I’ve been seeing an osteopathic physician for chronic low back pain. He is suggesting a treatment called prolotherapy. I understand the procedure and how it’s supposed to work. What if it doesn’t help? Could I end up worse than before the treatment?

Prolotherapy has been around for more than 60 years. The basic idea is to inject a solution into ligaments or joints that causes an inflammatory reaction. The end result is a build-up of collagen fibers and connective tissue. Pain from joint laxity decreases as the joint fills in with organized scar tissue.

Most people experience a decrease in painful symptoms after treatment. But adverse events can occur. The most common problem to develop is an increase in pain and/or stiffness. These symptoms occur at the site of the injection. They are usually temporary and go away 12 to 96 hours after the injection.

A small number of patients report bruising at the injection site. Less common side effects can include headache, leg pain, nausea, and diarrhea. Rarely, disc injury, hemorrhage, or nerve damage occurs. There have been no reports of death with this treatment. Permanent injury is possible but very rare.

There are some risk factors to be aware of. Obesity, use of tobacco products, and mental illness can increase the risk of post treatment problems. Anyone with serious health issues or an inability to do the required range of motion exercises after injection may not be a good candidate for this treatment.