In a systematic review of dextrose prolotherapy for chronic musculoskeletal pain by Hauser et al (Clinical Med Insights Arthritis Musculoskele Disord Jul 2016), the role of prolotherapy in spinal and pelvic pain was evaluated. The authors reviewed two randomized control trials looking at the effects of dextrose prolotherapy and corticosteroid injections for low back pain. One study (Kim et al) found a greater cumulative incidence of pain reduction (greater than or equal to 50%) for those given dextrose prolotherapy. However, in the second study that focused on iliac crest pain syndrome, there was no reported differences between dextrose and triamcinolone when looking at pain (VAS) and disability scores.
In another study by Hooper et al, patients with chronic cervical, thoracic, or lumbar pain showed significant improvement in pain and disability scores with dextrose prolotherapy. Dextrose prolotherapy has also been found to be effective for coccygodynia (tailbone pain) in randomized control trials and published case series.
The systematic review concluded that there is level 1 evidence that dextrose prolotherapy results in significantly greater long-term reduction in pain than cortisone injections in patients with sacroiliac (SI) joint pain. There is level 2 evidence supporting dextrose prolotherapy for short-term pain reduction vs. cortisone injection for SI joint pain. As for chronic neck, thoracic, and low back pain, there is level 4 evidence for improvement in pain and disability with dextrose prolotherapy.
This review again demonstrates that dextrose prolotherapy is efficacious for specific musculoskeletal conditions and is a safe alternative to corticosteroids in many cases.