Periarticular Neurofascial Dextrose Prolotherapy Versus Physiotherapy for the
Treatment of Chronic Rotator Cuff Tendinopathy: Randomized Clinical Trial
Kazempour Mofrad, M., Rezasoltani, Z., Dadarkhah, A., Kazempour Mofrad, R.,
Abdorrazaghi, F., & Azizi, S. (2021). Periarticular Neurofascial Dextrose Prolotherapy
Versus Physiotherapy for the Treatment of Chronic Rotator Cuff Tendinopathy:
Randomized Clinical Trial. J Clin Rheumatol, 27(4), 136-142.
https://doi.org/10.1097/rhu.0000000000001218
Rotator cuff tendinopathy is a common cause of shoulder pain. We aimed to compare
periarticular (neurofascial) dextrose prolotherapy versus physiotherapy for treatment
of chronic rotator cuff tendinopathy in the short term. We carried out a randomized
clinical trial with 2 arms at a university hospital. In total, 66 patients with chronic
rotator cuff tendinopathy, proven by magnetic resonance imaging, were randomly
allocated to 2 groups. The outcomes were change in shoulder pain intensity (primary)
and disability (secondary) index using a questionnaire for Shoulder Pain and
Disability Index. For physiotherapy, participants received superficial heat,
transcutaneous electrical nerve stimulation, and pulsed ultrasound. Also, they carried
out an exercise program, 10 sessions of 30 minutes for 3 weeks. For prolotherapy, we
used 8 mL of 12.5% dextrose and 40 mg of 2% lidocaine. The mixture was injected 2
times with 1-week interval superficially around the shoulder joint and to tender points
along the suprascapular nerve. Neurofascial dextrose was more effective than
physiotherapy for alleviating pain in 2 weeks (p < 0.001), and they were similar 3
months after the interventions (p = 0.055). For disability, dextrose was more effective
than physiotherapy 2 weeks and 3 months (both p < 0.001) after the interventions.
However, the changes in the physiotherapy group seemed to be more sustained. Both
interventions are effective for the short-term management of rotator cuff
tendinopathy. However, prolotherapy is more successful as the initial treatment.
Besides, the treatment time is much shorter for dextrose prolotherapy compared with
physiotherapy.