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A Retrospective Study on Hackett-Hemwall Dextrose Prolotherapy for Chronic Hip Pain
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Authors: Ross A. Hauser, MD & Marion A. Hauser, MS, RD
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A B S T R A C T |
Objective: To investigate the outcomes of patients undergoing Hackett-Hemwall dextrose Prolotherapy treatment for chronic hip pain.
Design: Sixty-one patients, representing 94 hips who had been in pain an average of 63 months, were treated quarterly with Hackett-Hemwall dextrose Prolotherapy. This included a subset of 20 patients who were told by their medical doctor(s) that there were no other treatment options for their pain and a subset of eight patients who were told by their doctor(s) that surgery was their only option. Patients were contacted an average of 19 months following their last Prolotherapy session and asked questions regarding their levels of pain, physical and psychological symptoms and activities of daily living, before and after their last Prolotherapy treatment.
Results: In these 94 hips, pain levels decreased from 7.0 to 2.4 after Prolotherapy; 89% experienced more than 50% of pain relief with Prolotherapy; more than 84% showed improvements in walking and exercise ability, anxiety, depression and overall disability; 54% were able to completely stop taking pain medications. The decrease in pain reached statistical significance at the p<.0001 for the 94 hips, including the subset of patients who were told there was no other treatment options for their pain and those who were told surgery was their only treatment option.
Conclusion: In this retrospective study on the use of Hackett-Hemwall dextrose Prolotherapy, patients who presented with over five years of unresolved hip pain were shown to improve their pain, stiffness, range of motion, and quality of life measures even 19 months subsequent to their last Prolotherapy session. This pilot study shows that Prolotherapy is a treatment that should be considered and further studied for people suffering with unresolved hip pain.
Journal of Prolotherapy. 2009;2:76-88. |
Chronic hip pain is a common condition resulting in over 383,000 hip replacements annually in the United States and the number is increasing every year.1 The high rates of wear and tear, attributable to normal use of the hip, can result in long term problems. This makes sense when one considers that patients move their hips at least one million times per year during activities of daily living.2,3 Population-based surveys of patients who have arthritis of the hip document a large untapped need for these procedures, suggesting that the rates of total hip arthroplasty will likely increase in the future.4 Not everyone who is a candidate for a new hip will choose this option, as the operation has inherent risks including poor outcome, osteolysis and need for revision, deep vein thrombosis and limited life span.5,6 Because of the limited response of chronic hip pain to other traditional therapies, many people are turning to alternative therapies, including Prolotherapy, for pain control.7,8
Prolotherapy is becoming a widespread form of pain management in both complementary and allopathic medicine.9 Its primary use is in the pain management associated with tendinopathies and ligament sprains in peripheral joints.10-12 It is also being used in the treatment of spine and joint degenerative arthritis.13,14 Prolotherapy has long been used for chronic low back pain arising from the sacroiliac joints and as an alternative to surgery.15-19 Prolotherapy has been shown in low back studies to improve pain levels and range of motion.20,21 In doubleblinded human studies the evidence on the effectiveness of Prolotherapy has been considered promising but mixed.22-25
George S. Hackett, MD, coined the term Prolotherapy.26 As he described it, “The treatment consists of the injection of a solution within the relaxed ligament and tendon which will stimulate the production of new fibrous tissue and bone cells that will strengthen the ‘weld’ of fibrous tissue and bone to stabilize the articulation and permanently eliminate the disability.”27 Animal studies have shown that Prolotherapy induces the production of new collagen by stimulating the normal inflammatory reaction.28,29 In addition, animal studies have shown improvements in ligament and tendon diameter and strength.30,31 While Prolotherapy has been used for chronic hip pain, no study has been published to date to show its effectiveness for this condition.32 To evaluate the effectiveness of Hackett-Hemwall dextrose Prolotherapy, not just on hip pain but on quality of life measures, as well as its ability to reduce or eliminate the need or other medical therapies including total hip replacement this observational study was undertaken.
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