and other cointerventions, prolotherapy may improve chronic low-back pain and disability (NNT* = 3).
(* NNT= number needed to treat to benefit one individual.)

Caveat

The data come from five small trials. Cointerventions confounded interpretation of results and clinical heterogeneity in the trials prevented pooling of results. Minor side effects, such as increased back pain and stiffness, were common but short-lived.

Context

Prolotherapy injections involve repeatedly injecting ligaments with compounds such as dextrose and lidocaine. The rationale is to stimulate the body's natural healing process by causing controlled acute inflammation in the areas injected.