Friday, June 21, 2013

Can Prolotherapy Help With Knee Pain?

I’ve written very little about prolotherapy. The idea sounds intriguing and promising: Create a minor irritation in knee joint tissue, through injections of a substance such as sugar water, and stimulate the body’s own healing process. Doug Kelsey seems to be a fan, which is a good sign. But I’ve refrained from writing about it because I don’t know much about the treatment or how effective it’s proven to be.

Well, here’s some good news.
Knee pain appears to decrease up to one year after “prolotherapy,” a series of sugar water injections at the site of the pain, according to a new study.
The study included 90 knee osteoarthritis sufferers, ages 40 to 76, who were randomly assigned to one of three groups. The first group received sugar-water prolotherapy injections, the second salt-water placebo injections, and the last set of subjects were just shown how to do at-home exercises. The injection groups got at least three shots over 17 weeks, and were monitored over a year.

The results: The prolotherapy subjects improved 16 points on a 100-point scale for knee function (compared with a gain of 5 points for the saline group and 7 points for the exercisers). When it came to reporting less frequent and less severe pain, the prolotherapy group impoved 16 points on the same scale, compared with 7 points for the saline injected and 9 points for the exercise group.

Hmm. Sure sounds good. Also the researchers said the study, though small, was not too small.

Is it worth giving prolotherapy a whirl, if your knees are stubbornly resistant to getting better? I’d certainly consider it. Anyone out there who’s had prolo who wants to chime in?

Note: Unfortunately, I should add a bit of a negative footnote. Prolotherapy treatments cost $200 to $1,000 apiece, and they’re not covered by Medicare. I’m not sure about private insurance though.


  1. I have not undergone prolotherapy myself (yet) but I have looked into it quite a bit.

    A common prolotherapist in the Chicago area is Ross Hauser. I'm in no way trying to promote him, he's just of one the most popular prolotherapits worldwide. He learned prolotherapy from two of the claimed progenitors of prolotherapy--hemwall and Hackett. He actually calls his prolotherapy method hemwall-hackett prolotherapy.

    Another prolotherapist is Darrow in Los Angeles, he is popular.

    The theory behind the stimulations is that it replicates the body's natural healing process, I guess when an area needs healing it sends out a near-identical chemical to the sugar used. I've heard Hauser explain it and it makes a lot more sense.

    The theory behind is that it increases the stability of joints--that's his and a lot of prolotherapists concept for the cause of most joint pain. Obviously it can be from overuse and ignoring (earlier) pain signals, or an accident or a lot of random things.

    Some prolotherapists now use alternative therapies that you will not find in most orthopedic offices. This includes platlet-rich plasma (which is increasing in popularity in orthopedic offices). Also, bone marrow or fat-derived stem cell mixtures or human growth horomone joint injections are becoming more popular.

    The HGH idea is from odd guy named Dr. Alan Dunn out of Miami, FL. His website is here: He is an orthopedist.

    Anyways the prolotherapy is basically the next step if totally conservative measures don't work (the ones you ascribe to here on this blog). Obviously it would depend on the persons problem.

    Anyways thought I would share what I know about prolotherapy.

    Hausers site is here:

    He has a lot of useful video and writes a lot of papers (that are actually fun to read). There are videos too on youtube. He is good at explaining it (obviously he has bias because he is a prolotherapist and from my observations he does overstate it's effectiveness--from what is read elsewhere but it's one side of the coin....)

  2. I've never heard of prolotherapy so this is all very fascinating. Will do more reading on that.

    Speaking of Doug Kelsey (in the first paragraph of Richard's post), within the last few days Doug has written an article about healing knees on his new blog that I'd like to bring to the attention of readers of Richard's blog and I think Richard would approve:


  3. Yes, that's a very informative essay by Doug on healing bad knees, with some good exercise suggestions at the end. The url is a bit different though fyi:

  4. I might be wrong but I think I read that the paper you refer to was published in a journal backed by Hauser.... so it seems a little suspect to me. I would really like to hear from other patients with PFPS who had prolo as to their experiences. I made a brief foray on Knee Guru but didnt come up with much. My problem is I would like to see some similarly encouraging papers from other non-Hauser related authors... I came close to trying this but was scared away by the required PT after... cycling which I am pretty sure I couldnt handle at present. Then I would have been a failed patient due to inability to do the PT..and not the fault of prolo which may or may not have helped anyway. PLus, I already have pretty tight quads, so tightening things up more??? not sure I can buy into that. Seems like more patella grating on the femur.I would be happy to be proven wrong..