New Research: Prolotherapy effective, well tolerated for elbow pain
Ross Hauser, M.D.

Prolotherapy in my opinion is the treatment of choice for lateral epicondylitis (also known as tennis elbow). Lateral elbow pain is a common condition that affects people who use their arms a lot, like tennis players. But nowadays with people typing on the computor for hours and hours at a time, the condition is becoming epidemic. When the condition first starts there is a dull lateral elbow pain that often progresses down the forearm. If the condition is treated by anti-inflammatory medication or cortisone shots then tendinosis can form. This means the muscle/tendon attachment on the bone has become degenerated. Again I believe the treatment of choice should be Prolotherapy. Prolotherapy, unlike cortisone shots, stimulates the body to repair the injured tendon/muscle attachment, often curing lateral epicondylitis (or lateral tendinosis).

In a recent study Prolotherapy with dextrose and sodium morrhuate was compared to saline. Prolotherapy was shown to statistically significant levels, decrease the pain and weakness with the condition. In other words the people who had lateral condylitis who actually received the Prolotherapy had improved wrist extension strength and grip strength. Clinically what this would mean is that if they were tennis players they would have a great chance to getting back to playing. For those who want to learn more about this study please note the reference and abstract:

The efficacy of prolotherapy for lateral epicondylosis: a pilot study
Scarpone M, Rabago DP, Zgierska A, Arbogast G, Snell E. The efficacy of prolotherapy for lateral epicondylosis: a pilot study. Clin J Sport Med. 2008 May;18(3):248-54.

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. 

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