To Ease Knee Arthritis Pain, This Depression-Era Treatment Is Newly Popular

When it comes to treating the pain of knee arthritis, something old is new again. Prolotherapy, a procedure first developed in the 1930s, is becoming an increasingly prescribed treatment in modern sports rehab clinics and primary care doctors’ offices. It involves injections of an innocuous substance such as dextrose, a form of sugar, into the knees.

Why the new popularity? Possibly for the simplest of reasons—the treatment works. We reported in 2013 that it reduces pain and stiffness and improves function, but newer studies have additionally found…

• It works for people at any weight range—normal, overweight, obese and morbidly obese.
• It’s effective for people with diabetes, who hadn’t been included in studies before.
• It may benefit people with severe, advanced knee arthritis, not just those with mild-to-moderate cases.
• The benefits last at least two and a half years.
• Different kinds of injections work, not just dextrose. Some researchers recommend a combination for best effect.

Exactly how prolotherapy works isn’t understood, but the current hypothesis is that it stimulates short-term inflammation, which promotes a healing response, and new research suggests that it may help build cartilage—actually modifying the progression of the disease, not just providing symptomatic relief.

Patients usually undergo three to five treatments, sometimes more—side effects are modest, but the procedure itself can be painful. It’s not a cure-all, to be sure, but if you have bothersome knee pain from arthritis, it’s worth discussing with your doctor.

To learn more, see the Bottom Line article “Prolotherapy Sugar Injections Relieve Knee Arthritis Pain.”