Among the complex causes of chronic low back pain, suboptimal injury of ligament in the lumbosacral spine is common. Injured ligaments can become a primary pain source and raise secondary pain with referred pain pattern. Due to the low blood supply to the ligaments, ligaments are notoriously poor healer. In order to compensate the poor healing of ligament, prolotherapy has been introduced and used for more 60 years. To date, no definite recommendations have not been made based on literature available. However, if conventional treatment modalities have failed in patient with chronic back pain in lumbosacral spine, prolotherapy targeted on ligaments around lumbosacral spine should be considered in appropriate patients.