Low and High Dose Dextrose Prolotherapy in the Treatment of Lateral Epicondylitis
Status:
Recruiting
Trial end date:
2021-10-01
Target enrollment:
Participant gender:
Summary
Lateral epicondylitis (tennis elbow) is an enthesopathy seen in 1-2% of the population aged
30-65 years, which can occur in the lateral epicondyle origo of the extensor carpi radialis
brevis and longus muscles, after frequently repetitive activities and can lead to limitations
in the daily life activities of the patients. The diagnosis is made by anamnesis and clinical
examination, cases that last more than 3 months are defined as chronic lateral epicondylitis.
Treatment options are analgesics, non-steroidal anti-inflammatory drugs, hand-wrist splints,
eccentric strengthening exercises for forearm muscles and wrist dorsiflexors, injection
therapies, physical therapy agents such as therapeutic ultrasound, ESWT(extracorporeal
shockwave therapy), low-level laser therapy, and surgery. Prolotherapy is a treatment method
that is performed with repetitive injections of a small amount of irritant or sclerosing
solutions such as hypertonic dextrose, phenol-glycerin-glucose, or sodium morrhuate and aims
to activate the healing process by increasing the blood flow around the damaged tendinopathy
or enthesopathy area with the effect of these solutions. Hypertonic dextrose solutions in
concentrations ranging from 12.5-20% are frequently used in prolotherapy. Prolotherapy can be
done with ultrasound guidance or by determining anatomical landmarks. The injection is
applied to the annular ligament, lateral epicondyle, and supracondylar area where the forearm
extensor muscles adhere. Injection side effects and complications are pain, bruising, muscle
spasm, nerve or vessel damage at the injection site. Based on previous studies, the low dose
of dextrose solutions (1%, 5%, and 10%) may have a similar effect with fewer side effects
than higher concentrations of dextrose solutions (15%, 20%, 25%) and the low dose may have
fewer cell damage. Thus, it may be possible to apply an effective treatment method with fewer
side effects in the treatment of lateral epicondylitis. Also, in this study, the effect of
inflammation created by injection of saline in one group and the inflammatory, proliferative
and angiogenic effects of dextrose injected in other groups at different concentrations on
the treatment outcome will be compared.
Phase:
Phase 4
Details
Lead Sponsor:
Ahi Evran University Education and Research Hospital