Chronic Shoulder Pain Results

Prolotherapy Research - Chronic Shoulder Pain Results

Patient Characteristics

Table 1 From a total of 122 patients with unresolved shoulder pain whose charts were analyzed and who were interviewed via telephone, 94 met the inclusion criteria. The main reasons for exclusion were inability to come for treatments primarily due to travel/distance (42%), stopped treatments because of their medical doctor’s recommendation (i.e. needed treatments more frequently or other medical problems) or on their own (31%), inability or unwillingness to answer survey (16%), and other (11%).

A total of 94 shoulders from 90 people met the inclusion criteria. Of these, 60% were female and 40% were male. The average age of the patients was 54 years-old. Patients had an average of fifty-three months of pain, 33% had pain for greater than six years, and 19% had pain for between four and six years. Seventy-six percent received their first Prolotherapy treatment primarily because of the recommendation of a friend. The average patient saw 2.9 MD’s before receiving Prolotherapy. Twenty-one percent were told by one of their physicians that surgery was the only answer to their pain problem, and 39% of patients were told by their physicians that there were no other treatment options for their chronic pain. Twenty-eight percent were taking one pharmaceutical drug for pain. Thirty percent were taking two or more drugs for pain. (See Table 1.)

Treatment Outcomes

Patients received an average of 3.8 Prolotherapy treatments per shoulder. The average time of follow-up after their last Prolotherapy session was 20 months.

Patients were asked to rate their pain, stiffness, and crunching sensation on a scale of 1 to 10. With 1 being no pain/stiffness/crunching and 10 being severe/crippling pain/stiffness/crunching. The 94 shoulders had an average starting pain level of 7.1, starting stiffness level of 5.4, and starting crunching level of 3.9. Patients were asked to rate their mobility on a scale of 1 to 7, with 1 being no motion, 2 through 5 were percentages of normal motion with 2 being 1-24%, 3 being 25-49%, 4 being 50-74% and 5 being 75-99% of normal motion. Normal motion was 6, and 7 was excessive motion or hypermobility. The average starting mobility level was 3.7.

The patients reported that their ending pain level after Prolotherapy was 2.3, ending mobility 5.2, ending stiffness 2.0, and ending crunching 1.9. Eighty-eight percent started with greater than serious pain (5 or more) but after Prolotherapy only 9.6% had that much pain. The percentage of patients who had a decrease in their pain level was 97%. (See Figure 2.) More than 86% of patients had minimal stiffness when finished with treatments, but only 28% started with it. (See Figure 3.) Ninety-seven percent of patients finished with 50% or greater of normal motion, whereas, prior to Prolotherapy only 58% had that amount of motion. Seventy percent of patients who were on prescription pain medications were able to stop taking them after Prolotherapy. Another 17% were able to decrease the amount needed by 75% or more. No patient had to increase their pain medication usage since receiving Prolotherapy. Sixty-six percent of the patients receiving other pain management care were able to stop after Prolotherapy. Another 10% were able to decrease it by 75% or more.

In regard to quality of life issues prior to receiving Prolotherapy, 81% of patients felt they had some type of overall disability before Prolotherapy, but only 20% felt so after it. (See Figure 4.) Before Prolotherapy, 12% noted some dependency on another person for activities of daily living which decreased to 4% after Prolotherapy. In regard to athletic ability prior to Prolotherapy, 28% said it was totally compromised (couldn’t do any athletics), 15% ranked it as severely compromised (less than 10 minutes), 18% ranked it as very compromised (less than 30 minutes), in all 85% ranked it as at least somewhat compromised. After Prolotherapy, 34% were back to completely normal athletic ability with 77% able to do more than 30 minutes of exercise per day. (See Figure 5.)

Before Prolotherapy, 47% considered themselves having some depression and 55% had some anxiety but after Prolotherapy this decreased to 12% and 19%, respectively after Prolotherapy. (See Figure 6.) Three patients were on medications for depression and two other patients were on anxiety medications before Prolotherapy, but after treatment all five were able to stop taking their medications. Ninety-one percent of patients who started with depressed feelings and 75% of those with anxiety were improved at the time of follow-up. In regard to sleep, 80% said that their shoulder pain affected their ability to sleep before Prolotherapy. After Prolotherapy, 88% could sleep much better.

To a simple yes or no question: “Has Prolotherapy changed your life for the better?” 97% of patients treated answered “yes.” In quantifying the response, 49% felt their life was at least radically better with 67% noting that they were very much better with Prolotherapy, but 99% rated their condition as at least somewhat better. Eighty-seven percent rated Prolotherapy as at least very successful in treating their condition (50% or greater pain improvement) with 56% noting the Prolotherapy to be extremely successful (75% or greater pain improvement).

The average person in this study was 20 months out since their last Prolotherapy session. The patients were asked if the improvement with Prolotherapy lasted, and how much of the effect remained. In regard to pain, for instance, 68% noted that 100% of the improvement continued to this day, with 88% stating that at least 50% of the effect remained. Eighty-five percent of patients stated that the overall results of Prolotherapy has mostly continued (50% or greater). A summary of the lasting effects of Prolotherapy on the various quality of life measures is seen in Table 2.

Patients were asked the question, “Are there reasons besides the Prolotherapy effect wearing off that are causing your pain/disability?” Eighty-two percent with continued pain answered “Yes.” Forty-three percent believed they stopped Prolotherapy too soon (before pain was totally gone), 21% had other medical reasons/conditions for their pain, 18% re-injured the area that had received Prolotherapy, 11% had a new area of pain, and 6% had increased life stressors. Of the clients whose pain increased for the above reasons after Prolotherapy was stopped, 80% are planning on receiving more Prolotherapy.

Patient Satisfaction

Overall 97% of patients showed improvement in their pain with Prolotherapy. Eighty-six percent of patients treated considered the Prolotherapy treatment to be very successful (greater than 50% pain relief). In regard to the question “Has Prolotherapy changed your life for the better?” 97% answered “Yes.” Ninety-two percent knew someone who has benefited from Prolotherapy. Ninety-seven percent have recommended it to someone.