A Review of Dextrose Prolotherapy and Clinically-based Evidence for Usage
Prolotherapy, originally termed sclerotherapy, is a technique that has been around the medical community for many years. The first recorded usage in humans occurring as early as 400 BC by Hippocrates. Hippocrates was reported to utilize a hot poker in the axilla for treatment of pain associated with a dislocated shoulder. Years later, a physician by the name of Alfred Velpaeu successfully improved pain from a hernia by injection with iodine (Velpaeu, 1847). However, it was not until the early 1930’s that conventional prolotherapy was discovered. This occured after a physician by the name of Earl Gedney sustained a ligamentous injury to his thumb that was thought to end his surgical career. In 1937, Dr. Gedney wrote the pioneering article reviewing two successful case studies involving a knee and low back “irritant” injections (Gedney, 1938). Into the 1980’s, Dr. Hackett and Dr. Liu et al utilized dextrose as the main irritant. Dr. Hackett, considered the father of current day prolotherapy, is credited with proposing the three stages of prolotherapy: inflammation, granulation or proliferation, and maturation (Anderson, 2015).
Image 1. Graphical illustration of the healing timeline after prolotherapy (courtesy of goldcoastosteopathic.com.au)
Image 2. The three phases of healing status post prolotherapy injection (courtesy of goldcoastosteopathic.com.au)