Prolotherapy shows promise for sacroiliac joint instability in EDS
Treatment reduced self-reported pain, improved functional outcomes
Prolotherapy, a type of regenerative medicine, may be a promising option to treat sacroiliac joint instability in people with Ehlers-Danlos syndrome (EDS), according to a small study.
Treatment reduced self-reported pain in the sacroiliac joint, where the spine meets the pelvis, and improved the functional outcomes of patients, the results showed.
“Further prospective studies with larger sample sizes are needed to confirm these findings and to optimize treatment protocols,” researchers wrote in the study, “Prolotherapy For the Treatment of Sacroiliac Joint Instability in Patients with Ehlers-Danlos Syndrome,” published in Advances in Integrative Medicine.
Team reviewed outcomes for patients who received prolotherapy for EDS
EDS is a group of connective tissue disorders characterized by unusually mobile joints that easily dislocate, chronic pain, and soft, stretchy skin. While no cure for EDS exists, current treatments can help manage some symptoms and prevent complications.
The sacroiliac joints are among the joints affected. Sacroiliac joint instability, marked by excessive joint movement, often presents as nonspecific lower back or pelvic pain.
“There continues to be a significant amount of difficulty in both diagnosing and treating sacroiliac joint instability, which is exacerbated in EDS patients,” the researchers wrote.
Prolotherapy is a minimally invasive treatment in which small amounts of an irritant solution are injected directly into areas of pain or injury. It aims to activate growth factors that promote the development of new, healthy tissue and improve structural integrity.
In this study, the team retrospectively reviewed the outcomes of 10 EDS patients, ages 13 to 55, who received prolotherapy. All participants were female, white, and had previously undergone either physical therapy (30%) or physical therapy and bracing (70%).
The most common prolotherapy agent used was polidocanol (60%), followed by sodium tetradecyl sulfate (30%), and platelet-rich plasma (10%). Patients received up to three injections.
Our study suggests that prolotherapy utilizing sclerosing agents like polidocanol and tetradecyl may be an effective treatment option for [sacroiliac joint ] instability in patients diagnosed with EDS.
Self-reported pain was measured using a visual analog scale (VAS) and pain-associated disability related to lower back pain was measured with the Oswestry Disability Index before and after prolotherapy. With both assessments, higher scores indicate greater pain and disability.
After a median follow-up of nine months, the median VAS score was significantly lower after treatment than before (2 vs. 5). Likewise, the median Oswestry score was 13% (out of 100%), with nearly all participants (90%) reporting minimal to moderate disability. Compared with before prolotherapy, most reported a higher level of athletic ability and satisfaction (90% for each).
When asked for clarification, nearly all participants said they experienced a moderate to significant improvement in their exercise ability and activities of daily living. All participants reported moderate to significant improvement in their level of apprehension to move.
A statistical analysis showed no correlation between the number of injections and VAS and Oswestry scores.
“Our study suggests that prolotherapy utilizing sclerosing agents like polidocanol and tetradecyl may be an effective treatment option for [sacroiliac joint ] instability in patients diagnosed with EDS,” the researchers concluded. “However, the small sample size and limited follow-up period [highlight] the need for additional prospective studies to confirm the safety and efficacy of these findings.”
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