Prolotherapy for Musculoskeletal Pain and Disability in Low- and Middle-Income Countries - 26/09/19

Doi : 10.1016/j.pmr.2019.07.003

David Rabago, MD ^a,^⁎ , Kenneth Dean Reeves, MD ^b, Mary P. Doherty, RTR ^c, Maelu Fleck, BS ^d
^a UW Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, 1100 Delaplaine Court, Madison, WI 53715, USA
^b Private Practice, Physical Medicine and Rehabilitation, 4740 El Monte Street, Roeland Park, KS 66205, USA
^c Hackett Hemwall Patterson Foundation, 2532 Baldwin Street, Madison, WI 53713, USA
^d American Association of Orthopaedic Medicine, 3700 East Quebec Street, 100-236, Denver, CO 80207-1639, USA

^∗Corresponding author.

Résumé

Chronic musculoskeletal pain and disability dramatically reduce quality and quantity of life worldwide, disproportionately so in low- and middle-income countries. Complementary therapies not typically learned in conventional medical training have much to offer but are under-utilized. Prolotherapy is an injection-based complementary therapy supported by high-quality evidence for osteoarthritis, tendinopathy, and low back pain. Prolotherapy addresses causes of pain and disability at the tissue level, is straightforward to learn, and relies on common, inexpensive material, and requires no refrigeration. Not-for-profit organizations are delivering prolotherapy to underserved patients in low- and middle-income countries through service-learning projects.

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Keywords : Prolotherapy, Osteoarthritis, Tendinopathy, Chronic pain, Low- and middle-income countries, Regenerative therapy

Plan

Key points

Global impact of back pain, osteoarthritis, and tendinopathy

Prolotherapy

Definition and History

Mechanism of Action

Conditions for Which Prolotherapy Is Evidence Based

Contraindications/Side Effects and Adverse Events

Prolotherapy and service-learning organizations

Disclosure: None of the authors have a financial relationship with a commercial company that has a direct financial interest in subject matter or materials discussed in this article. Organizations discussed are nonprofit (501c3). D. Rabago is immediate past president and member of the board of directors of the Hackett Hemwall Patterson Foundation; K.D. Reeves is a member of the board of directors of the American Association of Orthopaedic Medicine; neither are paid for these efforts. M.P. Doherty and M. Fleck are paid vice president and executive director of the Hackett Hemwall Patterson Foundation and American Association of Orthopaedic Medicine, respectively.