PROLOTHERAPY A NEW TREATMENT MODALITY IN CHRONIC MUSCULOSKELETAL PAIN; SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract

Conceptual Background: Picture a therapeutic approach that empowers the restoration of weakened ligaments and tendons, while simultaneously offering a cost-effective and secure remedy to chronic afflictions of the musculoskeletal system. Prolotherapy emerges as such an alluring alternative. However, its triumphs hinge on the accuracy of the injection process, contrast against other treatment options, and the yardsticks applied for appraisal. This scholarly pursuit endeavors to unravel the enduring potency of prolotherapy, employing dextrose, as a combatant against relentless musculoskeletal ailments. The research aims to elucidate the genuine virtues of this treatment in bestowing lasting relief from unyielding musculoskeletal torment.

Investigative Blueprint: A comprehensive scrutiny was conducted, casting a net over a diverse selection of repositories such as Medline, Embase, Cochrane Central, KoreaMed, and KMbase, taking into account studies published until March 2019. The spotlight was cast primarily on randomized controlled trials that contrasted the effects of dextrose prolotherapy against a gamut of alternative interventions including physical exertions, saline, platelet-enriched plasma, and corticosteroid injections. The cornerstone for assessment was the flux in pain indices during quotidian physical engagements.

Insights: The meticulous inquiry aggregated a collection of ten studies, with an adapted aggregate of 600 subjects, retouched from the initial count of 750. Within a span of 6 months to 1 year following dextrose prolotherapy, a noteworthy abatement in pain indices was observed compared to saline injections (standardized mean deviation [SMD] -0.35; 95% probability range [CI] -0.60 to -0.09, P = 0.008) and physical exertions (SMD -0.34; 95% CI -0.61 to -0.06, P = 0.02). Remarkably, the outcomes stemming from prolotherapy stood shoulder to shoulder with platelet-enriched plasma or corticosteroid injections, indicating an absence of consequential disparity in pain indices.

Culmination: Within the realm of alleviating chronic pain, dextrose prolotherapy surfaces as a formidable candidate, transcending the prowess of saline injections or physical exertions, and matching the caliber of platelet-enriched plasma or corticosteroid injections. To cast a more luminous spotlight on the merits of prolotherapy, an imperative exists for additional holistic, uniform, and protracted investigations.