SHILOH, IL – After years of having nothing but case reports and the occasional case series to guide his fledgling Sports Medicine practice, Dr. Trev Smith was getting frustrated.
“I knew that every patient that came into the FP Clinic with an extremity problem needed an injection to avoid being forced to have unnecessary or even necessary surgery. The hard part was what exactly did they need injected into or relatively close to the problem area?” Smith relayed.
Prolotherapy, or dextrose injection into and around joints, muscles and tendons has been utilized for decades with relatively minimal supporting evidence.
Traditionally, sugar has been used as a placebo in medical studies, which makes finding a placebo to compare sugar injections to a challenge.
“Then one day, while driving home from work, I saw some kids selling Koolaid by the cup and it hit me!” Smith recalls, “I could use another sugar as a placebo to compare to the sugar that was being tested!!!”
Dr. Smith promptly performed a RCT using his next 3 patients. He randomly injected dextrose into the fat overlying a rotator cuff, purple Koolaid into the dermis of an ankle and red Koolaid “intraarticularly” into a knee prepatellar bursa.
“The patient who was randomized to the prolotherapy had a 0.4 improvement in their pain on the Wong-Baker scale after taking motrin. The Koolaid recipients had worse pain scores after the injections, so clearly we proved that prolotherapy works. No point doing any more research!” Smith explained.
When asked if he’d ever read any studies about orthopaedic surgeries, Dr. Smith was dismissive, “How could anyone read those studies? The methods sections alone are multiple whole paragraphs! Prolotherapy articles are a page tops, you can’t beat that science!”
