People with lower back pain often receive steroid injections to ease inflammation and suffering. The number of steroid shots you can get is limited, however, because cortisone-type drugs can slow wound healing and speed bone deterioration.

A new study from Johns Hopkins suggests that injections of saline or local anesthetic may work about as well as corticosteroid injections. The mere act of injecting fluid around the spinal column appears to accelerate healing.

These epidural injections were twice as effective at alleviating as intramuscular injections of steroids. It is encouraging to have evidence that this sort of prolotherapy can be effective without the damaging side effects of powerful corticosteroids.

[Anesthesiology, Oct., 2013]

Some People’s Pharmacy visitors have shared their experience with prolotherapy for joints. Bocabayla said: I can tell you from personal experience prolotherapy works. I had muscle and ligament pains that started from an injured knee. The pains in the knee got better, leaving me with just the muscle and ligament pain.

After having the dextrose shots over a 3 week period, directly into the areas of pain, a month later, those pains are all but forgotten.”

But the procedure is not universally successful. (What in medicine is?) CFP related: Prolotherapy treatment did not work for me at all. It was the last treatment I tried before going ahead with total knee replacement surgery. I had several injections directly into the pain area 4 to 5 weeks apart that did absolutely nothing for my knee pain. I previously had several knee injections of SYNVISC and SUPARTZ over the years that worked for a while and basically delayed the need for surgery. However, after a while these injections stop working also.

“I am not a big fan of surgery, but with my replaced knee I can ski and play tennis with no pain; however the recovery was not easy and required a lot of physical therapy. That’s the trade off, I guess. Anyway, these injections will not build up new knee cartilage.”


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  1. Diane
    Houston, TX

    Prolotherapy has been a life saver for me. 19 years after having a very successful spinal fusion, my back began to hurt. Acupuncture did not help and I did not want a cortisone injection. Prolotherapy worked amazingly well. After about five years, I needed it again and it helped immensely. I have no pain in my back! After 6 months of unresolved pain, I then used it for a mildly torn rotator cuff and, again, it miraculously fixed my shoulder. I am a real believer in prolotherapy. Your column today – 7/24/17 – did not sing its praises adequately, in my opinion.

  2. VFC

    Trigger-point dry needling is a technique similar to acupuncture except meridians & energy flow is not the target. An acupuncture needle is inserted into tight muscle knots, which interrupts the pain signal to the brain & releases Factor P, involved in neurotransmissions. My PT says when the needle twitches, he knows he has hit the right spot!
    He will often attach electrodes and do electric stimulation to these needles. That part feels good. It takes about a week for the full effect even though I do feel immediate pain reduction. I am really a needle-phobe, but after one has had chronic pain you get braver and it really doesn’t hurt so much that I am unwilling to repeat when necessary. Not as bad as electrolysis!
    In Georgia physical therapists are able to perform this, just check in your state. He has even helped post hip replacement patients function better.

  3. Rebecca Gulickson

    What is trigger-point dry needling as mentioned in above comment?

  4. VFC

    I have had great success with trigger-point dry needling for my chronic low back & sciatic pain. Same thing as prolotherapy but with nothing introduced into your body. Better than Percocet and epidural steroid injections, with none of the complications. I require a “tune-up” every 3-4 months but it is well worth it.

  5. Nancy Davison

    I am a licensed acupuncturist (13 yrs) and physical therapist. If “saline” helps why not just plain acupuncture? I have had success placing needles at the sight of the pain AND adding gentle movement (based on Qigong) is an essential tool in relieving back pain. If movement isn’t happening, patients have a tendency to “guard” against moving that may cause pain. Releasing spasms can be a major part of releasing pain. Where there is movement(the right kind of movement), spasms have difficulty surviving.
    Love your show.

  6. Donnie

    People with corn allergy can have severe reactions to dextrose in shots, and every other form. I am allergic to corn, and have to avoid anything that contains dextrose.

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