Presented at the 2012 AAPM Annual Meeting « Back

Pain Management and Accompanying Scoliotic Curvature Reduction with Prolotherapy

Duane E. Griffin, MPH MPAS OPA-C, duane.griffin@amedd.army.mil¹, Brandon J. Goff, DO², (1) U.S. Army, Converse, Texas, (2) U.S. Army, San Antonio, Texas

Introduction/Statement/Problem: A 29-year-old female presented to the Pain Clinic for treatment of low back pain. She was diagnosed with scoliosis at age 14 and began to complain of back pain the year prior to consultation. Scoliosis survey measured 25° right apex thoracic curvature and 22° left apex lumbar curvature. After treatment options were discussed, the patient requested a trial of prolotherapy for pain management. Methods and Materials: Treatment consisted of three sessions over 4- to 6-week intervals. Prolotherapy solution used was a mixture of 6ml 50% dextrose, 1ml 1% lidocaine, and 3ml sterile water. The diluted solution was 12.5% dextrose in 10ml syringes. The patient was treated in the prone position. The spinous and transverse processes were indentified and marked with a skin marker. Each spinous process and the lateral vertebral bodies and transverse processes T4 through L5 were injected with 1ml of the solution. Results: The patient reported progressive improvement in back pain after each treatment. Original pain score was 7-8/10. Following the third treatment, pain score was 3/10. A post-treatment scoliosis survey as part of her routine scoliosis monitoring demonstrated the curvature in the lumbar had decreased by 3°. Conclusion: Prolotherapy is hypothesized to strengthen weakened ligaments and tendons. Patients often experience significant pain relief as well. In this case, there was both improvement in low back pain as well as a measurable decrease in lumbar scoliosis. This was an unanticipated but welcome outcome worthy of further research. References: 1)Dagenais S, Haldeman S, Wooley JR. Intraligamentous injection of sclerosing solutions (prolotherapy) for spinal pain: a critical review of the literature. The Spine Journal, Volume 5, Issue 3, May-June 2005, Pages 310-328. 2)Yelland MJ, Glasziou PP, Bogduk N, Schluter PJ, McKernon M. Prolotherapy Injections, Saline Injections, and Exercises for Chronic Low-Back Pain: A Randomized Trial. Spine: 1 January 2004 - Volume 29 - Issue 1 - pp 9-16. 3)Lonstein JE, Moskovich R, Nordin M. Scoliosis: Surgical versus Nonsurgical Treatment. Clinical Orthopaedics & Related Research: February 2006 - Volume 443 - Issue - pp 248-259.

Funding: None