Prolotherapy for SI joint pain

Posted by lara2323 @lara2323, Mar 6 6:53am

I am considering undergoing prolotherapy for chronic SI joint pain. Unfortunately the practitioner couldn't tell me how long patients had relief.
Has anyone had prolotherapy on their SI joint? If so, how many treatments did you receive and how long did the pain relief last?

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Prolotherapy is an old treatment seeing a resurgence. Usually the substance used is a glucose solution, but it may be combined with other ingredients. Some factors to be aware of include: This is an unregulated treatment, so may be done by any practitioner allowed to do injections, without special training or qualifications. Prolotherapy appears to be more effective if the injections are done by a skilled pain injection practitioner who has skill in placing therapeutic substances exactly where needed for a specific condition. Therapy appears to be more successful when combined with other treatment such as stretching or PT.

Here is what the spine clinic experts at Mayo have to say about prolotherapy: https://www.mayoclinic.org/prolotherapy/expert-answers/faq-20058347

And what the docs on Spine Health have to say: https://www.spine-health.com/treatment/injections/prolotherapy-and-chronic-back-pain

The following is a lengthy review of studies of pain reduction from prolotherapy – only one addresses SI joint pain directly, and shows improvement in about 50% of people at 15 months (you would need to locate & read the complete study to see how many injections, adjunct therapy, etc.)

In doing your research on the technique, be sure to differentiate information published by the practitioners and those published by an independent group.

What practitioner has recommended prolotherapy to you? Have you already tried more conservative therapies including ice, stretching and physical therapy?
Sue

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Hello @lara2323 and welcome to Mayo Clinic Connect. @sueinmn has graciously joined your discussion so I will let you respond to her but I did want to pop in to share that we do have another member, @kpickowitz, who has shared a bit on this topic too in case they may be able to join.

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There are two kinds of prolotherapy, one using glucose and the other using platelets. My daughter had the latter for her SI joint. This procedure is called platelet rich plasma or PRP. Often docs will try the glucose on first but my daughter has diabetes. Her PRP was done by a Spaulding physiatrist affiliated with Mass. General Hospital, who has done reams of studies. That doc requires imaging showing no bone issues since PRP works for soft tissues. PT was required as well, to see if that helped. The PRP itself involved drawing blood, spinning it to concentrate platelets and reinjecting at the very specific site of pain. It was miraculous for my daughter. After 10 years of pain she was better in 24 hours. She did a little PT afterward because that was part of the procedure and study, but didn't need it. It has lasted 6 years. She also had a knee done (same knee had surgery at age 10). She was born with hypermobile joints.

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@sueinmn

Prolotherapy is an old treatment seeing a resurgence. Usually the substance used is a glucose solution, but it may be combined with other ingredients. Some factors to be aware of include: This is an unregulated treatment, so may be done by any practitioner allowed to do injections, without special training or qualifications. Prolotherapy appears to be more effective if the injections are done by a skilled pain injection practitioner who has skill in placing therapeutic substances exactly where needed for a specific condition. Therapy appears to be more successful when combined with other treatment such as stretching or PT.

Here is what the spine clinic experts at Mayo have to say about prolotherapy: https://www.mayoclinic.org/prolotherapy/expert-answers/faq-20058347

And what the docs on Spine Health have to say: https://www.spine-health.com/treatment/injections/prolotherapy-and-chronic-back-pain

The following is a lengthy review of studies of pain reduction from prolotherapy – only one addresses SI joint pain directly, and shows improvement in about 50% of people at 15 months (you would need to locate & read the complete study to see how many injections, adjunct therapy, etc.)

In doing your research on the technique, be sure to differentiate information published by the practitioners and those published by an independent group.

What practitioner has recommended prolotherapy to you? Have you already tried more conservative therapies including ice, stretching and physical therapy?
Sue

Jump to this post

Hi! I have had chronic SI joint pain for 11 years. It has gradually gotten worse. I have tried all the conservative treatments. I even tried a cortisone shot directly into the joint. Pain relief lasted 4 weeks.
I have h-EDS as well which may be the reason for SI joint instability.
I will have the prolotherapy done at Mayo Clinic's Regenerative Medicine department, in Jacksonville. I know I will be receiving expert care so that is not an issue.
Thank you for the advice. I will look into the independent research studies.

REPLY
@windyshores

There are two kinds of prolotherapy, one using glucose and the other using platelets. My daughter had the latter for her SI joint. This procedure is called platelet rich plasma or PRP. Often docs will try the glucose on first but my daughter has diabetes. Her PRP was done by a Spaulding physiatrist affiliated with Mass. General Hospital, who has done reams of studies. That doc requires imaging showing no bone issues since PRP works for soft tissues. PT was required as well, to see if that helped. The PRP itself involved drawing blood, spinning it to concentrate platelets and reinjecting at the very specific site of pain. It was miraculous for my daughter. After 10 years of pain she was better in 24 hours. She did a little PT afterward because that was part of the procedure and study, but didn't need it. It has lasted 6 years. She also had a knee done (same knee had surgery at age 10). She was born with hypermobile joints.

Jump to this post

Thank you for sharing. I have hypermobile Elhers Danlos Syndrome which is why I have joint instability and chronic pain.
I find it encouraging that your daughter had pain relief that lasted 6 years! Thank you for the insight. I am considering the (glucose) prolotherapy mainly because it is less expensive, so I will start there, and try the PRP in the future if needed.

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I read that most people start with the glucose. She went straight to PRP only because she has type 1 diabetes. Good Luck!

REPLY
@windyshores

There are two kinds of prolotherapy, one using glucose and the other using platelets. My daughter had the latter for her SI joint. This procedure is called platelet rich plasma or PRP. Often docs will try the glucose on first but my daughter has diabetes. Her PRP was done by a Spaulding physiatrist affiliated with Mass. General Hospital, who has done reams of studies. That doc requires imaging showing no bone issues since PRP works for soft tissues. PT was required as well, to see if that helped. The PRP itself involved drawing blood, spinning it to concentrate platelets and reinjecting at the very specific site of pain. It was miraculous for my daughter. After 10 years of pain she was better in 24 hours. She did a little PT afterward because that was part of the procedure and study, but didn't need it. It has lasted 6 years. She also had a knee done (same knee had surgery at age 10). She was born with hypermobile joints.

Jump to this post

Hello, I recently came across this forum and your post when searching for SI Joint specialists. I have had severe pain for over 7 years and believe after years of getting no answers – it is Si Joint dysfunction. I’m near the Massachusetts area and have been to Spaulding in Wellesley as well as have seen several doctors/neurologists at Mass General. I was wondering/hoping if you might be able to share the name of the doctor who helped your daughter with PRP for SI joint dysfunction? I am in desperate need of help to rid this pain in my buttock and behind my leg which has haunted me for too long. I would be extremely grateful for help and a recommendation.

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A pain management doctor in your area could perform SI joint radifrequency ablation – it brought me great relief – may have to do it yearly but worth it. Good luck.

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@lara2323

Hi! I have had chronic SI joint pain for 11 years. It has gradually gotten worse. I have tried all the conservative treatments. I even tried a cortisone shot directly into the joint. Pain relief lasted 4 weeks.
I have h-EDS as well which may be the reason for SI joint instability.
I will have the prolotherapy done at Mayo Clinic's Regenerative Medicine department, in Jacksonville. I know I will be receiving expert care so that is not an issue.
Thank you for the advice. I will look into the independent research studies.

Jump to this post

Hi- I was curious of the prolotherapy worked for you or helped?

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