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Prolotherapy in the Academy: A Mixed Methods Survey Study.

Jared Dubey1, Nathan R Jones2, Jane Alice Evered1

  • 1Department of Family Medicine and Community Health, Prolotherapy Education and Research Lab, University of Wisconsin, School of Medicine and Public Health, Madison, WI, USA.

Journal of Integrative and Complementary Medicine
|August 27, 2025
PubMed
Summary
This summary is machine-generated.

Prolotherapy is used and taught in a significant minority of U.S. medical training programs, particularly in pain management specialties. Further research is needed to explore its efficacy and effectiveness in chronic pain treatment.

Keywords:
chronic paincross-sectionalmixed-methodsprolotherapysurvey

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Area of Science:

  • Integrative Medicine
  • Pain Management
  • Medical Education

Background:

  • Chronic pain necessitates safe and effective treatments.
  • Prolotherapy, an injection therapy with emerging evidence, is anecdotally used but not standard in practice guidelines.
  • Limited knowledge exists regarding prolotherapy's integration into U.S. medical training programs.

Purpose of the Study:

  • To evaluate the current use and teaching of prolotherapy within U.S. graduate medical education programs.
  • To identify specialties and training levels where prolotherapy is most prevalent.
  • To understand perspectives on prolotherapy adoption and education.

Main Methods:

  • A cross-sectional, mixed-methods survey was administered to directors of Accreditation Council for Graduate Medical Education (ACGME)-accredited residency and fellowship programs (11 chronic pain specialties).
  • The survey included 21 items assessing prolotherapy use, teaching, and related perspectives.
  • Data analysis involved descriptive statistics, ANOVA, and qualitative content analysis.

Main Results:

  • Out of 854 survey responses (46.1% return rate), 24.7% of programs reported using prolotherapy, and 13.9% provided prolotherapy-focused education.
  • Osteopathic Manipulative Medicine/Neuromusculoskeletal Medicine (OMM/NMM) and Physical Medicine and Rehabilitation (PM&R) programs, along with Sports Medicine and Musculoskeletal Radiology fellowships, most frequently reported use and teaching.
  • Educational efforts primarily focused on knee, shoulder, and elbow pathologies, often with ultrasound guidance. Qualitative analysis revealed mixed views, with non-adopters citing limited evidence and adopters noting safety and efficacy.

Conclusions:

  • Prolotherapy is utilized and instructed in a notable portion of U.S. ACGME-accredited medical training programs, particularly in OMM/NMM, PM&R, and Sports Medicine.
  • Perspectives on prolotherapy vary, with barriers including perceived lack of evidence and facilitators including a favorable safety profile.
  • The findings underscore the need for further research into prolotherapy's use, training, efficacy, and effectiveness in managing chronic pain.