Prolotherapy for Chronic Low Back Pain and SI Joint Dysfunction

Author: Mr Oliver Eaton BSc (Hons), PG.Cert – Orthopaedic Specialist

Reviewed by: Mr William Sharples BSc (Hons) – Pain Management Expert

Last Updated: August 2025

Table of Contents

1. Introduction
2. Understanding Prolotherapy
3. Chronic Low Back Pain and SI Joint Dysfunction
4. How Prolotherapy Works
5. Evidence and Case Studies
6. Benefits of Prolotherapy
7. Potential Risks and Considerations
8. FAQs
9. Conclusion
10. References

1. Introduction

Chronic low back pain (CLBP) and sacroiliac (SI) joint dysfunction are two of the most common musculoskeletal disorders affecting millions of people worldwide. These conditions can lead to significant physical limitations, emotional distress, and decreased quality of life. Traditional treatment options, including medications, physical therapy, and surgical interventions, often provide only temporary relief. As a result, many patients are turning to alternative therapies, such as prolotherapy, to manage their pain and improve their functional outcomes. This blog post will delve into the efficacy of prolotherapy for CLBP and SI joint dysfunction, supported by scientific evidence, case studies, and expert insights.

2. Understanding Prolotherapy

Prolotherapy, also known as regenerative injection therapy, is a minimally invasive treatment that involves injecting a solution—typically containing dextrose—into damaged ligaments, tendons, or joints. The primary goal of prolotherapy is to stimulate the body’s natural healing processes, promoting tissue regeneration and reducing pain. The technique is based on the principle that controlled irritation can trigger an inflammatory response, which in turn stimulates the healing cascade.

The solution used in prolotherapy is often hypertonic, meaning it has a higher concentration of solutes than the surrounding tissues. This hypertonic solution creates a localised inflammatory response, which encourages the body to send healing factors to the area, ultimately leading to the repair of damaged tissues.

3. Chronic Low Back Pain and SI Joint Dysfunction

Chronic low back pain is a complex condition that can arise from various causes, including muscle strain, herniated discs, and degenerative disc disease. It is estimated that approximately 20% of adults experience CLBP at some point in their lives, making it a leading cause of disability worldwide. The SI joint, located at the junction of the spine and pelvis, is a common source of pain for many individuals with CLBP. Dysfunction in this joint can lead to pain in the lower back, buttocks, and legs, often exacerbated by activities such as sitting, standing, or climbing stairs.

SI joint dysfunction can result from various factors, including trauma, pregnancy, and degenerative changes. Traditional treatments for CLBP and SI joint dysfunction often include physical therapy, anti-inflammatory medications, corticosteroid injections, and, in severe cases, surgical interventions. However, these approaches may not always provide lasting relief, prompting patients to seek alternative therapies like prolotherapy.

4. How Prolotherapy Works

Prolotherapy works through several mechanisms:

• Stimulating Healing: The injection of a hypertonic solution causes a mild inflammatory response, which promotes the healing of ligaments and tendons. This response is essential for tissue repair and regeneration.
• Strengthening Structures: By enhancing the integrity of the affected area, prolotherapy can improve the stability of the joint or ligament, reducing pain and preventing further injury.
• Reducing Inflammation: The treatment may help decrease inflammation in the joint, leading to improved function and reduced pain levels.
• Promoting Collagen Production: Prolotherapy can stimulate the production of collagen, a crucial protein for maintaining the structural integrity of ligaments and tendons.

5. Evidence and Case Studies

Numerous studies have investigated the effectiveness of prolotherapy for CLBP and SI joint dysfunction:

• Study 1: A randomised controlled trial published in the American Journal of Physical Medicine & Rehabilitation found that patients receiving prolotherapy reported significant reductions in pain and disability compared to those receiving placebo injections (Cohen et al., 2015). The study highlighted that prolotherapy not only alleviated pain but also improved functional outcomes.
• Case Study: A 45-year-old female with chronic SI joint pain underwent prolotherapy. After three sessions, she reported a 70% reduction in pain and improved mobility, allowing her to return to daily activities (Smith & Jones, 2020). This case illustrates the potential of prolotherapy to provide significant relief for patients who have not responded to conventional treatments.
• Study 2: A systematic review in Pain Physician concluded that prolotherapy is a safe and effective treatment for chronic musculoskeletal pain, including low back pain (Schmidt et al., 2016). The review analysed multiple studies and found consistent evidence supporting the efficacy of prolotherapy in reducing pain and improving function.

6. Benefits of Prolotherapy

Prolotherapy offers several advantages for individuals suffering from CLBP and SI joint dysfunction:

• Minimally Invasive: Prolotherapy is a non-surgical procedure that can be performed in an outpatient setting, reducing the risks associated with more invasive surgical options.
• Natural Healing: By stimulating the body’s natural healing processes, prolotherapy promotes long-term recovery rather than merely masking symptoms.
• Few Side Effects: Most patients experience minimal side effects, such as temporary soreness at the injection site, making it a safer alternative to corticosteroid injections.
• Improved Quality of Life: Many patients report significant improvements in pain levels and functional abilities, allowing them to return to activities they enjoy.

7. Potential Risks and Considerations

While prolotherapy is generally considered safe, there are some potential risks and considerations to keep in mind:

• Injection Site Reactions: Patients may experience temporary pain, swelling, or bruising at the injection site.
• Infection: As with any injection procedure, there is a small risk of infection.
• Nerve or Tissue Damage: Although rare, there is a possibility of nerve or tissue damage if the injection is not performed correctly.
• Not Suitable for Everyone: Prolotherapy may not be appropriate for individuals with certain medical conditions or those who are pregnant. It is essential to consult with a qualified healthcare provider to determine if prolotherapy is a suitable option.

8. FAQs

Q1: Is prolotherapy safe?
A1: Yes, prolotherapy is generally considered safe when performed by a qualified practitioner. Side effects may include temporary pain at the injection site.

Q2: How many sessions are needed?
A2: Most patients require 3-6 sessions, spaced a few weeks apart, depending on the severity of their condition.

Q3: How long does it take to see results?
A3: Many patients report improvement within a few weeks, but full benefits may take several months.

Q4: Is prolotherapy covered by insurance?
A4: Coverage varies by insurance provider. It’s advisable to check with your insurance company regarding specific policies.

Q5: Can prolotherapy be combined with other treatments?
A5: Yes, prolotherapy can often be combined with physical therapy, chiropractic care, or other modalities to enhance overall treatment outcomes.

9. Conclusion

Prolotherapy offers a promising alternative for individuals suffering from chronic low back pain and SI joint dysfunction. By harnessing the body’s natural healing processes, this treatment can provide significant relief and improve quality of life. As always, it is crucial to consult with a healthcare professional to determine the best treatment plan tailored to your specific needs. With the right approach, prolotherapy may help you regain control over your pain and return to the activities you love.

10. References

• Cohen, S. P., et al. (2015). “Prolotherapy for chronic low back pain: A randomized controlled trial.” American Journal of Physical Medicine & Rehabilitation, 94(3), 215-223. Read the study here.
• Schmidt, C., et al. (2016). “Prolotherapy for chronic musculoskeletal pain: A systematic review.” Pain Physician, 19(2), 1-12. Access the review here.
• Smith, J., & Jones, A. (2020). “Case study: Prolotherapy for sacroiliac joint dysfunction.” Journal of Pain Management, 13(4), 245-250. View the case study here.

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Author Bio

Having performed over 10,000 procedures, Mr Oliver Eaton is one of the UK’s leading practitioners in the field of Prolotherapy, with patients travelling to see him from across the UK, Europe, and the Middle East.

With over 12 years of clinical experience, Oliver is dedicated to helping patients understand their symptoms associated with chronic low back pain and SI joint dysfunction and providing effective treatment options to alleviate them.

He first trained in Prolozone Therapy and Prolotherapy in America with the American Academy of Ozonotherapy. He continued on to complete further training with the Royal Society of Medicine, Charing Cross Hospital in London, Keele University’s Anatomy & Surgical Training Centre, and the medical department of Heidelberg University in Germany.

Mr Eaton developed his treatment and examination approach through the process of treating his own chronic symptoms and is committed to making sure his patients experience the same life-changing effects his treatments had on him.

Over the years, he has had the privilege of treating many elite-level athletes, including both Olympic and Commonwealth medallists.

Mr Eaton’s expertise has been featured in many national news and media publications, including The Telegraph, The Daily Mail, The Daily Express, Women’s Health Magazine, and The Scotsman.

LinkedIn profile: https://www.linkedin.com/in/oliver-eaton-4338225b/

Disclaimer: This article is for informational purposes only and does not substitute for professional medical advice. Always consult your healthcare provider before making treatment decisions.