Last time I got into some exciting work being done in stem cell research to address various maladies outside orthopedics and sports medicine.

This time I want to get back a little closer to home and talk about work being done to further the efficacy of prolotherapy.  Prolotherapy, as a reminder, is an alternative therapy for treating musculoskeletal pain that involves injecting an irritant substance, such as dextrose, into a ligament or tendon to promote the growth of new tissue. I use prolotherapy in my practice to treat patients with low back pain, tendinitis and osteoarthritis.

Along with Platelet-rich Plasma Therapy (PRP) injection therapy, which involves using a patient’s own blood plasma to help promote healing, prolotherapy is among the most effective non-surgical techniques that I use for helping patients to heal from “soft tissue” tendon, muscle and joint injuries.

In Hawaii, research Dr. Liza Smigel is close to publishing findings of a year-long clinical study examining the use of prolotherapy with dextrose injections to treat chronic low back pain.

Some of her team’s findings (which I learned about at a recent Hackett-Hemwall Foundation conference at the University of Wisconsin-Madison) will show that people who suffered for up to 10 years from low back pain, usually from the result of disc degeneration, had a high level of pain reduction with the introduction of prolotherapy treatment.

The standard of care currently used to treat low back pain is to inject cortisone into the affected area, but Dr. Smigel’s research could show that prolotherapy has the potential to be more effective in reducing pain and improving day-to-day function.  And while cortisone injections are required at regular intervals to help manage pain, some patients in the study required shots at longer time intervals – essentially requiring prolotherapy treatment every two to four weeks to gradually requiring it only once every few months.

For people who have suffered with sometimes crippling pain in the lower back or buttocks, this could be life-changing.  And the main ingredient in the treatment is dextrose, a simple sugar.

In Rosario, Argentina, a team led by Dr. Gaston Topol is looking at the effect of dextrose injections on knee cartilage. What they are finding is that people who have lost cartilage are getting patches of new cartilage, verified by the use of arthroscopy, growing with dextrose prolotherapy treatment.  Although similar clinical trials likely would not be approved in the United States, thankfully teams from this nation are involved in helping further this work in countries willing to allow this type of cutting-edge research.

Dr. Topol also was involved in research presented two years ago using dextrose prolotherapy to treat Osgood-Schlatter disease, a painful knee affliction that normally impacts children in youth sports.  My friend Dr. David Rabago and the late Dr. Jeffrey Patterson at the Hackett Hemwall Foundation were involved in the double-blind placebo study, which showed “statistically significant improvement with the dextrose Prolotherapy,” according to an article by Dr. Ross A. Hauser in the Journal of Prolotherapy.

Again, it’s a very exciting time to be involved in orthopedics and sports medicine for people like me who are proponents of regenerative injection therapy. I look forward to keeping you updated on current research and, hopefully, approved methods for using these therapies to improve patient’s lives.

Dr. Annette “Dr. Z” Zaharoff heads the Non-Surgical Center of Texas, focusing on non-surgical alternatives to relieve pain and repair injuries. A former professional tennis player who competed in the WTC circuit, Dr. Zaharoff remains actively involved with the US Tennis Association. Learn more about her at