The Effect of 5-in-1 Dextrose Neural Prolotherapy for Periscapular Myofascial Pain Syndrome: A Retrospective Study

Background and objective Myofascial pain syndrome (MPS) is a chronic musculoskeletal condition characterized by the presence of myofascial trigger points (MTrPs) that cause localized and referred pain, often leading to functional impairments. Despite a multimodal therapeutic approach, some cases prove refractory to conservative management. This study aimed to evaluate the effectiveness of a 5-in-1 dextrose neural prolotherapy injection targeting key muscles and nerves in the periscapular region among patients with chronic MPS. Methods A retrospective case series was conducted involving 16 patients with chronic periscapular MPS persisting for at least six months. The 5-in-1 dextrose neural prolotherapy injection involved ultrasound-guided administration of dextrose, lignocaine, and saline to the trapezius, rhomboid minor, levator scapulae, and hydrodissection of the spinal accessory and dorsal scapular nerves (DSN). Pain severity was assessed using the Numerical Rating Scale (NRS) at baseline and three months post-injection. Results Sixteen patients (four males, 12 females; mean age: 35.75 ± 12.76 years) were included. The mean NRS pain score decreased significantly from 7.06 ± 0.85 at baseline to 3.25 ± 2.26 at three months post-intervention (mean reduction: 3.81; 95% confidence interval (CI): 2.63-4.99; p<0.001). No statistically significant differences in pain reduction were observed between genders. No major complications were reported. Conclusions The 5-in-1 dextrose neural prolotherapy injection resulted in a significant reduction in pain intensity for patients with chronic periscapular MPS refractory to conservative management. These results highlight the need for larger, controlled studies to validate its effectiveness and refine treatment protocols.