Mid-Week Conundrum: Prolo or Pro-no?

Ahhhh, I’m back at the old crossroads of evaluating ways to provide more lasting relief from this chronic SI injury. With my frustration levels reaching new heights, I am back in the same conversation about whether prolotherapy is a suitable treatment plan for me.

What’s prolotherapy? It’s one or a series of injections of an irritant solution that is intended to create an inflammatory response. It increases collagen formation and protein synthesis, basically creating a scar tissue that can reduce ligament laxity.  Doesn’t that all just sound scientific-y and wonderful?

Well that’s a winning slogan if I ever saw one.

Unfortunately, as with most treatment paths, it carries with it a fair deal of controversy around long term (and even short term) effectiveness, both sides of which are largely anecdotal. You know the drill: someone’s cousin’s sister had it and it made the problem twice as bad, another person’s dog-walker’s husband had it and he ran a marathon the next week. In the wake of such compelling evidence, how is one expected to make a decision?

I tried to do research, but realized I hate research. After reading a grand total of six articles, including some long and incredibly dry, small sample medical studies, this is what I have to offer for my own consideration:

–There appear to be few long-term, large sample-size studies of the impact of prolotherapy, particularly on SI joint pain. Strike one.

–It hurts like a bitch. Well, yes, I imagine that sticking a needle into a joint, and then aggravating the hell out of it with an irritant solution will do that. As the scar tissue forms, most people experience pain similar to their initial injury.  Although I can handle that, and have a number of times since this injury, I still give this a strike two.

–For some, it has caused long-term pain relief and the ability to resume normal activities after just a few treatments. One point in its favour.

–It may create a softer and less dense form of collagen tissues, which  may prevent the formation of denser and more effective collagen forms. Evidently, this could someone cause more long-term issues, though why isn’t clear to me. Strike three.

–Severe side effects of rash, infection or nerve damage can occur, but this seems to be more about the individual themselves or hack doctors administering the solution. I consider this a low risk and therefore it is neither a strike nor a point in favour.

–The collagen tissues formed can reduce ligament laxity, giving the illusion and feel of greater joint stability. Much like the pain reduction, this can lead to a return to more intense activity. Two points in favour!

–It’s relatively straight-forward and non-invasive. It’s a few injections. For SI joints, it’s not near your spinal cord so there’s no scary ‘I-don’t-want-a-needle-near-my-spinal-cord’ moments. Three points in favour.

We have a tie here. If anyone has had an experience with prolotherapy, good or bad, please chime in–and I will even accept the anecdotal tale of your long-lost best friend’s sister’s husband.  I need all the help I can get here.



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