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Neck Pain - Prolotherapy Study From "Practical Pain Management", Oct 2007

Authors: Ross A. Hauser, MD; Marion A. Hauser, MS, RD; and Krista A. Blakemore, BA.

Practical Pain Management. 2007;7(8):58-69.


Neck pain is a common condition affecting about 10% of the general population of North America at any given time, over a year up to 45%, and over a lifetime 70%.1-3 Neck pain results in a significant amount of disability and health care use in the United States, with large personal and economic consequences.4,5 As the duration of neck symptoms increases, especially beyond six months, one’s mental health is negatively affected. Younger patients are more impacted by neck and referral arm symptoms more than older patients.6 It is well documented that the longer the pain persists, the more likely it will become chronic—with up to 7% of patients ending up with chronic neck pain.7,8

While there is some consensus on how to treat acute painful neck episodes, there is much debate on how to treat chronic neck pain. Most monotherapies either do not work or have limited efficacy.9 Non-steroidal anti-inflammatory drugs and anti-depressants have some short term benefit but no published data vindicate their long-term use.10 Manipulative therapy, physiotherapy,and massage therapy all show some temporary benefit but do little to curb long-term pain.11-13 Some people turn to more invasive therapies like percutaneous radiofrequency neurotomy or surgery, but long-term results have been poor and surgeries are fraught with complications.14-17 Because of the limited response to traditional therapies, many people are turning to alternative therapies including prolotherapy for pain control.18-20

Prolotherapy is becoming a widespread form of pain management in both complementary and allopathic medicine.21,22 Its primary use is in pain management associated with tendinopathies and ligament sprains in peripheral joints.23-25 It is also being used in the treatment of spine and joint degenerative arthritis.26,27 Prolotherapy has long been used for chronic low back pain arising from the sacroiliac joints and as an alternative to surgery.28-30 Prolotherapy has been shown in low back studies to improve pain levels and range of motion.31,32 In double-blinded human studies, the evidence on the effectiveness of prolotherapy has been considered promising but mixed.33-36

Current conventional therapy for unresolved neck pain include: medical treatment with analgesics, non-steroidal anti-inflammatory drugs, anti-depressant medications, epidural or other steroid shots, trigger point injections, muscle strengthening exercises, physiotherapy, weight loss, rest, massage therapy, intradiscal electrothermal therapy, manipulation, neck braces, implanted spinal cord stimulators or morphine pumps, surgical treatments that range from disc replacements to fusions, multidisciplinary group rehabilitation, education, and counseling. The results of such therapies often leave the patients with residual pain.9-17 Because of this, many patients with chronic neck pain are searching for alternative treatments for their pain.18 One of the treatments they find promising is prolotherapy.37

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