The efficacy of prolotherapy for lateral epicondylosis: a pilot study.

Abstract

OBJECTIVES:

To assess whether prolotherapy, an injection-based therapy, improves elbow pain, grip strength, and extension strength in patients with lateral epicondylosis.

SETTING:

Outpatient Sport Medicine clinic.

STUDY DESIGN:

Double-blind randomized controlled trial.

PARTICIPANTS:

Twenty-four adults with at least 6 months of refractory lateral epicondylosis.

INTERVENTION:

Prolotherapy participants received injections of a solution made from 1 part 5% sodium morrhuate, 1.5 parts 50% dextrose, 0.5 parts 4% lidocaine, 0.5 parts 0.5% sensorcaine and 3.5 parts normal saline. Controls received injections of 0.9% saline. Three 0.5-mL injections were made at the supracondylar ridge, lateral epicondyle, and annular ligament at baseline and at 4 and 8 weeks.

OUTCOME MEASURES:

The primary outcome was resting elbow pain (0 to 10 Likert scale). Secondary outcomes were extension and grip strength. Each was performed at baseline and at 8 and 16 weeks. One-year follow-up included pain assessment and effect of pain on activities of daily living.

RESULTS:

: The groups were similar at baseline. Compared to Controls, Prolotherapy subjects reported improved pain scores (4.5 +/- 1.7, 3.6 +/- 1.2, and 3.5 +/- 1.5 versus 5.1 +/- 0.8, 3.3 +/- 0.9, and 0.5 +/- 0.4 at baseline and at 8 and 16 weeks, respectively). At 16 weeks, these differences were significant compared to baseline scores within and among groups (P < 0.001). Prolotherapy subjects also reported improved extension strength compared to Controls (P < 0.01) and improved grip strength compared to baseline (P < 0.05). Clinical improvement in Prolotherapy group subjects was maintained at 52 weeks. There were no adverse events.

CONCLUSIONS:

Prolotherapy with dextrose and sodium morrhuate was well tolerated, effectively decreased elbow pain, and improved strength testing in subjects with refractory lateral epicondylosis compared to Control group injections.

• Authors: Michael Scarpone, David P Rabago, Aleksandra Zgierska, Gennie Arbogast, Edward Snell
• Journal: Clinical journal of sport medicine : official journal of the Canadian Academy of Sport Medicine (Clin J Sport Med) Vol. 18 Issue 3 Pg. 248-54 (May 2008) ISSN: 1050-642X [Print] United States
• PMID: 18469566 (Publication Type: Journal Article, Randomized Controlled Trial)

Chemical References

• Drug Combinations

Topics

• Adolescent
• Adult
• Double-Blind Method
• Drug Combinations
• Female
• Humans
• Injections
• Male
• Middle Aged
• Ohio
• Pilot Projects
• Tennis Elbow (drug therapy, physiopathology)
• Treatment Outcome