Treatment Outcomes

Patients received an average of 4.4 prolotherapy treatments per ankle. The average time of follow-up after their last prolotherapy session was twenty-one months.

Patients were asked to rate their pain and stiffness levels on a scale of 1 to 10 on a visual analog scale (VAS) with 1 being no pain/stiffness and 10 being severe crippling pain/stiffness. The 19 ankles had an average starting pain level of 7.9 and stiffness of 5.4. Ending pain and stiffness levels were 1.6 and 1.5 respectively (See Figures 2a and 2b). Ninety-five percent reported a starting pain level of 6 or greater, while none had a starting pain level of four or less. After prolotherapy none had a pain level of 6 or greater, while 90% had a pain level of two or less.

Figure 2a. Pain levels before and after receiving Hackett-Hemwall Prolotherapy in 19 patients with unresolved ankle pain.

Figure 2b. Stiffness levels before and after receiving Hackett-Hemwall Prolotherapy in 19 patients with unresolved ankle pain.

One hundred percent of patients stated their pain and stiffness was better after prolotherapy. Over 78% reported that pain and stiffness since their last prolotherapy session had not returned. Ninety percent of patients stated prolotherapy relieved them of at least 50% of their pain (See Figure 3). One hundred percent of patients experienced at least 25% pain relief with prolotherapy. In regard to pain medication usage, before prolotherapy the average patient was taking 1.0 pain medications but this decreased to only one patient needing one pain medication after prolotherapy. No one not on medications when their prolotherapy sessions ended had to subsequently return to taking medications because of increased ankle pain.

Figure 3. Percent of patients who reported 50% or greater pain relief after receiving Hackett-Hemwall dextrose Prolotherapy.

Patients ranked their crepitation (crunching) on a scale of 1 to 10 with 1 being no crepitation and 10 being severe crepitation. Before prolotherapy, the average crepitation was rated as a 3.2, but after prolotherapy 1.3. Forty-seven percent reported at least 75% of normal motion before prolotherapy, but this increased to 95% percent of normal motion after prolotherapy (See Figure 4).

Figure 4. Starting and ending range of motion before and after receiving Hackett-Hemwall dextrose Prolotherapy in 19 patients with ankle pain.

In regard to quality of life issues prior to receiving prolotherapy, 74% noted problems with walking, but after prolotherapy only 37% experienced compromised walking. In regard to exercise ability before prolotherapy, only 47% could exercise longer than 30 minutes, but after prolotherapy this increased to 90% (See Figure 5).

Figure 5. Starting and ending ability to exercise before and after receiving Hackett-Hemwall dextrose Prolotherapy in 19 patients with ankle pain.

Prior to prolotherapy, 47% of patients expressed feelings of depression and anxiety. After prolotherapy, only 5% expressed depressed feelings and 16% anxiety (See Figure 6 and Figure 7). In regard to sleep, 79% of patients felt pain interrupted their sleep. After prolotherapy, 74% experienced improvements in their sleeping ability.

Figure 6. Starting and ending depression levels before and after receiving Hackett-Hemwall dextrose Prolotherapy in 19 patients with ankle pain.

Figure 7. Starting and ending anxiety levels before and after receiving Hackett-Hemwall dextrose Prolotherapy in 19 patients with ankle pain.

To a simple yes or no question, “Has prolotherapy changed your life for the better,” all of the patients treated answered “yes.” One hundred percent of patients knew someone who had received prolotherapy. Sixty-seven percent came to receive their first prolotherapy session because of the recommendation of a friend. One hundred percent of patients have recommended prolotherapy to someone.

RESULTS FOR THOSE WHOSE MDs SAID NO OTHER TREATMENT OPTIONS AVAILABLE

As previously noted, 63% of patients (12) prior to prolotherapy were told that there were no other treatment options for their pain. As a group they suffered with pain on average 53 months. In analyzing these patients, their starting average pain level was 8.0 and after prolotherapy 4.3. Prior to prolotherapy, they rated their ankle stiffness and crunching as 5.9 and 3.5 respectively. After prolotherapy stiffness and crunching were 1.4 and 1.3, respectively. Ten of twelve (83%) experienced 50% or greater pain relief. Before prolotherapy all twelve felt that their exercise ability was compromised. After prolotherapy, 75% felt their exercise ability was completely back to normal.

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 for the 19 patients and the subgroup of 12 patients who were told by their medical doctor(s) that there were no other treatment options available. Using the paired t-test, all p values for pain and stiffness for the two groups reached statistical significance at the p < 0.0007 level or less (See Table 2).

Table 2. Summary of results of Hackett-Hemwall dextrose Prolotherapy ankle study.