Effectiveness of dextrose prolotherapy for chronic musculoskeletal pain: A prospective observational study

The increasing prevalence and burden of musculoskeletal conditions has led to an interest in effective nonsurgical solutions, which are more cost efficient and minimally invasive. Prolotherapy is an alternative therapeutic procedure used for management of chronic musculoskeletal conditions which involves injection of irritant solution into affected area. Primary objective of this study was to assess effectiveness of prolotherapy in relieving pain. This study was undertaken to assess the effectiveness of prolotherapy with Inj. Ropivacaine 0.25% & Dextrose 12.5% in patients with chronic musculoskeletal pain. The primary objective was to evaluate reduction in pain 3 months after procedure. Secondary objectives were to assess number of sessions of prolotherapy required, patient satisfaction and complications if any. Seventy patients of either sex aged 18 years and above, diagnosed with a chronic musculoskeletal pain condition, who were selected for the prolotherapy as the treatment modality, were included in the study. All patients received prolotherapy with 0.25% ropivacaine and 12.5% in the involved area. A Wilcoxon signed-rank test showed that there was statistically significant difference in mean VAS, 3 months after prolotherapy as compared to mean VAS pre-procedure. The mean VAS reduced from 6.61 ± 0.95 at the beginning of the study, reduced to 0.88 ± 1.95 by the end of the study (p = 0.000.) Maximum volume of drug required for adequate pain relief by prolotherapy was 30 cc with the mean of 17.53 ± 7.28. 58.3% of the study population needed 2 sessions of prolotherapy while 10% required 3 sessions. 80% of patients, had more than 50% pain relief at the end of 3rd month after prolotherapy. Prolotherapy using 12.5% Dextrose + 0.25% Ropivacaine offers minimally invasive, cost effective and safe management option for patient with chronic musculoskeletal pain.