[annapurna]

I've used prolotherapy for my sacroiliac area and lumbar spine as well as shoulders and knees. It can be effective if all or part of your problem is the result of ligament or general connective tissue damage and laxity. If your problem is due to anything else, it won't really help. It has helped me some, but, as I have other pain generators, I don't expect it to be a "cure all".

The theory behind prolotherapy is simple: reinforce connective tissue by stimulating the production of scar tissue in key areas. The scar tissue is similar in composition to most connective tissue and works as a reinforcement. The stimulation is provided by injection of an irritating chemical the causes a local inflammatory response. Additional stimulation can be achieved by using the injection needle to poke holes in the blood-rich periosteum cover on bones near connective tissue attachment points. This second method would be analagous to microfracture or abrasion arthroplasty minus the stem cells.

A new variant on prolotherapy uses platelet-rich plasma from your own blood to stimulate a healing response rather than the standard proliferant solutions. This "platelet rich plasma" treatment is currently being used at the Stone Clinic in San Francisco to improve the surgical outcomes for meniscal transplant and collagen meniscal implants in knees.

There have been several controlled studies to prove-disprove the effectiveness of prolotherapy. Some say it works, other say it does not. I do know that, just like surgery, technique is important and you want to go to someone with lots of prolo experience if you want the best chance of it helping at all.

Other than cost and the discomfort of getting a zillion injections, the technique is relatively safe. Injections should not be anywhere near nerves or other structures you don't want scarred. If someone proposes to perform prolotherapy in a disc interior, I'd think twice.

Best of Luck!
Laura