Dextrose Prolotherapy for Recalcitrant Coccygodynia

Khan, Shakil Ahmed; Kumar, Abhishek; Varshney, Manish Kumar; Trikha, Vivek; Yadav, Chandra Shekhar

doi:10.1177/230949900801600107

Cited by 59 publications

(56 citation statements)

References 7 publications

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“…Also, it was reported in some of them that the most effective benefits could be gained with repeated injections. [8,12,27,28] We, therefore, preferred the use of three prolotherapy injection sessions in our study to provide maximum pain relief to, and improved function in, patients with chronic plantar fasciitis. The patient's satisfaction and VAS and FAOS scores significantly increased after each injection session.…”

Section: Discussionmentioning

confidence: 99%

A randomized-controlled trial of prolotherapy injections in the treatment of plantar fasciitis

Erşen

Koca

Akpancar

et al. 2017

Turk J Phys Med Rehab

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Objectives: This study aims to evaluate the efficacy of prolotherapy injections for the treatment of plantar fasciitis. Material and methods:Between October 2014 and October 2015, 60 patients with symptomatic chronic plantar fasciitis were randomly divided into two groups, as control (n=31) and prolotherapy (n=29) groups. In the prolotherapy group, ultrasound-guided prolotherapy injections into the plantar fascia up to five different points were performed three times every 21 days. In the control group, the patients received instructions for plantar fascia and Achilles tendon stretching exercises three times a week for three months. Additionally, all patients were given heel lifts and instructed to refrain from heavy loading activity. The patients were evaluated via the Visual Analog Scale (VAS), Food and Ankle Outcome Score (FAOS), and Foot Function Index (FFI) at baseline and at 21, 42, 90, and 360 days during follow-up.Results: A total of 50 patients completed follow-up (26 patients in the prolotherapy group and 24 patients in the control group). The VAS, FAOS, and FFI scores were significantly improved in both groups (p<0.001). There were no statistically significant differences in the pain and functional scores at 21 days of treatment between the groups. The VAS and FAOS scores were higher in the prolotherapy group than the control group at 42, 90, and 360 days of treatment. The FFI scores were also higher in the prolotherapy group than the controls at 42 and 90 days of treatment; however, both groups had similar scores at 360 days. Conclusion:Our study results suggest that prolotherapy is an effective auxiliary method for treating chronic plantar fasciitis.

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Section: Discussionmentioning

confidence: 99%

A randomized-controlled trial of prolotherapy injections in the treatment of plantar fasciitis

Erşen

Koca

Akpancar

et al. 2017

Turk J Phys Med Rehab

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“…5,6 Recent MRI and ultrasound reports are also consistent with a description of OSD as "a tendinopathy/ apophysosis of the patellar tendon/tibial tubercle." [7][8][9][10][11][12] Safety and level A-C evidence of efficacy (per US Preventive Services Task Force criteria) of injection of 10% to 25% dextrose in areas of damaged ligament, tendon, and cartilage in adults has been demonstrated in randomized controlled trials in Achilles tendinosis, 13 finger osteoarthritis, 14 knee osteoarthritis, 15 lateral epicondylosis, 16 sacroiliac joint pain, 17 and in case series collections of patients with Achilles degeneration, 18,19 anterior cruciate ligament laxity, 20 coccygodynia, 21 hip adductor and abdominal tendinosis, 22 and plantar fasciosis. 23 There are no previous reports of application of dextrose injection in a strictly pediatric population, nor are there reports of injection about an apophysis where, as described, the source of pain and pathomechanism are not yet clear.…”

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confidence: 99%

Hyperosmolar Dextrose Injection for Recalcitrant Osgood-Schlatter Disease

Topol¹,

Podestá

Reeves

et al. 2011

Pediatrics

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WHAT'S KNOWN ON THIS SUBJECT:Osgood-Schlatter disease symptoms may wax and wane until maturity and affect sport confidence and participation periodically. Chronic sequelae may include anterior knee pain, kneeling discomfort, or sports limitation. Symptom reduction parallels resolution of patellar tendinopathy by MRI/ultrasound, although ossicles may persist radiographically. WHAT THIS STUDY ADDS:Small-needle injection of the patellar tendon enthesis/tibial apophysis with 12.5% dextrose was safe and well tolerated in adolescents with recalcitrant OsgoodSchlatter disease. Dextrose injection resulted in more rapid and frequent achievement of unaltered sport and asymptomatic sport than did usual care. abstract OBJECTIVE: To examine the potential of dextrose injection versus lidocaine injection versus supervised usual care to reduce sport alteration and sport-related symptoms in adolescent athletes with OsgoodSchlatter disease. PATIENTS AND METHODS: Girls aged 9 to 15 and boys aged 10 to 17 were randomly assigned to either therapist-supervised usual care or double-blind injection of 1% lidocaine solution with or without 12.5% dextrose. Injections were administered monthly for 3 months. All subjects were then offered dextrose injections monthly as needed. Unaltered sport (Nirschl Pain Phase Scale Ͻ 4) and asymptomatic sport (Nirschl Pain Phase Scale ϭ 0) were the threshold goals. RESULTS: Sixty-five knees in 54 athletes were treated. Compared with usual care at 3 months, unaltered sport was more common in both dextrose-treated (21 of 21 vs 13 of 22; P ϭ .001) and lidocaine-treated (20 of 22 vs 13 of 22; P ϭ .034) knees, and asymptomatic sport was more frequent in dextrose-treated knees than either lidocaine-treated (14 of 21 vs 5 of 22; P ϭ .006) or usual-care-treated (14 of 21 vs 3 of 22; P Ͻ .001) knees. At 1 year, asymptomatic sport was more common in dextrose-treated knees than knees treated with only lidocaine (32 of 38 vs 6 of 13; P ϭ .024) or only usual care (32 of 38 vs 2 of 14; P Ͻ .0001). CONCLUSIONS: Our results suggest superior symptom-reduction efficacy of injection therapy over usual care in the treatment of OsgoodSchlatter disease in adolescents. A significant component of the effect seems to be associated with the dextrose component of a dextrose/ lidocaine solution. Dextrose injection over the apophysis and patellar tendon origin was safe and well tolerated and resulted in more rapid and frequent achievement of unaltered sport and asymptomatic sport than usual care. Pediatrics 2011;128:e1121-e1128

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“…Ex juvantibus the treatment was successful, as in many cases described by Khan et al [5] but the remaining questions are why it was successful and was it Prolotherapy? Naming every hyperosmolar dextrose injection prolotherapy is arbitrary.…”

mentioning

confidence: 69%

An Assessment on the Ultrasound Guided Dextrose Prolotherapy for Persistent Coccygeal Pain: A Case Series and Review of Literature

Torres¹

2014

Altern Integ Med

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Dextrose Prolotherapy for Recalcitrant Coccygodynia

Abstract: Dextrose prolotherapy is an effective treatment option in patients with chronic, recalcitrant coccygodynia and should be used before undergoing coccygectomy. Randomised studies are needed to compare prolotherapy with local steroid injections or coccygectomies.

Cited by 59 publications

References 7 publications

A randomized-controlled trial of prolotherapy injections in the treatment of plantar fasciitis

A randomized-controlled trial of prolotherapy injections in the treatment of plantar fasciitis

Hyperosmolar Dextrose Injection for Recalcitrant Osgood-Schlatter Disease

An Assessment on the Ultrasound Guided Dextrose Prolotherapy for Persistent Coccygeal Pain: A Case Series and Review of Literature

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