Are you tired of living with low back pain?

The statistics involving low back pain are alarming, with approximately 70 to 85 percent of all people experiencing this condition at some time in their lives.

by Dr. Fred G. Arnold — 

Low back pain, also referred to as backache and lumbago, is one of the most common health concerns for which people see a doctor. If you have not experienced low back pain, the odds are that you will sometime in the future.

The statistics involving low back pain are alarming, with approximately 70 to 85 percent of all people experiencing this condition at some time in their lives. Low back pain is the fifth most common reason for all physician visits in the United States. Americans spend at least $50 billion per year on back pain — and that amount only includes the more easily identified costs.

Causes of low back pain

Most cases of low back pain (98 percent) are mechanical or nonorganic — meaning they are not caused by serious conditions, such as inflammatory arthritis, infection, fracture or cancer. It should be noted that each ligament, muscle and tendon, facet joint and disc is supplied by a unique system of nerves that can cause pain independently or in combination.

While disc problems have received much of the blame for causing low back pain, ligament injury is a more common source of back pain. In fact, it has been reported that only 4 percent of low back pain is due to a disc problem, such as a herniated disc. Most low back pain is triggered by a combination of overuse and injury to the muscles, tendons, ligaments and discs that support the spine.

The causes of low back pain in the lumbar and sacroiliac regions tend to compound one another. This leads to constant tension on the muscles, ligaments, bones and discs, making the back more prone to injury or re-injury. For example, after straining muscles, you are more likely to walk or move in different ways to avoid pain or to use muscles that are not sore. That can cause you to strain other muscles and create stress on the facet joints, sacroiliac joints and discs, and even cause nerve-root compression. Compression of nerve roots between the vertebrae can cause a condition called sciatica.

A disc condition can be brought on by repeated vibration or motion, by a sudden heavy strain or increased pressure to the lower back. Although osteoarthritis (joint degeneration) is a condition that develops as we age, it can be accelerated by imbalances in the musculoskeletal system of the low back.

Treatments for low back pain

Treatments for low back pain can be both frustrating and very expensive. The more common medical treatments include muscle relaxants, pain medications, physical therapy and surgery. Chiropractic and acupuncture are considered alternative methods of treatment by many members of the medical community. Sometimes people have surgical fusion performed, not realizing that prolotherapy is an alternative to this type of surgery.

A study by Dr. Merriman, a general and industrial surgeon, evaluated 15,000 patients who were treated with prolotherapy or surgical fusion for sciatic pain. He found prolotherapy to be a highly successful conservative approach in 80 to 90 percent of patients, causing fewer side effects than those patients who were treated with fusion.

Prolotherapy:  The missing link

Prolotherapy is the “missing link” when it comes to the treatment of musculoskeletal conditions. Prolotherapy, also known as regenerative injection therapy (RIT), ligament reconstructive therapy or sclerotherapy, is a recognized orthopedic procedure that stimulates the body’s natural healing processes to strengthen joints weakened by trauma or arthritis, or when ligaments and tendons are stretched, torn, fragmented or become hypermobile and painful. Other conditions responsive to prolotherapy include neck pain, shoulder pain, elbow problems, wrist and hand conditions, hip pain, tailbone pain, knee pain, and ankle and foot problems.

What to expect

The average number of prolotherapy treatments needed is between four and six. As an injection therapy, a small amount of specialized solution is applied to the affected ligament or tendon attachment. The solution most commonly used for the low back includes a mixture of dextrose (a sugar solution) with anesthetics such as Lidocaine and Marcaine™. These therapeutic injections have been shown to result in enlargement and strengthening of damaged ligamentous, tendon and intra-articular structures.

Although the treatment may take a little longer, prolotherapy also can be successfully used for people who have had a failed back surgery. The surgical scar may also require specific treatment called neural therapy, which is a highly effective injection therapy used by more than 40 percent of doctors in Germany; however, very few doctors in this country have even heard of it.

Before prolotherapy is performed, each patient should be thoroughly evaluated with a personal history that includes an orthopedic physical exam, neurologic assessment and careful palpation of the low back. Palpation of a painful joint is usually associated with weakened tissues and can at times be more beneficial in identifying the problem areas than diagnostic testing. On an individual basis, further evaluation may include X-rays and/or MRI before receiving prolotherapy. In cases involving chronic pain, a comprehensive treatment approach should be considered that includes rehabilitative exercises, nutrition and specific supplements to maximize your health and ability to heal.


If you, a family member or friend are experiencing low back pain, prolotherapy should be considered if the pain is not responding to medications, and especially if surgery has been recommended. Patients who report at least temporary improvement with chiropractic and spinal manipulation usually benefit from prolotherapy.

Prolotherapy is a safe, reasonable and proven orthopedic procedure that has provided significant relief to thousands of patients when other methods of treatment have failed. Strengthening weakened ligaments and tendons provides support to joints and muscles injured by overuse and trauma, and improves the associated painful condition. Osteoarthritis and disc herniations are consequences of weakened ligaments and tendons, and also respond well.

Prolotherapy is a treatment modality that provides long-term relief for low back conditions without the negative consequences of medications and surgery.


Alderman, Donna, DO, Prolotherapy for Low Back Pain, Practical Pain Management, May 2007, pp. 58-63.

Cusi, M., Saunders, J., Hungerford, B., Wisbey-Roth, T., Lucas, P., Wilson, S., The Use of Prolotherapy in the Sacroiliac Joint, Br J Sports Med, 2010, 44:100-104.

Hooper, RA, Ding, M., The Journal of Alternative and Complementary Medicine, Volume 10, Number 4, 2004, pp. 670–674.

Ongley, Klein, Dorman, Eek and Hubert, A New Approach to the Treatment of Chronic Low Back Pain, The Lancet, July 18, 1987, pp. 143-146.


Fred G. Arnold, D.C., N.M.D., specializes in prolotherapy/pain rehabilitation services. He is a Diplomate of the American Academy Health Care Providers and is one of the few physicians in the nation with both a naturopathic medical degree and chiropractic degree. 602-292-2978 or

Reprinted from AzNetNews, Volume 30, Number 1, Feb/Mar 2011.

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