K. Dean Reeves in Kansas, has a very detailed chapter giving a good overview of the technique on his website. Reeves KD. Prolotherapy: Regenerative Injection Therapy. In: Waldman SD (ed): Pain Management. Philadelphia; Saunders (Elsevier); 2007; pg 1106-1127
Mooney V Prolotherapy in the spine and pelvis: an introduction. Spine, 1995; 9(2):309-11
Banks AR: A rationale for prolotherapy. J Orthopaed Med 1993; 13:54-59. This article has a detailed description of the inflammatory process and its relevance to prolotherapy.
Miller MR, Mathews RS, Reeves KD. Treatment of painful advanced internal disc derangement with intradiscal injection of hypertonic dextrose. Pain Physician 2006 9:115-121
Wilkinson HA, Injection therapy for enthesopathies causing axial spine pain and the "failed back syndrome": a single blinded, randomized and cross-over study. Pain Physician. 2005 Apr;8(2):167-73 Chakraverty R, Dias R. Audit of conservative management of chronic low back pain in a secondary care setting--part I: facet joint and sacroiliac joint interventions. Acupunct Med. 2004 Dec;22(4):207-13
Hooper RA, Ding M, Retrospective case series on patients with chronic spinal pain treated with dextrose prolotherapy. J Altern Complement Med 2004; 10(4):670-4.
Dorman TA et al, Energy efficiency during human walking before and after prolotherapy. J Orthopaed Med 1995; 17:24-26. Visit the Fact, Fiction and Fraud in Modern Medicine website and search Scientific articles for the year 1995. Using oxygen consumption as a measure of energy expenditure, 9 patients with low back pain were assessed before and after prolotherapy. All patients were substantially improved symptomatically and 7 of the 9 were able to walk faster and consumed less oxygen even at the new faster walking speed.
Klein R, Eek BC, DeLong B, et al: A randomized double-blind trial of dextrose-glycerine-phenol injections for chronic low back pain. J Spinal Disord 1993; 6:23-33. Visit Fact, Fiction and Fraud in Modern Medicine and search Scientific articles from 1993 This second double-blind trial found 77% of the experimental group got more than 50% improvement in pain or disability scores compared to 52% in the lignocaine-only group.
Klein R, Dorman TA, Johnson: Proliferant injections for low back pain: Histological changes of injected ligaments & objective measurements of lumbar spine mobility before & after treatment: J Neurol & Orthop Med & Surg 1989; 10:123-126. Visit Fact, Fiction and Fraud in Modern Medicineand search Scientific articles for the year 1989. Biopsies of 3 patients’ sacro-iliac ligaments before and after prolotherapy showed and average increase in collagen fibre diameter from 0.055 to 0.087 micrometres. There was also significant increase in range of motion, and decrease in pain visual analogue scale and disability score.
Ongley M, Klein R, Dorman T, et al: A new approach to the treatment of chronic low back pain. Lancet 1987;2:143-146. Visit Fact, Fiction and Fraud in Modern Medicine and search Scientific articles from 1997
This was the first double-blind trial of prolotherapy. The patients averaged 10 years of chronic low back pain. 35 of 40 (ie88%) of the treatment group had greater than 50% improvement in disability scores compared with 16 of 41 (39%) in the control group.
Reeves KD, Hassanein K: Randomised, prospective double-blind, placebo controlled study of dextrose prolotherapy for knee osteoarthritis with or without ACL laxity. Evidence of pain improvement, range of motion increase, reduction of ACL laxity, and early evidence for radiographic stabilization. Altern Ther Health Med 2000; 6:68-74, 77-80. This DB trial used a non-inflammatory 10% glucose solution and they still found 40% decrease in pain, 63% decrease in swelling and 14% increase in flexion by 12 months.
Ongley M, Dorman TA et al: Ligament instability of knees: A new approach to treatment. Manual Med 1988; 3 Visit Fact, Fiction and Fraud in Modern Medicine and search Scientific articles for the year 1998. Five patients with severe and reproducible ligament instability were treated and assessed with a Genucom computerized electrogoniometer. The article gives detailed instructions of how to inject the anterior and posterior cruciate ligaments and details the measurable and clinical improvements.
Reeves KD and Hassanein K, Long term effects of dextrose prolotherapy for anterior cruciate ligament laxity. Altern Ther Health Med, 2003;9(3):52-56. The ACL Laxity Study: 10 of 16 knees were measurably normal by 3 years and 9 were normal by 12 months.
Centeno CJ, Elliott J, Elkins WL, Freeman M, Fluoroscopically guided cervical prolotherapy for instability with blinded pre and post radiographic readings. Pain Physician. 2005 Jan;8(1):67-72
Dorman TA, Whiplash injuries: treatment with prolotherapy and a new hypothesis. J Orthopaed Med 1999; 21:13-21. Visit Fact, Fiction and Fraud in Modern Medicine and search Scientific articles for the year 1999. Retrospective analysis of 48 patients for decrease in pain and improvement in daily living activities. Includes a detailed description of his method.
Hakala RV, Prolotherapy (proliferation therapy) in the treatment of TMD. Cranio.2005 Oct;23(4):283-8 The study shows that prolotherapy can be effective in reducing jaw joint pain and noise.
Reeves KD & Hassanein K: Randomised, prospective, placebo-controlled double-blind study of dextrose prolotherapy for osteoarthritic thumb and finger (DIP, PIP, and trapeziometacarpal) joints: evidence of clinical efficacy. J of Altern Complementary Med 2000;6(4):311-320. 42% improvement in pain in the dextrose group compared with 15% in the placebo group. Movement also was significantly improved.
Topol GA, Reeves KD, Hassanein K. Efficacy of Dextrose Prolotherapy in Elite Male Kicking-Sport Athletes With Chronic Groin Pain. Archives Phys Med Rehabil, 2005;86:697-702. 20 of 24 players had no pain, VAS decreased from average 6.3 to 1.0 in average 2.8 treatments.
Chakraverty RC, A case of osteitis pubis secondary to unilateral sacroiliac joint instability treated with prolotherapy. J Orthopaed Med 2003;25:10-13
Healing of many tendon problems (eg Achilles, patella, elbow etc) is inhibited by VEGF produced in neovessels around the tendon. Hypertonic glucose is as effective as more expensive injections (polidocanol) or more effective, according to recent work published by John Lyftogt in Australasian Musculoskeletal Medicine, Nov 2007. The injections are more effective if subcutaneous than if injected into the tendon and much less painful.
Reeves KD, Treatment of consecutive severe fibromyalgia patients with prolotherapy. J Orthopaed Med 1994;16: 84-89 31 patients treated with prolotherapy to multiple tender points - many had significant improvement, some to no pain.
Dorman TA, Prolotherapy: A Survey. J Orthopaedic Med 1993;15:49. Very few complications in nearly half a million treatments.
Dagenais S, Ogunseitan O, Haldeman S, Wooley JR, Newcomb RL, Side effects and adverse events related to intraligamentous injection of sclerosing solutions (prolotherapy) for back and neck pain: A survey of practitioners. Arch Phys Med Rehabil. 2006 Jul;87(7):909-13
Dorman TA and Ravin TM: Diagnosis and Injection Techniques in Orthopedic Medicine, 1991 pub Williams & Wilkins. An excellent textbook of Orthopedic Medicine which includes prolotherapy techniques. Available from his website
.Hackett G, Hemwall and Montgomery: Ligament and Tendon Relaxation Treated by Prolotherapy 1991 The pioneering textbook by Hackett, revised by Hemwall. Available from Beulah Land Press for ~US$50
Ross Hauser's website has many useful articles and books for non-medical people
The American Association of Orthopedic Medicine website has articles by some of the leaders in prolotherapy in the USA.