Managing Refractory Tendinopathy: Dextrose Prolotherapy Explained Prolotherapy is an injection therapy used to treat musculoskeletal pain, including tendinopathies.
Managing Refractory Tendinopathy: Dextrose Prolotherapy Explained Prolotherapy is an injection therapy used to treat musculoskeletal pain, including tendinopathies. Loosely defined, it involves the injection of hypertonic dextrose solution combined with a local anesthetic into painful areas of the tendon or ligament with the goal of stimulating inflammation. Although dextrose is most commonly used, other potential irritants include polidocanol, manganese, zinc, human growth hormone, pumice, ozone, glycerin, or phenol.
Prolotherapy may increase collagen deposition, thickening of healing ligaments and reverse neovascularization seen in pathologic tendons. A major goal of of prolotherapy in chronic musculoskeletal conditions is the stimulation of regenerative processes in the joint that will facilitate the restoration of joint stability by augmenting the tensile strength of joint stabilizing structures, such as ligaments, tendons, joint capsules, menisci, and labral tissue. The exact mechanism through which this occurs remains unclear.
The use of ultrasound is generally suggested for prolotherapy. Some areas, such as the tibial tubercle may not require ultrasound. However most pathologic tendons benefit from increased procedural accuracy with ultrasound use and some obviously require it.
Prolotherapy also appears to demonstrate sonographic changes associated with tissue healing. The dosage and frequency of dextrose prolotherapy injections remains unclear in the literature. Some studies use 12.5% dextrose while others use 25% or 50%.
The volume of injectant is generally low, ranging from 5 - 10 mL when including local anesthetic. Most studies involve multiple injections chronologically, anywhere from 3 - 5 total, for example at 0, 4 and 8 weeks. Typical supplies of dextrose prolotherapyProlotherapy is also generally safe with few adverse effects reported in the literature.
If you are experiencing symptoms that may be related to managing refractory tendinopathy (part 3): dextrose prolotherapy, it is important to see a sports medicine physician. Early evaluation and treatment typically lead to better outcomes. Do not ignore pain or symptoms that are limiting your activity.
*This article is for educational purposes only and does not substitute for professional medical advice. Always consult a qualified healthcare provider.*
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