Document Detail


Prolotherapy injections, saline injections, and exercises for chronic low-back pain: a randomized trial.
MedLine Citation:
PMID:  14699269     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To assess the efficacy of a prolotherapy injection and exercise protocol in the treatment of chronic nonspecific low back pain. DESIGN: Randomized controlled trial with two-by-two factorial design, triple-blinded for injection status, and single-blinded for exercise status. SETTING: General practice. PARTICIPANTS: One hundred ten participants with nonspecific low-back pain of average 14 years duration were randomized to have repeated prolotherapy (20% glucose/0.2% lignocaine) or normal saline injections into tender lumbo-pelvic ligaments and randomized to perform either flexion/extension exercises or normal activity over 6 months. MAIN OUTCOME MEASURES: Pain intensity (VAS) and disability scores (Roland-Morris) at 2.5, 4, 6, 12, and 24 months. RESULTS: Follow-up was achieved in 96% at 12 months and 80% at 2 years. Ligament injections, with exercises and with normal activity, resulted in significant and sustained reductions in pain and disability throughout the trial, but no attributable effect was found for prolotherapy injections over saline injections or for exercises over normal activity. At 12 months, the proportions achieving more than 50% reduction in pain from baseline by injection group were glucose-lignocaine: 0.46 versus saline: 0.36. By activity group these proportions were exercise: 0.41 versus normal activity: 0.39. Corresponding proportions for >50% reduction in disability were glucose-lignocaine: 0.42 versus saline 0.36 and exercise: 0.36 versus normal activity: 0.38. There were no between group differences in any of the above measures. CONCLUSIONS: In chronic nonspecific low-back pain, significant and sustained reductions in pain and disability occur with ligament injections, irrespective of the solution injected or the concurrent use of exercises.
Authors:
Michael J Yelland; Paul P Glasziou; Nikolai Bogduk; Philip J Schluter; Mary McKernon
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Spine     Volume:  29     ISSN:  1528-1159     ISO Abbreviation:  Spine     Publication Date:  2004 Jan 
Date Detail:
Created Date:  2003-12-30     Completed Date:  2004-04-12     Revised Date:  2009-07-09    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  9-16; discussion 16     Citation Subset:  IM    
Affiliation:
Centre for General Practice and School of Population Health, University of Queensland, Brisbane, Australia. myelland@bigpond.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Chronic Disease
Disability Evaluation
Double-Blind Method
Exercise Therapy*
Female
Follow-Up Studies
Humans
Injections
Ligaments, Articular
Low Back Pain / physiopathology,  therapy*
Male
Middle Aged
Pain Measurement
Sodium Chloride / administration & dosage*,  therapeutic use
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
7647-14-5/Sodium Chloride
Comments/Corrections
Comment In:
Spine (Phila Pa 1976). 2004 Aug 15;29(16):1840-1; author reply 1842-3   [PMID:  15303038 ]
Spine (Phila Pa 1976). 2004 Aug 15;29(16):1841-2; author reply 1842-3   [PMID:  15303039 ]
Spine (Phila Pa 1976). 2004 Oct 1;29(19):2195; author reply 2195-6   [PMID:  15454717 ]
Spine (Phila Pa 1976). 2004 Aug 15;29(16):1839-40; author reply 1842-3   [PMID:  15303037 ]

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