Murat Tolga AVŞAR, Resmiye Nur OKUDAN, İlker SOLMAZ, Rumeysa SAMANCİ, Gökhan NALBANT

Prolotherapy Method in Treatment of Chronic Low Back Pain

Objective: The aim of this study is to evaluate the effectiveness of 5% dectrose prolotherapy on low back pain in patients with chronic low back pain without neurological deficits. Material-Method: Prolotherapy with 5% dextrose was applied to patients with localized low back pain, hip pain, spreading pain in the legs for more than six months. Stretching exercises were recommended after prolotherapy and an analgesic containing paracetamol (500 mg) + codeine phosphate (10 mg) + caffeine (30) mg was used for analgesia for the first 3 days. Prolotherapy was planned 3 times with an interval of twenty days. Results: Thirty patients between the ages of 24-73 were included in the study. Eighteen patients received 3 sessions whereas twelve patients received 2 sessions of prolotherapy. Visual analogue scale (VAS) pain scores of all patients decreased. The mean pre-treatment VAS score was 8.43 and it decreased to 2.41 after the treatment. None of the patients had side effects that would terminate the treatment.Conclusion: The data obtained in the study show that prolotherapy is effective in treating chronic low back pain. We did not conduct long-term follow-up in our study. After three sessions and between sessions, we assessed the current state of well-being. More extensive studies will guide clarification of its place in the treatment of long-term low back pain.

Keywords:

Low back pain, prolotherapy, visual analogue scale,

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1. Frymoyer JW and Cats-Baril WL. An overview of the incidences and costs of low back pain. Orthopedic Clinics of North America. 1991. 22:263-271.
2. Hills EC, Wieting JM, et al. (eds). Mechanical low back pain. Updated 21 November 2004. Available at http://www.emedicine.com/pmr/topic73.htm.
3. Hackett GS, Hemwall GA, and Montgomery GA. Ligament and Tendon Relaxation Treated by Prolotherapy, Fifth Edition. Institute in Basic Life Principles. OakBrook, IL. 1991.
4. Kim WJ, Shin HY. Ultrasound guided Prolotherapy with Polydeoxyribonucleotide Sodium in Ischiofemoral Impingement Syndrome. Pain Pract. 2014 Sep;14(7):649-55. doi: 10.1111/papr.12215. Epub 2014 Apr 16.
5. Hakelius A. Prognosis in sciatica: A clinical follow up of surgical and nonsurgical treatment. Acta Orthop Scand Suppl. 1970;129:1-76. doi: 10.3109/ort.1970.41.suppl-129.01.
6. Schwarzer A. The sacroiliac joint in chronic low back pain. Spine. 1995; 20:31-37.
7. Boden SD, Davis DO, Dina TS, Patronas NJ, Wiesel SW. Abnormal magnetic-resonance scans of the lumbar spine in asymptomatic subjects. A prospective investigation. J Bone Joint Surg Am. 1990 Mar;72(3):403-8.
8. Ombregt L, Bisschop P and ter Veer HJ. A System of Orthopedic Medicine, Second Edition Churchill Livingstone 2003 p 775.
9. Nachemson A. Advances in lowbackpain. Clin. Orthop. 1985. 200:266.
10. Reeves KD. Prolotherapy: Basic Science, Clinical Studies, and Technique. In Lennard TA (Ed) Pain Procedures in Clinical Practice, 2nd Ed. Hanley and Belfus. Philadelphia. 2000. pp 172-190.
11. Sheeler R. Alternative treatments: dealing with chronic pain. Mayo Clinic Health Letter. 2005; 23(4):1-3.
12. Merriman JR. Prolotherapy versus operative fusion in the treatment of joint instability of the spine and pelvis. J of Int Coll of Surgeons. August 1964. 42(2):150-159.
13. Hauser RA, Hauser MA. Dextrose Prolotherapy for Unresolved Low Back Pain: A Retrospective Case Series Study. Journal of Prolotherapy. 2009;1(3):145-155.
14. Maniquis-Smigel L, Reeves KD, Rosen HJ, Lyftogt J, Graham-Coleman C, Cheng AL, Rabago D. Analgesic Effect and Potential Cumulative Benefit from Caudal Epidural D5W in Consecutive Participants with Chronic Low-Back and Buttock/Leg Pain. J Altern Complement Med. 2018 Dec;24(12):1189-1196. doi: 10.1089/acm.2018.0085. Epub 2018 Jun 8.
15. Dagenais S, Yelland MJ, Del Mar C, Schoene ML. Prolotherapy injections for chronic low back pain. Cochrane Database Syst Rev. 2007 Apr 18;2007(2):CD004059. doi: 10.1002/14651858.CD004059.pub3.
16. Solmaz İ, Akpancar S, Örsçelik A, Yener-Karasimav Ö, Gül D. Dextrose injections for failed back surgery syndrome: a consecutive case series. Eur Spine J 2019 Jul;28(7):1610-1617. doi: 10.1007/s00586-019-06011-3. Epub 2019 May 21.