The existence of connective tissue disorder and hypermobile joints syndrome plays a significant role in sacroiliac (SI) joint dysfunction. Extra-articular elements, such as ligamentous injuries and enthesopathy, likely the most frequent sources of joint dysfunction and potential hypermobility (1,2).
Prolotherapy is not a new treatment in medicine. However, the results of prolotherapy and the e‑ect of this intervention to reduce the narcotic consumption and improvement in the quality of life have not been appropriately shown in the past. Available studies that assessed the outcome of prolotherapy either had a small sample size or rigid patient selection criteria.
The concept of creating irritation or inflammation to simulate healing was described as early as the fifth century BC. During this time, Hippocrates treated unstable joints by poking the ligaments with a hot metal rod. Although the procedure was rudimentary and experimental, Hippocrates hypothesized that causing inflammation of injured ligaments would lead to selfrepair.
This was one of the first steps towards using the body’s own healing potentials to repair injured connective tissues. During prolotherapy, small amounts of an irritant solution are injected into the damaged tendon insertions, joints, ligaments, and adjacent to joint spaces to promote tissue repair or growth (3).