It’s a one-sided ache low in your back, right near the dimple above your buttock. It flares when you roll over in bed, climb stairs, or stand on one leg to put on your pants. Or maybe your whole lower back feels unstable, like it could “go out” at any moment.
Ligament strain and sacroiliac (SI) joint dysfunction are common, underrecognized sources of chronic low back pain. They’re also areas where prolotherapy is used.
How prolotherapy is used in the low back
Your SI joints connect the spine to the pelvis. They’re held together by strong ligaments. When those ligaments are strained or lax, the joint can become painful and unstable.
Prolotherapy injects a solution at or near the SI joint and the supporting ligaments of the lower back. The aim is to stimulate the body’s repair response. At Venturis Clinic, this may use dextrose or an oxygen-ozone mixture, depending on your situation.
What the research shows
The evidence for the low back is more mixed than for the knee, and we think you should know that:
- A Cochrane review (Dagenais et al., 2007) found that prolotherapy alone was not shown to be effective for chronic low back pain. When combined with other approaches such as exercise and spinal manipulation, results across trials were inconsistent.
- For the SI joint specifically, a randomized trial (Kim et al., Journal of Alternative and Complementary Medicine, 2010) compared dextrose prolotherapy with steroid injections into the SI joint. Both groups improved at first, and the prolotherapy group maintained pain relief longer.
In short: SI joint and ligament-related pain has more encouraging data than nonspecific low back pain. Careful evaluation to identify the pain source matters.
Signs your pain may involve the SI joint or ligaments
- Pain on one side, low in the back or buttock, sometimes into the groin or thigh
- Pain with standing on one leg, climbing stairs, or rolling over
- A feeling of instability, or of the back “slipping”
- Pain that started after pregnancy, a fall, or a lifting injury
- Temporary relief from a pelvic belt or manipulation that doesn’t last
Who may not be a candidate
- Pain caused by nerve compression with leg weakness or numbness, which needs spine evaluation first
- Active infection, certain bleeding disorders, or uncontrolled diabetes
- Pain that hasn’t been evaluated for other serious causes
What to expect
- Evaluation: history, exam including SI joint provocation tests, and review of prior imaging.
- Plan: the injection sites, the approach, and a realistic number of sessions.
- Injection visit: usually brief.
- Afterward: soreness and stiffness for a few days are common.
Risks
- Common: post-injection soreness and stiffness.
- Uncommon: bruising, infection, or nerve irritation.
- Rare with ozone: serious complications if gas enters a blood vessel.
When to get emergency care
Go to the emergency room immediately for:
- loss of bladder or bowel control,
- numbness in the groin or inner thighs,
- rapidly worsening leg weakness, or
- back pain with fever or unexplained weight loss.
Serving Oklahoma City, Tulsa, and all of Oklahoma
Venturis Clinic sees patients from Oklahoma City and surrounding areas, including Tulsa, and from across Oklahoma. Learn more on our Prolotherapy in Oklahoma City page.
Frequently asked questions
Does prolotherapy work for lower back pain? Evidence is mixed. Prolotherapy alone hasn’t been shown effective for general chronic low back pain. SI joint pain has more encouraging trial data.
How do I know if my SI joint is the problem? A hands-on exam with specific provocation tests, along with your symptom pattern, helps identify the SI joint as a likely source.
Is prolotherapy an alternative to back surgery? For ligament or SI joint–related pain, some people explore it first. It isn’t appropriate for problems that require surgery, like severe nerve compression.
Can prolotherapy help pain that started after pregnancy? SI joint and ligament laxity after pregnancy is a common reason people are evaluated for it.
Ready to find the source of your back pain? Book a free 15-minute discovery call, or learn more about prolotherapy in Oklahoma City.
Individual results vary. This page is for educational purposes and is not a guarantee of outcome.
By Alvin Philipose, DC, ICCP
Sources
- Dagenais S, et al. Prolotherapy injections for chronic low-back pain. Cochrane Database of Systematic Reviews. 2007;(2):CD004059.
- Kim WM, et al. A randomized controlled trial of intra-articular prolotherapy versus steroid injection for sacroiliac joint pain. Journal of Alternative and Complementary Medicine. 2010;16(12):1285–1290.