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Evidence-Based Use of Dextrose Prolotherapy for Musculoskeletal Pain: A Scientific Literature Review
Authors: Ross A. Hauser, MD, Marion A. Hauser, MS, RD, & Nicole M. Baird, CHFP
Objective: To evaluate, through a scientific review of the current literature, the efficacy of dextrose Prolotherapy in treating musculoskeletal pain.
Data Sources: All possible internet sources, especially online medical databases including PUBMED, PREMEDLINE, EMBASE, AMED, HEALTHLINE, OMNIMEDICALSEARCH, MEDSCAPE and MEDLINE, were searched through October 2011 for scientific articles on dextrose Prolotherapy. The bibliographies of retrieved articles were also searched.
Study Selection: All published studies that could be found on human subjects that included at least five subjects and at least one outcome measure related to pain intensity were included. Nonhuman studies and those studies (human and nonhuman) on Prolotherapy involving other solutions besides dextrose were excluded.
Main Results: Data from forty-four case series, two nonrandomized controlled trials (NRCT) and nine randomized controlled trials (RCT) were included in this review. A total of 2,443 patients were treated which included 2,181 in the case series, 27 in the NRCT and 235 in the RCT. In the 27 case series, involving 1,478 musculoskeletal structures treated, that used VAS or NRS in monitoring the response to treatment, dextrose Prolotherapy caused a decline of over 4.4 points (0 to 10 scale). Seven of nine double-blind placebo-controlled studies showed statistically significant improvements in pain and/or function with dextrose Prolotherapy over placebo for myofascial pain syndrome, sacroiliac pain, knee osteoarthritis, Osgood-Schlatter disease and Achilles tendinosis. There is level 1 and 2 evidence to support the use of dextrose Prolotherapy for osteoarthritis pain and function, tendinopathies, myofascial pain syndrome, and sacroiliac ligament pain. There is level 3 evidence in support of the use of dextrose Prolotherapy for diffuse musculoskeletal pain involving the spine, pelvis and peripheral joints. Using the U.S. Preventative Services Task Force guidelines there is fair to good evidence to support the use of dextrose Prolotherapy for musculoskeletal pain.
Conclusion: This scientific literature review shows there is level 1 and 2 evidence to support the use of dextrose Prolotherapy for osteoarthritic pain and function, tendinopathies, myofascial pain syndrome, sacroiliac pain, and myofascial pain syndrome. There is level 3 evidence in support of the use of dextrose Prolotherapy for diffuse muscusloskeletal pain involving the spine, pelvis and peripheral joints. Dextrose Prolotherapy should be recommended for such musculoskeletal conditions as tendinopathy, ligament sprains, Osgood-Schlatter disease and degenerative joint disease, including osteoarthritis.
Journal of Prolotherapy. 2011;3(4):765-789.