Treatment Outcomes

Patients received an average of 4.2 prolotherapy treatments. The average time of follow-up after their last prolotherapy session was 18 months.

Figure 2. Starting and ending pain, stiffness and crunching level before and after receiving Hemwall-Hackett dextrose prolotherapy in 98 patients with unresolved neck pain.

Pain, Crunching Sensation, Stiffness. Patients were asked to rate their pain and stiffness on a scale of 1 to 10, with 1 being no pain/stiffness and 10 being severe, crippling pain/stiffness.The 98 patients had an average starting pain level of 5.6, crunching sensation of 5.1, and stiffness of 6.7. Their average ending pain, crunching and stiffness levels were 2.3, 2.1, and 2.4 respectively (see Figure 2). Over seventy percent said the improvements in their pain, crunching, and stiffness since their last treatment session had very much continued. Eighty-nine percent of patients reported that pain relief was at least 50% of their pain while 60% reported greater than 75% pain relief. Only one patient had less than 25% of their pain relieved with prolotherapy.

Range of Motion. Patients were asked to rate their range of motion on a scale of 1 to 7 with 1 being no motion, 2 through 5 were fractions of normal motion, 6 was normal motion, and 7 was excessive motion. The average starting range of motion was 3.9 and ending range of motion was 5.1. Before prolotherapy, 38% had very limited motion (49% or less of normal motion).This decreased to only 2% after treatments were concluded (see Figure 3).

Figure 3. Starting and ending range of motion before and after receiving Hemwall-Hackett dextrose prolotherapy in 98 patients with unresolved neck pain.

Pain Medication Utilization. Seventy two percent discontinued pain medications altogether after prolotherapy. In all, 83% of patients on medications at the start of prolotherapy were able to decrease them by 75% or more. None of the patients had to increase pain medication usage after stopping prolotherapy. Seventy-eight percent of patients who had been using additional pain management therapies before prolotherapy were able to decrease them by 50% or more after.

Exercise and Athletic Ability. In regard to exercise or athletic ability prior to prolotherapy, 36% said it was totally compromised (couldn’t do any athletics), 14% ranked it as severely compromised (less than 10 minutes), 21% ranked it as very compromised (less than 30 minutes), and 28% ranked it as at least somewhat compromised. After treatments, 80% of patients were able to do 30 or more minutes of exercise with 34% not being compromised at all. Eighty percent of the patients stated that the improvements in regard to exercise ability had continued with an over 75% improvement (see Figure 4).

Figure 4. Starting and ending and Improvement in athletic ability before and after receiving Hemwall-Hackett dextrose prolotherapy in 98 patients with unresolved neck pain.

Disability. In regard to quality of life issues prior to receiving treatment, 48% had an overall disability of at least 50% (could only do about half of the tasks they wanted to). This decreased to 13% after prolotherapy. Sixty-eight percent noted they had at least a 25% overall disability prior to treatments and this decreased to 23% after (see Figure 5).

Figure 5. Starting and ending overall disability before and after receiving Hemwall-Hackett dextrose prolotherapy in 98 patients with unresolved neck pain.

Before receiving prolotherapy, 14% of the patients were dependent on someone for activities of daily living (dressing self and additional general self care) with 12 patients that rated their dependency on someone else as greater than minimum assist (25% or greater assist). This went down to 4% after treatments with only one patient needed that much assistance after treatment. Sixteen percent of patients had some prior dependency in activities of daily living but this went down to 6% after prolotherapy. Fourteen percent had considered themselves completely disabled as far as their work situation but this decreased to 6% after prolotherapy. All patients stated these improvements had continued since conclusion of prolotherapy sessions.

Depression & Anxiety. Prior to prolotherapy, 54% of patients had feelings of depression and 60% had feelings of anxiety. After treatments, only 16% had depressed feelings and 19% had feelings of anxiety (see Figures 6 and 7). According to the patients, 78% of the improvements in depression and anxiety had continued and that a greater than 75% improvement remains at follow up.

Figure 6. Starting and ending depression level before and after receiving Hemwall-Hackett dextrose prolotherapy in 98 patients with unresolved neck pain.

Figure 7. Starting and ending anxiety level before and after Hemwall-Hackett dextrose prolotherapy in 98 patients with unresolved neck pain.

Sleep. Eighty percent of patients reported their pain interrupted their sleep prior to prolotherapy treatments and 88% subsequently had improvements in their sleeping ability. Seventy five percent of patients stated that improvement had continued with a greater than 50% improvement still remaining at follow up.

Quality of Life. To a simple yes or no question: ‘Has prolotherapy changed your life for the better?’ 97% of patients treated answered ‘yes.’ In quantifying the response:

• Seventy-four percent felt their life was at least very much better from prolotherapy.
• Sixty-nine percent stated that the results from prolotherapy have very much continued to this day.
• Ninety-five percent felt that they still have some benefits from the prolotherapy they received.

When patients experiencing some regression were asked “Are there reasons besides the prolotherapy effect wearing off that are causing some return of my pain/disability?’ 84% answered ‘yes’. The patients noted the reasons for some of their returning pain were:

• because stopped prolotherapy treatments too soon(before pain completely gone) — 45%,
• re-injury — 21%
• new area of pain — 10%
• had increased life stressors — 6%, and
• had other explanations for the pain — 18%.

Of the patients whose pain recurred after prolotherapy was stopped, 77% were planning on receiving additional prolotherapy treatments.

Patient Satisfaction. Ninety-three percent of patients knew someone who had received prolotherapy. In fact, seventy-one percent came to receive their first prolotherapy session at the recommendation of a friend. Ninety percent of patients treated considered the prolotherapy treatment to be very successful(greater than 50 percent pain relief). Ninety-nine percent noted the prolotherapy was at least somewhat successful (greater than 25 percent pain relief). Only one of the 98 patients noted that there was no change. None indicated that the prolotherapy treatments made them worse. Ninety-nine percent had subsequently recommended prolotherapy to someone.

Neck study reference:
Hauser, R. and Hauser, M. An observational study of patients with unresolved neck pain who were treated with dextrose prolotherapy at an outpatient charity clinic in rural Illinois. Practical Pain Management. Oct 2007. pp 56-69.