Results

Treatment Outcomes

Patients received an average of 4.5 Prolotherapy treatment sessions. The average time of follow-up after their last Prolotherapy session was 10 months. Prior to Prolotherapy the average patient was taking 1.1 medications for pain, but this decreased to 0.2 after Prolotherapy. Thirteen patients were able to stop taking medications or decrease them because of Prolotherapy. One of the 26 patients not on pain medications following Prolotherapy had to resume since stopping Prolotherapy.

Patients were asked to rate their levels of crunching, stiffness, and pain on a scale of 0 to 10, with 0 being no crunching/stiffness/pain and 10 being severe/crippling crunching/stiffness/pain. The average starting crunching level was 5.2, the average starting stiffness level was 7.2, and the average starting pain level was 7.6. Following Prolotherapy, patients reported an average ending crunching level of 1.5, an ending stiffness level of 2.5, and an average pain level of 1.3. (See Figure 3.) The before and after Prolotherapy pain levels are seen in Figure 4. Ninety-one percent of patients felt Prolotherapy gave them 50% or greater pain relief, and 71% felt the pain relief was greater than 75%. Of patients who still reported pain, 21% felt they stopped the Prolotherapy sessions too soon.

Before Prolotherapy, 6% of patients had normal range of motion, but that increased to 24% after Prolotherapy. Prior to Prolotherapy, 9% of patients had only a slight restriction of motion (75% or greater of normal range of motion), but this increased to 77% after Prolotherapy.

In regard to activities of daily living (ADL), 50% of participants said their overall disability was 50% or greater, due to pain. After Prolotherapy, none of the participants had an overall disability of greater than 50%. Seventeen percent of patients had an overall disability of 25% or less, but after Prolotherapy this increased to 81%. Specifically, before Prolotherapy 23% felt that in regard ADLs (including bathing and dressing self), they were dependent on someone else, but after Prolotherapy 100% of patients were independent in ADLs. Concerning another important quality of life issue, only two (6%) out of the 34 patients reported having normal walking ability prior to treatment, but after treatment this increased to 20 (59%). (See Figure 5.)

Before receiving Prolotherapy, 53% of the patients reported feelings of depression, and 62% reported feelings of anxiety. After receiving Prolotherapy, 94% were no longer depressed and 71% were no longer anxious. Prior to Prolotherapy, 76% of the patients reported hindered sleep due to chronic pain. After receiving Prolotherapy, 79% of patients noticed that their ability to sleep had much improved.

When patients were asked if Prolotherapy had changed their life for the better, 91% answered “yes.” Only one out of the 34 patients said Prolotherapy did not help their pain. Three out of 34 (9%) received less than 25% pain relief with Prolotherapy. Seventy-nine percent of the patients answered “yes” to having enough relief after their Prolotherapy treatment that they felt they will never need surgery. For the seven patients (21%) who answered “no” to that question, three felt they will need surgery. The four remaining patients noted greater than 50% pain relief, but plan to receive additional Prolotherapy treatment in the future. Of interest, is 100% of the patients treated stated that they have recommended Prolotherapy to someone else.

Statistical Analysis

A matched sample paired t-test was used to calculate the difference in responses between the before and after measures for pain and stiffness. The paired sample t ratio was computed on this pre-post Prolotherapy study. The paired t ratios for all the groups were highly significant, using N pairs minus one as the degrees of freedom. For the entire 34 participants the paired t ratio was significant for pain reduction (t = 16.085, p<.0000001). For the analysis on stiffness resolution, the paired t was also highly significant (t = 11.323, p<.0000001). In summary, for the 34 participants in this study, their pain and stiffness was significantly reduced at the p<.0000001 level by Hackett-Hemwall dextrose Prolotherapy.