Prolotherapy

Prolotherapy
Intervention
HCPCS-L2	M0076
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Prolotherapy, also called proliferation therapy or regenerative injection therapy is an alternative medicine treatment that uses injection of an irritant solution into a joint space, ligaments or tendon insertion in an effort to relieve pain or address ligament laxity.

Prolotherapy may help in low back pain, tendinitis and osteoarthritis. The evidence for these uses, however, is tentative. There is also little good evidence for sports related injuries.

A 2007 Cochrane review of prolotherapy in adults with chronic low-back pain found unclear evidence of effect. A 2009 review concluded the same for subacute low back pain. There was tentative evidence of benefit when used with other low back pain treatments.

A 2009 systematic review of the efficacy in the treatment of lateral epicondylosis concluded that these therapies may benefit people with lateral epicondylosis, but the evidence was limited. A 2010 systematic review concluded moderate evidence exists to support the use of prolotherapy injections in the management of pain in lateral epicondyalgia and that prolotherapy was no more effective than eccentric exercise in the treatment of Achilles tendinopathy.

In 2012, a systematic review studying various injection therapies found that prolotherapy and hyaluronic acid injection therapies were more effective than placebo when treating lateral epicondylosis. Of the studies evaluated, one of ten glucocorticoid trials, one of five trials for autologous blood injection or platelet-rich plasma, one trial of polidocanol, and one trial of prolotherapy met the criteria for low risk of bias. The authors noted that few of the reviewed trials met the criteria for low risk of bias.

There is tentative evidence that prolotherapy may be useful in osteoarthritis.

Contraindications for patients to receive prolotherapy injections may include:

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