Advancing a Promising Treatment for Chronic Pain

Prolotherapy, an injection-based outpatient therapy practiced for over a century, offers the potential for effective, non-opioid management of pain due to osteoarthritis, overuse tendon disorders and back pain.

When performed by appropriately trained clinicians, prolotherapy can help decrease the impact of chronic musculoskeletal pain.

The UW Prolotherapy Education and Research Lab (UW PEARL), a collaboration between primary care and specialty clinicians based at the University of Wisconsin Department of Family Medicine and Community Health (DFMCH), furthers education and research on this promising treatment.

Why Focus on Prolotherapy?

  1. Chronic musculoskeletal pain has grown to epidemic levels.
  2. Existing therapies, including opioid medications, often do not address the root cause of chronic pain and may result in unwanted side effects.
  3. National organizations such as the Agency for Healthcare Research and Quality and the Institute of Medicine have called for new therapies for these conditions.
  4. Prolotherapy is understood to stimulate natural healing processes and is a promising modality at the intersection of conservative care and surgical intervention.

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?

UW PEARL is an interdisciplinary collaboration of clinicians conducting prolotherapy-related basic and clinical science, and providing education about prolotherapy. Founded by David Rabago, MD, in 2015, it is now directed by UW family physicians Michael Weber, MD and Jared Dubey, DO; Dr. Rabago continues in a consultant role.

Researchers associated with UW PEARL 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.

PEARL Successes

Scientific Papers

LANDMARK 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. (Link)

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.

Jensen KT, Rabago D, Best TM, Patterson J, Vanderby R; Response of Knee Ligaments to Prolotherapy in a Rat Injury Model; Am J Sports Med; 26: 816-823; 2008. PMID: 18310313

Jensen KT, Rabago D, Best TM, Patterson J, Vanderby R; Early Inflammatory Response of Knee Ligaments to Prolotherapy in a Rat Model; J Ortho Res; 36:1347-57, 2008. PMID: 18240327

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.

Jeff Patterson: A Prolotherapy Advocate and Mentor

Jeff Patterson, DO

Our work began in 2004 with the visionary leadership of Jeff Patterson, DO, who refined the practice of prolotherapy and was a tireless advocate for its use.

His mentorship led to several successful clinical trials reporting prolotherapy’s effectiveness.

Sadly, Dr. Patterson’s unexpected death in 2014 cut short his participation. To continue this transformative research, we have formalized our efforts as UW PEARL.

How Can You Help?

Your donation will allow us to continue this important work.

Donor funding will specifically support clinician education and translational, team-oriented research of prolotherapy for knee osteoarthritis, overuse tendon disorders, and back pain.

For more information on making a donation, contact Jerome Garrett, MBA, FACHE, Director, Business Services.