Marc Darrow, MD, JD. Joint Rehab Los Angeles
Prolotherapy is the injection of a mild irritant, often dextrose (a simple sugar), into a specific area of the body that is arthritic, worn down, or injured.
To learn more about prolotherapy
A November 2023 paper (1) the compared the use of dextrose prolotherapy for plantar fasciopathy versus normal saline and corticosteroid. “Low certainty evidence (insufficient data numbers or lack of controlled testing procedure) demonstrated that dextrose prolotherapy was superior to normal saline injections in reducing pain and improving function in the medium term, but moderate certainty evidence showed that dextrose prolotherapy was inferior to corticosteroid in reducing pain in the short term.”
A 2014 study (2) compared Prolotherapy to PRP for chronic recalcitrant plantar fasciitis. The researchers found all patients in both the Prolotherapy group and the PRP group showed significant improvements. They concluded: “PRP treatment also may lead to better initial improvement in function compared with dextrose Prolotherapy treatment.”
An August 2021 study (3) compared the effectiveness of ultrasound-guided dextrose Prolotherapy with radial extracorporeal shock wave therapy (ESWT) for chronic plantar fasciitis.
- 59 patients were divided into two groups receiving three sessions of radial ESWT (29 patients) vs. two sessions of ultrasound-guided interfacial 2 cc dextrose 20% injection (30 patients).
- At six and 12 weeks after treatment, pain, disability and plantar fascia thickness were monitored.
- Pain and disability patient reported outcomes showed significant improvements in pain and function in both study groups 6 weeks and 12 weeks after the treatments.
- A significant reduction was also seen in plantar fascia thickness at these intervals.
- Dextrose Prolotherapy is comparable to radial ESWT in reducing pain, daily-life functional limitation, and plantar fascia thickness in patients with plantar fasciitis.
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References
1Fong HP, Zhu MT, Rabago DP, Reeves KD, Chung VC, Sit RW. Effectiveness of hypertonic dextrose injection (prolotherapy) in plantar fasciopathy: A systematic review and meta-analysis of randomized controlled trials. Archives of Physical Medicine and Rehabilitation. 2023 Apr 23.
2 Kim E, Lee JH. Autologous platelet-rich plasma versus dextrose prolotherapy for the treatment of chronic recalcitrant plantar fasciitis. PM&R. 2014 Feb 28;6(2):152-8.
3 Asheghan M, Hashemi SE, Hollisaz MT, Roumizade P, Hosseini SM, Ghanjal A. Dextrose prolotherapy versus radial extracorporeal shock wave therapy in the treatment of chronic plantar fasciitis: A randomized, controlled clinical trial. Foot and Ankle Surgery. 2020 Aug 25.