Advancing a Promising Treatment for Chronic Pain
How can clinicians decrease the devastating impact of chronic musculoskeletal pain due to osteoarthritis, overuse tendon disorders, and back problems? Is there a safe, effective outpatient procedure for treating these disabling conditions?
Prolotherapy, an injection-based therapy practiced for over a century, offers the potential for effective management. We have created the UW Prolotherapy Education and Research Lab (UW PEARL), a collaboration between primary care and specialty clinicians, to further education and research on this promising treatment.
Why Focus on Prolotherapy?
- Chronic musculoskeletal pain has grown to epidemic levels.
- Existing therapies, including opioid medications, often do not address the root cause of chronic pain and may result in unwanted side effects.
- National organizations such as the Agency for Healthcare Research and Quality and the Institute of Medicine have called for new therapies for these conditions.
- Because prolotherapy stimulates natural healing processes, it is an important step between conservative care and surgery.
Evidence suggests that prolotherapy is effective for chronic musculoskeletal pain due to osteoarthritis, overuse tendon disorders and back problems—but more research is urgently needed.
What is UW PEARL?
Directed by David Rabago, MD, a National Institutes of Health-trained clinician-scientist, UW PEARL is an interdisciplinary collaboration of clinicians evaluating prolotherapy for the treatment of chronic musculoskeletal pain.
We have conducted research on knee osteoarthritis, tennis elbow and other overuse tendon disorders. Through our education and research efforts, we hope to increase understanding of the appropriate use of prolotherapy.
- We work closely with the Hackett Hemwall Patterson Foundation (HHPF), an international leader in the practice and teaching of clinical prolotherapy, and collaborate with the HHPF on annual prolotherapy education and research conferences.
- We have published numerous scientific reports on the effectiveness of prolotherapy for osteoarthritis and tennis elbow.
- While we have received federal, state and local funding to conduct this research, further efforts require additional support not available through granting organizations.
SEMINAL PAPER: Rabago D, Patterson JJ, Mundt M, Kijowski R, Grettie J, Segal NA, Zgierska A. Dextrose prolotherapy for knee osteoarthritis: a randomized controlled trial. Ann Fam Med. 2013 May-Jun;11(3):229-37. PMID: 23690322.
Rabago D, Mundt M, Zgierska A, Grettie J.Hypertonic dextrose injection (prolotherapy) for knee osteoarthritis: Long term outcomes. Complement Ther Med. 2015 Jun;23(3):388-95. PMID: 26051574.
Rabago D, Patterson JJ, Mundt M, Zgierska A, Grettie J, Fortney L, Kijowski R. Dextrose and morrhuate sodium injections (prolotherapy) for knee osteoarthritis: A prospective open label trial. J Altern Complement Med. 2014;20(5):383-91. PMID: 24635447.
Rabago D, Kijowski R, Woods M, Patterson JJ, Mundt M, Zgierska A, Grettie J, Lyftogt J, Fortney L. Association between disease-specific quality-of-life and magnetic resonance imaging outcomes in a clinical trial of prolotherapy for knee osteoarthritis. Arch Phys Med Rehabil. 2013;94(11):2075-82. PMID: 23850615.
Rabago D, Lee KS, Ryan M, Chourasia AO, Sesto ME, Zgierska AE, Kijowski R, Grettie J, Wilson JJ, Miller D. Hypertonic dextrose and morrhuate sodium injections (prolotherapy) for lateral epicondylosis (tennis elbow): results of a single-blind, pilot-level randomized controlled trial. Am J Phys Med Rehab. 2013;92(7);587-96. PMID: 23291605.
Rabago D, Zgierska A, Fortney L, Kijowski R, Mundt M, Ryan M, Grettie J, Patterson JJ. Hypertonic dextrose injections (prolotherapy) for knee osteoarthritis: results of a single-arm uncontrolled study with 1-year follow-up. J Altern Complement Med. 2012;18(4):408-14. PMID: 22515800.
Rabago D, Yelland M, Patterson J, Zgierska A. Prolotherapy for chronic musculoskeletal pain. Am Fam Physician. 2011;84(11):1208-1210. PMID: 22150651.
Rabago D, Kijowski, RX, Zgierska A, Yelland M, Scarpone MA. Magnetic resonance imaging outcomes in a randomised controlled trial of prolotherapy for lateral epicondylosis. Int Musculoskel Med.2010;32(3):117-123. (http://www.maneyonline.com/doi/abs/10.1179/175361410X12652805808395)
Rabago D, Slattengren A, Zgierska A. Prolotherapy in primary care practice. Prim Care. 2010 Mar;37(1):65-80. PMID: 20188998.
Rabago D, Best TM , Zgierska A , Zeisig E , Ryan M, Crane D. A systematic review of four injection therapies for lateral epicondylosis: prolotherapy, polidocanol, whole blood and platelet-rich plasma. Br J Sports Med. 2009;43:471-481. PMID: 19028733.
Rabago D, Best T, Beamsley M, Patterson J. Systematic review of prolotherapy for chronic musculoskeletal pain. Clin J Sport Med 2005;15(5):376-380. PMID: 16162983.