Effectiveness of prolotherapy injections for chronic low-back pain uncertain

Clinical question: 
Are prolotherapy injections for chronic low-back pain effective?
Bottom line: 
The evidence is conflicting. When used alone prolotherapy is not an effective treatment. When combined with spinal manipulation, exercise, and other co-interventions, prolotherapy may improve chronic low-back pain and disability (NNT=3).
Caveat: 
Co-interventions confounded interpretation of results and clinical heterogeneity in the trials prevented pooling of results. Minor side-effects such as increased back pain and stiffness were common but short-lived.
Context: 
Prolotherapy injections involve repeatedly injecting ligaments with compounds such as dextrose and lidocaine to help restart the body’s natural healing process by causing controlled acute inflammation in the areas injected.
Review CD#: 
CD004059
PEARLS No: 
17
Date: 
May, 2007
Authored by: 
Brian R McAvoy