Prolotherapy for the treatment of sacroiliac joint instability in patients with Ehlers-Danlos syndrome

IF 1.7 Q2 Medicine

Advances in integrative medicine Pub Date : 2025-09-10 DOI:10.1016/j.aimed.2025.100577

Philip Montana , Hung M. Le , Jeffrey Lo , Olivia Elie , Danielle L. Cook , Sealy Hambright , Pierre d’Hemecourt

{"title":"Prolotherapy for the treatment of sacroiliac joint instability in patients with Ehlers-Danlos syndrome","authors":"Philip Montana , Hung M. Le , Jeffrey Lo , Olivia Elie , Danielle L. Cook , Sealy Hambright , Pierre d’Hemecourt","doi":"10.1016/j.aimed.2025.100577","DOIUrl":null,"url":null,"abstract":"<div><h3>Aim</h3><div>To evaluate patient response and efficacy of prolotherapy in managing sacroiliac joint (SIJ) instability and pain in patients with Ehlers-Danlos syndrome (EDS).</div></div><div><h3>Methods</h3><div>A retrospective cohort study on patients aged 13–55 years diagnosed with EDS who received prolotherapy for SIJ instability. Patient demographics, treatment characteristics, and clinical outcomes were assessed by phone follow-up. The visual analog scale (VAS) and Oswestry Low Back Disability (ODI) were utilized to measure pain and disability respectively pre- and post-intervention. Spearman correlation was used to determine correlations between injection number and VAS/ODI scores.</div></div><div><h3>Results</h3><div>Ten patients were included (median age 32 years). 60 % (6/10) had Polidocanol, 30 % (3/10) had sodium tetradecyl sulfate, and one person (10 %) had PRP. The median number of injections was 2 (range, 1–3). Median follow-up was 9 months (IQR, 6–11) after their injection(s). Median VAS score at follow-up was 2 (IQR, 0–4, p = 0.008). There was no significant correlation between the number of injections and VAS (r = 0.29; p = 0.42) or ODI scores (r = 0.21; p = 0.56). Median ODI score was 13 (IQR, 0–24) and 70 % (7/10) of the cohort resided in the “minimal disability” group. Compared to before treatment, 90 % reported moderate to significant improvement in exercise ability and activities of daily living while 100 % showed moderate to significant improvement in movement apprehension.</div></div><div><h3>Conclusions</h3><div>Prolotherapy may be a promising treatment option for SIJ instability in patients with EDS. It significantly reduced pain and improved functional outcomes. Further prospective studies with larger sample sizes are needed to confirm these findings and to optimize treatment protocols.</div></div>","PeriodicalId":7343,"journal":{"name":"Advances in integrative medicine","volume":"12 4","pages":"Article 100577"},"PeriodicalIF":1.7000,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Advances in integrative medicine","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2212958825001363","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}

引用次数: 0

Abstract

Aim

To evaluate patient response and efficacy of prolotherapy in managing sacroiliac joint (SIJ) instability and pain in patients with Ehlers-Danlos syndrome (EDS).

Methods

A retrospective cohort study on patients aged 13–55 years diagnosed with EDS who received prolotherapy for SIJ instability. Patient demographics, treatment characteristics, and clinical outcomes were assessed by phone follow-up. The visual analog scale (VAS) and Oswestry Low Back Disability (ODI) were utilized to measure pain and disability respectively pre- and post-intervention. Spearman correlation was used to determine correlations between injection number and VAS/ODI scores.

Results

Ten patients were included (median age 32 years). 60 % (6/10) had Polidocanol, 30 % (3/10) had sodium tetradecyl sulfate, and one person (10 %) had PRP. The median number of injections was 2 (range, 1–3). Median follow-up was 9 months (IQR, 6–11) after their injection(s). Median VAS score at follow-up was 2 (IQR, 0–4, p = 0.008). There was no significant correlation between the number of injections and VAS (r = 0.29; p = 0.42) or ODI scores (r = 0.21; p = 0.56). Median ODI score was 13 (IQR, 0–24) and 70 % (7/10) of the cohort resided in the “minimal disability” group. Compared to before treatment, 90 % reported moderate to significant improvement in exercise ability and activities of daily living while 100 % showed moderate to significant improvement in movement apprehension.

Conclusions

Prolotherapy may be a promising treatment option for SIJ instability in patients with EDS. It significantly reduced pain and improved functional outcomes. Further prospective studies with larger sample sizes are needed to confirm these findings and to optimize treatment protocols.

查看原文本刊更多论文

前驱疗法治疗ehers - danlos综合征患者骶髂关节不稳

目的评价前驱疗法治疗ehers - danlos综合征（EDS）患者骶髂关节（SIJ）不稳定及疼痛的疗效和反应。方法回顾性队列研究13-55岁诊断为EDS并接受前驱治疗的SIJ不稳定患者。通过电话随访评估患者人口统计学、治疗特征和临床结果。采用视觉模拟量表（VAS）和Oswestry腰背功能障碍量表（ODI）分别测量干预前和干预后的疼痛和功能障碍。采用Spearman相关法确定注射次数与VAS/ODI评分的相关性。结果纳入患者10例（中位年龄32岁）。聚多醇60 %(6/10)，硫酸十四烷基钠30 % (3/10)，PRP 1人（10 %）。注射次数中位数为2次（范围1-3）。注射后中位随访时间为9个月（IQR, 6-11）。随访时VAS评分中位数为2 （IQR, 0-4, p = 0.008）。注射次数与VAS （r = 0.29;p = 0.42）或ODI评分（r = 0.21;p = 0.56）无显著相关性。ODI得分中位数为13 (IQR, 0-24), 70% %（7/10）的队列处于“轻度残疾”组。与治疗前相比，90% %的患者报告在运动能力和日常生活活动方面有中度到显著的改善，而100% %的患者在运动恐惧方面有中度到显著的改善。结论前驱治疗可能是治疗EDS患者SIJ不稳定的一种有希望的治疗方法。它显著减轻了疼痛并改善了功能预后。需要进一步的更大样本量的前瞻性研究来证实这些发现并优化治疗方案。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Advances in integrative medicine INTEGRATIVE & COMPLEMENTARY MEDICINE-

CiteScore

3.20

自引率

11.80%

发文量

审稿时长

15 weeks

期刊介绍： Advances in Integrative Medicine (AIMED) is an international peer-reviewed, evidence-based research and review journal that is multi-disciplinary within the fields of Integrative and Complementary Medicine. The journal focuses on rigorous quantitative and qualitative research including systematic reviews, clinical trials and surveys, whilst also welcoming medical hypotheses and clinically-relevant articles and case studies disclosing practical learning tools for the consulting practitioner. By promoting research and practice excellence in the field, and cross collaboration between relevant practitioner groups and associations, the journal aims to advance the practice of IM, identify areas for future research, and improve patient health outcomes. International networking is encouraged through clinical innovation, the establishment of best practice and by providing opportunities for cooperation between organisations and communities.