Injury type: Acute / Chronic

Category: Medical Options

Rating: No research


What is it?

Prolotherapy is an injection treatment to strengthen weakened ligaments and muscular attachment points, and is used most commonly to treat musculoskeletal complaints.

How does it work?

Prolotherapy involves the injection of glucose or another irritating solution into the effected ligaments or tendons, which may lead to local inflammation. The localised inflammation triggers a wound healing cascade, resulting in the laying down of new collagen; the material that ligaments and tendons are comprised of. New collagen shrinks as it matures and this shrinking tightens the structure that was injected, making it stronger and stabilising the surrounding structures.

Is it effective?

While there no research studies examining the use of prolotherapy on whiplash associated symptoms, evidence on the effectiveness of prolotherapy in non-specific neck pain or spine related pain has been documented.

A recent systematic review of existing clinical practice guidelines1 found that prolotherapy was not recommended in general neck pain guidelines. Another literature review2 investigated the effect of prolotherapy in patients with axial and radicular spine pain. Collectively, positive outcomes were associated with the use of prolotherapy, particularly at intradiscal, facet joint, epidural and sacroiliac joint, are primarily supported by low level research studies (i.e. Level III and/or IV). Despite two high level research studies (i.e. Level I) reported findings associated with epidural or facet joint prolotherapy, the outcomes remained conflicting with only one study indicated a significant reduction in pain scores, which occurred within the first 48 hours for epidural prolotherapy but become insignificant afterwards.

Are there any disadvantages?

Prolotherapy is an invasive procedure and can involve some risk. Minor adverse effects may include some bruising, pain, stiffness and swelling in the area after treatment.

Where do you get it?

Many different practitioners may provide prolotherapy including doctors, specialists, chiropractors, physiotherapists, as long as they are appropriately qualified to deliver such treatments.

Recommendations

The use of prolotherapy for whiplash cannot be recommended due to a lack of scientific evidence. More research is required.