A Shot in the Back for Back Pain

Imagine suffering years and years of back pain with no relief. That's what this group of 110 patients had in common. They'd had an average of 14 years of back pain. They were recruited to be part of a study using prolotherapy as a treatment.

Prolotherapy is the injection of a solution into ligaments. The injection may have glucose, glycerin, or phenol in it, along with a local anesthetic such as lidocaine. The idea behind the treatment is to increase the growth of collagen fibers in the weak ligaments.

The subjects were put into different groups. They either got a real injection into the spinal ligaments in the problem area, or they got a placebo injection. The placebo was a saline (salt) solution. The groups were also either given a special exercise program or just told to do normal activity.

Everyone was injected every two weeks for a total of six treatments. Injections were repeated at four and six months if the patients were still in pain. Anyone who relapsed could get another injection between six and 12 months. All patients were followed for two years.

Everyone got pain relief from the injections whether the injections were real or placebo. And the good results lasted up to two years. There wasn't much difference between the exercise group and the normal activity group. Other measures such as mental health and use of drugs weren't different either.

The authors conclude that ligament injections work no matter what solution was used or whether patients exercised or not. The researchers compared their study with the results from other similar studies. They don't know why they got the results they did. They suggest the following theories: