JOURNAL OF THE AMERICAN FAMILY PHYSICIAN

1. Proliferative therapy is an injection-based complementary therapy for common chronic musculoskeletal conditions including tendinopathy, knee osteoarthritis, and low back issues.

2. Patients with severe refractory lateral epicondylitis (Tennis elbow) treated with proliferative therapy, reported approximately a 90 percent reduction in resting elbow discomfort on a 10-point visual analog scale compared with a 22 percent reduction in the control group.

3. Other overuse injuries including Achilles tendinopathy, Abductor tendinopathy, and Plantar fasciitis have responded well to prolotherapy.

4. Proliferative therapy has also been used in multidisciplinary care plans. Participants in an Achilles tendinopathy study responded earlier and with less money spent on treatment when physical therapy and prolotherapy were combined compared with either treatment alone.

5. The largest and most methodologically rigorous study compared proliferative therapy in 110 participants with an average of 14 years of nonsurgical low back discomfort. Participants reported substantial and sustained reductions in discomfort (26 to 44 percent) and disability (30 to 44 percent) at 12 months.

6. Positive outcomes have been reported in prospective studies assessing proliferative therapy for the following conditions: refractory coccygodynia, sacroiliac joint dysfunction, and leg discomfort caused by moderate to severe degenerative disk disease.

7. Proliferative therapy performed by an experienced injector appears safe; no clinical trials report significant adverse events. Current data suggest that proliferative therapy has a positive effect compared with baseline status, and in some cases compared with control therapy, in carefully selected patients for several indications including Achilles tendinopathy, Coccygodynia (tailbone discomfort), knee osteoarthritis, lateral epicondylitis, degenerative disk disease, nonspecific low back discomfort, plantar fasciitis, and sacroiliac joint dysfunction.