From the back pain blog at prolonews.com Ross Hauser, M.D.
Q. Is it necessary to have an X-ray or imaging study to do Prolotherapy?
A. These are usually unnecessary in the workup of acute onset back conditions, and are generally not required for a trial of Prolotherapy in most chronic cases that we see. Generally many of our patients have already had imaging studies. Degenerative changes and disc bulges are commonly noted, but their presence does not necessarily imply that they are causing the particular pain in that patient. Many traditional physicians overweight these imaging studies (which are filled with false negative and false positive findings) and use them to “fish” for a diagnosis, rather than using them to confirm a suspected clinical diagnosis derived from the history and physical.

The more common sources of back pain, lax or strained ligaments, usually do not show up abnormally on even the most sophisticated imaging studies. I may order new pictures (if prior films are dated) if a course of five Prolotherapy sessions fails to achieve the expected gains in the patient’s condition. The goal there is to rule out a condition which will necessitate surgical intervention. In general, Prolotherapiss are able to and find it preferable to evaluate pain complaints on the basis of history and physical examination alone, and new imaging studies are rarely needed or helpful.
 

MRI’s cannot tell a person what is causing their pain, it only confirms what is known by the history and physical examination.  Most MRI findings have nothing to do with why the person has pain and is thus the reason for most ‘failed surgery syndromes.’ Almost all people even after surgery are not pain free. Surgery for pain in the best case scenario should be done only after all of the conservative treatments have been tried and failed. This includes Prolotherapy!
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