Effects of Intraarticular Prolotherapy on Sacroiliac Joint Pain

Lee, Jae Dam; Lee, Dae Wook; Jeong, Chaehwan; Lee, Hyung Gon; Yoon, Myung Ha; Kim, Woong Mo

doi:10.3344/kjp.2009.22.3.229

Cited by 6 publications

(9 citation statements)

References 22 publications

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“…Conservative therapeutic options such as IAS injections, NSAIDs, physical therapy, and opioids are commonly used to manage chronic LBP emanating from the SIJ region. These therapies are fraught with performance limitations, [3][4][5][6][7]9] and may promote adverse events for patients [6,9]. Surgical fusion is highly invasive, may not be efficacious [8], and can be accompanied by complications such as infection [37][38][39], non-union [38][39][40][41], further surgery (hardware removal, scar tissue excision, second fusion) [38,40], and intraoperative fracture [40].…”

Section: Discussionmentioning

confidence: 99%

“…To combat this ailment, patients may engage in conservative therapies, which are non-invasive, but have limited effectiveness. Indeed, the utility of intraarticular joint steroid (IAS) injections or prolotherapy is equivocal [3][4][5], nonsteroidal anti-inflammatory drugs (NSAIDs) have short-term effectiveness but present adverse effects [6], while in patients with chronic non-specific LBP, the McKenzie physical therapy method was just slightly more effective than a placebo for pain [7]. Surgical fusion is an invasive intervention that may or may not resolve patients SIJ-derived LBP [8].…”

Section: Introductionmentioning

confidence: 99%

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Reduction of opioid intake after cooled radiofrequency denervation for sacroiliac joint pain: a retrospective evaluation up to 1 year

Tinnirello

2020

Korean J Pain

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Background: Opioids can present intolerable adverse side-effects to patients who use these analgesics to mitigate chronic pain. In this retrospective analysis, cooled radiofrequency (CRF) denervation was evaluated to provide pain and disability relief and reduce opioid use in patients with sacroiliac joint (SIJ) derived low back pain (LBP). Methods: Twenty-seven patients with pain from SIJ refractory to conservative treatments, and taking opioids chronically (> 3 mo), were included. Numeric rating scale (NRS) and Oswestry disability index (ODI) scores were collected at 1, 6, and 12 months post-procedure. Opioid use between baseline and each follow-up visit was compared for the entire group and for those who experienced successful (pain reduction ≥ 50% of baseline value) or unsuccessful CRF denervation. Results: Severe initial mean pain (NRS score: 7.7 ± 1.0) and disability (ODI score: 50.1 ± 9.0), and median opioid use (morphine equivalent daily dose: 40 ± 37 mg) were significantly reduced up to 12 months post-intervention. CRF denervation was successful in 44.4% of the patients at 12 months. Regardless of procedure success, patients demonstrated similar opioid reductions and changes in opioid use at 12 months. Two patients (7.4%) experienced neuritis following CRF denervation. Conclusions: CRF denervation of the SIJ can safely elicit pain and disability relief, and reduce opioid use, regardless of intervention success. Future studies may support CRF denervation as a dependable therapy to alleviate opioid use in patients with SIJ-derived LBP and show that opioid use measurements can be a surrogate indicator of pain.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Reduction of opioid intake after cooled radiofrequency denervation for sacroiliac joint pain: a retrospective evaluation up to 1 year

Tinnirello

2020

Korean J Pain

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“…Case series have documented the efficacy of prolotherapy for many ligament injuries: the sacroiliac joint [187][188][189], lower back [190,191], neck [192,193], shoulder [194], elbow [195], knee [196,197], temporomandibular joint [198,199], and other articulations [200,201]. …”

Section: Prolotherapymentioning

confidence: 99%

Ligament Injury and Healing: A Review of Current Clinical Diagnostics and Therapeutics

Hauser¹

2013

TOREHJ

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Ligament injuries are among the most common causes of musculoskeletal joint pain and disability encountered in primary practice today. Ligament injures create disruptions in the balance between joint mobility and joint stability, causing abnormal force transmission through the joint, which results in damage to other structures in and around the joint. The long-term consequence of nonhealed ligament injury is osteoarthritis, the most common joint disorder in the world today.Ligaments heal through a distinct sequence of cellular events that take place in three consecutive stages: an acute inflammatory phase, a proliferative or regenerative phase, and a tissue remodeling phase. The process can take months to resolve itself, and despite advances in therapeutics, many ligaments do not regain their normal tensile strength.Various diagnostic procedures have been used to determine and assess ligament injury. Traditionally, MRI and X-rays have been the most utilized techniques; however, because ligaments do not show up clearly with these devices, there have been many false positives and negatives reported due to inconclusive or inaccurate readings. Newer technologies, such as ultrasound and digital motion X-ray, are able to provide a more detailed image of a ligament's structure and function.Numerous strategies have been employed over the years attempting to improve ligament healing after injury or surgery. One of the most important of these is based on the understanding that monitoring early resumption of activity can stimulate repair and restoration of function and that prolonging rest may actually delay recovery and adversely affect the tissue's response to repair. Likewise, there is a shift away from the use of steroid injections and nonsteroidal antiinflammatory medications. Although these compounds have been shown effective in decreasing the inflammation and pain of ligament injuries for up to six to eight weeks, their use has been shown to inhibit the histological, biochemical, and biomechanical properties of ligament healing. For this reason their use is cautioned against in athletes who have ligament injuries. Such products are no longer recommended for chronic soft tissue injuries or for acute ligament injuries, except for the shortest possible time, if at all.Regenerative medicine techniques, such as prolotherapy, have been shown, in both case series and clinical studies, to resolve ligament injuries of the spine and peripheral joints. More research and additional studies are needed to better assess ligament injuries and healing properties.

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“…Results demonstrated improvements in pain and disability scores from baseline in both groups; however, the effects of the dextrose group lasted longer than the steroid group [125]. In another study, intraarticular dextrose prolotherapy to the sacroiliac joint gave significant improvements in the numeric rating scale and Oswestry Disability Index compared to baseline (p<0.01) [126].…”

Section: Effective Applications Of Prolotherapy In the Treatment Of Cmentioning

confidence: 93%

Structural Basis of Joint Instability as Cause for Chronic Musculoskeletal Pain and Its Successful Treatment with Regenerative Injection Therapy (Prolotherapy)

Hauser¹,

Blakemore²,

Wang³

et al. 2014

TOPAINJ

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Joint dysfunctions and associated musculoskeletal pain are among the most common medical complaints presented to clinicians. Ligaments are collagenous fibrous structures that are primarily responsible for maintaining smooth joint motion, restraining excessive joint displacement, and providing stability across the joint. Ligaments also act as sensory organs for the joints and have significant input to pain sensation. When ligaments are subjected to forces beyond their normal range of motion, injury and failure occur, resulting in joint laxity (looseness or instability), and subsequent disruptions in the balance between joint mobility and joint stability. These dysfunctions can result in joint pain and the development of osteoarthritis. Several strategies have been employed over the years in attempts to improve joint instability from ligament injury; however, some of the standard therapeutic approaches (drugs, corticosteroid injections, and surgery) employed to address these problems have not been very effective because they often do not address the underlying cause of the problems, and in fact can inhibit ligament healing and restoration. For these reasons, there is current and growing interest among patients and clinicians in prolotherapy, an alternative therapeutic modality that can reduce or eliminate pain by stimulating the natural regenerative processes in and around the joint to facilitate the restoration of degenerated ligaments and tendons to a healthy state, improving joint support, function and reducing pain. This review presents current evidence from clinical studies demonstrating that prolotherapy is a significant and effective alternative treatment modality for people with ligament-related injuries and resultant joint instability.

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Effects of Intraarticular Prolotherapy on Sacroiliac Joint Pain

Cited by 6 publications

References 22 publications

Reduction of opioid intake after cooled radiofrequency denervation for sacroiliac joint pain: a retrospective evaluation up to 1 year

Reduction of opioid intake after cooled radiofrequency denervation for sacroiliac joint pain: a retrospective evaluation up to 1 year

Ligament Injury and Healing: A Review of Current Clinical Diagnostics and Therapeutics

Structural Basis of Joint Instability as Cause for Chronic Musculoskeletal Pain and Its Successful Treatment with Regenerative Injection Therapy (Prolotherapy)

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