Dextrose Prolotherapy

Reeves, Kenneth Dean; Sit, Regina W.S.; Rabago, David

doi:10.1016/j.pmr.2016.06.001

Cited by 88 publications

(53 citation statements)

References 71 publications

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“…Taken together, these findings indicate a potential role of glucose in tendon pathologies and tendon healing, also in non-diabetic individuals. Clinically, hyperosmolar dextrose solutions together with an anaesthetic are often injected into or alongside tendons and ligaments aiming at reducing chronic pain and to stimulate cell proliferation and extracellular matrix (ECM) deposition by inducing an inflammatory response 14 . Generally, this increasingly popular treatment for a wide range of musculoskeletal pathologies is deemed safe, however evidence to support the effectiveness of this so-called prolotherapy is limited as only few randomised controlled clinical trials have been conducted 15 .…”

Section: Introductionmentioning

confidence: 99%

A high-glucose diet affects Achilles tendon healing in rats

Korntner

Kunkel

Lehner

et al. 2017

Sci Rep

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Chronic and acute tendinopathies are difficult to treat and tendon healing is generally a very slow and incomplete process and our general understanding of tendon biology and regeneration lags behind that of muscle or bone. Although still largely unexplored, several studies suggest a positive effect of nutritional interventions on tendon health and repair. With this study, we aim to reveal effects of a high-glucose diet on tendon neoformation in a non-diabetic rat model of Achilles tenotomy. After surgery animals received either a high-glucose diet or a control diet for 2 and 4 weeks, respectively. Compared to the control group, tendon repair tissue thickness and stiffness were increased in the high-glucose group after 2 weeks and gait pattern was altered after 1 and 2 weeks. Cell proliferation was up to 3-fold higher and the expression of the chondrogenic marker genes Sox9, Col2a1, Acan and Comp was significantly increased 2 and 4 weeks post-surgery. Further, a moderate increase in cartilage-like areas within the repair tissue was evident after 4 weeks of a high-glucose diet regimen. In summary, we propose that a high-glucose diet significantly affects tendon healing after injury in non-diabetic rats, potentially driving chondrogenic degeneration.

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Section: Introductionmentioning

confidence: 99%

A high-glucose diet affects Achilles tendon healing in rats

Korntner

Kunkel

Lehner

et al. 2017

Sci Rep

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“…Its diagnostic criteria consist of taut bands, hypersensitive spots, and referred pain over the affected area, and MTrPs are usually treated as the therapeutic targets [3]. Injection is an effective treatment for musculoskeletal disorders, and the commonly used injectates include corticosteroids, local anesthetics, hyaluronic acid, and high-concentration dextrose [4][5][6]. Botulinum toxin (BoNT) has been widely used in managing post-stroke spasticity, hemifacial spasm, and cervical dystonia.…”

Section: Study Identification and Selectionmentioning

confidence: 99%

Comparative Effectiveness of Botulinum Toxin Injection for Chronic Shoulder Pain: A Meta-Analysis of Randomized Controlled Trials

Hsu

Han

et al. 2020

Toxins

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Botulinum toxin (BoNT) injection is regarded as a promising treatment for musculoskeletal pain. However, its efficacy for treating chronic shoulder pain remains unclear. We investigated the effectiveness of BoNT injections for chronic shoulder pain by conducting a systematic search of electronic databases up to March 2020 for randomized control trials (RCTs) that used BoNT injections for chronic shoulder pain treatment. The primary outcome was the between-group comparison of pain reduction, quantified by the standardized mean difference (SMD). Nine RCTs comprising 666 patients were included and divided into two groups: one group with shoulder joint pain (n = 182) and the other group with shoulder myofascial pain (n = 484). Regarding shoulder joint pain, the efficacy of BoNT injections was similar to that of the reference treatment (SMD: −0.605, 95% confidence level [CI]: −1.242 to 0.032 versus saline; SMD: −0.180, 95% CI: −0.514 to 0.153 versus corticosteroids) at one month post-intervention, and was superior (SMD: −0.648, 95% CI: −0.1071 to −0.225 versus corticosteroids) between one and three months. Likewise, in terms of shoulder myofascial pain, the effectiveness of BoNT injections did not differ from the reference treatment (SMD: −0.212, 95% CI: −0.551 to 0.127 versus saline; SMD: 0.665, 95% CI: −0.260 to 1.590 versus dry needling and SMD: 1.093; 95% CI: 0.128 to 2.058 versus lidocaine) at one month post- intervention, and appeared superior (SMD: −0.314, 95% CI: −0.516 to −0.111 versus saline) between one and three months. Our meta-analysis revealed that BoNT injections could be a safe and effective alternative for patients with chronic shoulder pain.

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“…Incomplete healing or partial damage to ligaments can result in secondary laxity and lability of the joint regulated by the ligament, ultimately resulting in chronic pain [ 18 ]. Prolotherapy refers to a treatment for such chronic pain in which a small amount of stimulant is injected into the ligament or tendon enthesis, inducing regeneration of new cells via inflammatory responses [ 18 ]. Stimulants are injected into ligaments attached to the bone or tendon enthesis, leading to inflammation, which subsequently induces the healing process.…”

Section: Reviewmentioning

confidence: 99%

“…Stimulants are injected into ligaments attached to the bone or tendon enthesis, leading to inflammation, which subsequently induces the healing process. In other words, inflammatory mediators stimulate the secretion of growth factors that are directly helpful for healing, recruiting various cells, of which fibroblasts are the most important for the regeneration of the musculoskeletal system [ 18 ]. Regarding the treatment mechanism, these cells not only heal by inflammation but also actively produce collagen, inducing the regeneration of injured ligaments without healing, as well as tendon enthesis, which ultimately strengthens ligaments and tendon enthesis, leading to stability for pain control [ 18 ].…”

Section: Reviewmentioning

confidence: 99%

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Conservative Treatments Frequently Used for Chronic Pain Patients in Clinical Practice: A Literature Review

Lee¹

2020

Cureus

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Chronic pain is a common patient complaint in clinical practice. It results in the deterioration of patients’ quality of life and loss of productivity. Also, it often brings about psychiatric disorders such as depression and anxiety. Therefore, clinicians should manage chronic pain actively. Various conservative treatments, including pharmacological therapy, procedures, and exercise, are being used to control chronic pain. In this review article, I provide an overview of the commonly used treatments, including medication [anticonvulsants, nonsteroidal anti-inflammatory drugs (NSAIDs), opioids, antidepressants], procedures [injection of steroids and local anesthetics, pulsed radiofrequency (PRF), repetitive transcranial magnetic stimulation (rTMS), prolotherapy], and exercise. A brief overview of these treatments would allow clinicians to have an overall picture of the available tools for managing chronic pain in clinical practice at a glance.

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Dextrose Prolotherapy

Cited by 88 publications

References 71 publications

A high-glucose diet affects Achilles tendon healing in rats

A high-glucose diet affects Achilles tendon healing in rats

Comparative Effectiveness of Botulinum Toxin Injection for Chronic Shoulder Pain: A Meta-Analysis of Randomized Controlled Trials

Conservative Treatments Frequently Used for Chronic Pain Patients in Clinical Practice: A Literature Review

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