Abstract
Dagenais S, Ogunseitan O, Haldeman S, Wooley JR, Newcomb RL. Side effects and adverse
events related to intraligamentous injection of sclerosing solutions (prolotherapy)
for back and neck pain: a survey of practitioners.
Objective
To study the side effects and adverse events related to intraligamentous injection
of sclerosing solutions (prolotherapy) for back and neck pain.
Design
Practitioner postal survey.
Setting
Postal survey of practitioners of prolotherapy for back and neck pain in the United
States and Canada.
Participants
A sample of prolotherapy practitioners from 2 professional organizations were surveyed
about their training and experience, use of specific treatment procedures, estimated
prevalence of side effects, and adverse events related to prolotherapy for back and
neck pain.
Interventions
Not applicable.
Main Outcome Measures
Prevalence of side effects and adverse events.
Results
Surveys were completed by 171 practitioners (response rate, 50%). Ninety-eight percent
held medical degrees, and 83% were board certified in various disciplines. Respondents
had a median of 10 years of experience, during which they had treated a median of
500 patients and given a median of 2000 treatments. Side effects with the highest
median estimated prevalence were pain (70%), stiffness (25%), and bruising (5%). There
were 472 reports of adverse events, including 69 that required hospitalization and
5 that resulted in permanent injury secondary to nerve injury. The vast majority (80%)
were related to needle injuries such as spinal headache (n=164), pneumothorax (n=123),
temporary systemic reactions (n=73), nerve damage (n=54), hemorrhage (n=27), nonsevere
spinal cord insult (ie, meningitis, paralysis, spinal cord injury) (n=9), and disk
injury (n=2).
Conclusions
Side effects related to prolotherapy for back and neck pain, such as temporary postinjection
pain, stiffness, and bruising, are common and benign. Adverse events related to prolotherapy
for back and neck pain are similar in nature to other widely used spinal injection
procedures. Further study is needed to fully describe the adverse event profile of
prolotherapy for back and neck pain.
Key Words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Archives of Physical Medicine and RehabilitationAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Patterns and perceptions of care for treatment of back and neck pain.Spine. 2003; 28 (discussion 298): 292-297
- Intraligamentous injection of sclerosing solutions (prolotherapy) for spinal pain.Spine J. 2005; 5: 310-328
- A rationale for prolotherapy.J Orthop Med. 1991; 13: 54-59
- Multiple injections of sclerosant solution.West J Med. 1985; 142: 841
- What is a serious adverse event?2004 (January 23, Available at: http://www.fda.gov/medwatch/report/DESK/advevnt.htm. Accessed May 9, 2005.)
- Fatality after injection of sclerosing agent to precipitate fibro-osseous proliferation.JAMA. 1959; 170: 1768-1772
- Prolotherapy injections, saline injections, and exercises for chronic low-back pain.Spine. 2004; 29: 9-16
- Management of chronic low back pain.Med J Aust. 2004; 180: 79-83
- Chronic pain management.Anesthesiology. 2004; 100: 98-105
- Complications and side effects of cervical and lumbosacral selective nerve root injections.Arch Phys Med Rehabil. 2005; 86: 277-283
- Injuries associated with regional anesthesia in the 1980s and 1990s.Anesthesiology. 2004; 101: 143-152
- Injection therapy for subacute and chronic benign low back pain.Spine. 2001; 26: 501-505
- AHFS drug information. American Society of Health System Pharmacists, Bethesda2003
- Sweetman S.C. Martindale the complete drug reference. 33rd ed. Pharmaceutical Pr, London2002
- Gennaro A.R. Remington the science and practice of pharmacy. 20th ed. Lippincott Williams & Wilkins, Easton2000
- A new approach to the treatment of chronic low back pain.Lancet. 1987; 2: 143-146
- Prolotherapy.J Orthop Med. 1993; 15: 49-50
Article info
Footnotes
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.
Identification
Copyright
© 2006 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.
