When Prolotherapy Does Not Work

David K. Harris, MDDavid K. Harris, MD

Prolotherapy is effective in markedly reducing or curing musculoskeletal pain 80-90% of the time. Many end-stage medical problems are worth a trial of Prolotherapy, especially if the only alternative is a destructive or permanent alteration of a joint, such as a surgical fusion or the destruction of a nerve. The greater the anatomical injury, the more difficult it is resolving the problem.

There are several reasons why Prolotherapy may not resolve a problem:

1) Not enough treatments were attempted

Usually a positive response is seen in 2-3 treatments, but may take 4-6 or more.

2) The solution used was not strong enough

Typically, a mild solution is used first, and if the response is insufficient, a stronger solution is used after 2-3 treatments.

3) The points treated were not the source of the pain

Usually, it is fairly clear on examination from where the pain originates, but some structures are not easily provoked with a finger or thumb because of the depth. In such a case, the referral pattern helps to locate the injured structure, but the patterns often overlap. A thorough reassessment every visit or two is needed to ensure that the correct points are being treated.

4) The patient is taking anti-inflammatory medication

Such medicine inhibits a complete response. The only such medicine which we accept is a low-dose aspirin to prevent cardiac (heart attack, angina) or neurological (stroke) problems. Progress may be made despite these medicines but is likely to be delayed and reduced.

5) The patient has an underlying healing deficiency

This may be from an immune system dysfunction, rheumatoid illness, chronic infection, nutritional deficit, or hormonal deficiency. The common issues are hypothyroid, Testosterone deficiency, estrogen or progesterone deficiency, adrenal insufficiency, bowel infection with yeast, among others. These same conditions appear to underlie fibromyalgia and Chronic Fatigue Syndrome. Further investigation is warranted after 4-6 treatments if the response is poor.

© David Harris, M.D.
The opinions expressed here does not necessarily reflect the views of the other member physicians of getprolo.com.