Dextrose Prolotherapy Versus Normal Saline Injection for the Treatment of Lateral Epicondylopathy: A Randomized Controlled Trial

J Altern Complement Med. 2020 Dec;26(12):1159-1168. doi: 10.1089/acm.2020.0286. Epub 2020 Sep 28.

Abstract

Objective: To compare the effect of dextrose prolotherapy (DPT) with saline in the treatment of chronic lateral epicondylopathy (LE). Design: Triple-blinded randomized controlled trial. Setting: Physical medicine and rehabilitation outpatient clinic. Subjects: Sixty cases of chronic LE participants were included in the study. Methods: Participants were randomly divided into two groups as DPT and normal saline. Saline or hypertonic dextrose (15%) was injected at the baseline, and at the end of the 4th and 8th week. Assessments were performed at baseline, and at the end of the 4th, 8th, and 12th week. Outcome measures: Primary outcome measures were Visual Analog Scale (VAS) for pain, Patient Rated Tennis Elbow Evaluation (PRTEE-Total [PRTEE-T], PRTEE-Pain, PRTEE-Function); secondary outcome measures were Disabilities of the Arm, Shoulder, and Hand Score (DASH) and pain-free handgrip strength. Results: Intragroup analysis demonstrated that both groups significantly improved in VAS, PRTEE, DASH scores, and handgrip strength during the study period (p < 0.001, for all outcome measurements in both groups). Intergroup analysis showed that PRTEE-T score changes between baseline-4th and -12th week; VASrest change between baseline and 4th week in the DPT group were significantly higher than the saline group (p = 0.041, p = 0.038, p = 0.013 respectively). There was no significant difference between groups in VAS, DASH scores, and handgrip strength between any time points, in terms of improvement (p > 0.05). Conclusion: Our study results showed that DPT outperformed saline in PRTEE-T score. Although saline seems to be a comparable clinical effect with DPT, further studies comparing the effects of saline injection and DPT are necessary, in chronic LE.

Keywords: lateral epicondylopathy; prolotherapy; saline.