Prolotherapy – Shin Splints
Research concerning the use of Prolotherapy and medial tibial stress syndrome
Padhiar N, Jones PR, Curtin M, Malliaras P, Chan O, Crisp TA. The effectiveness of prolotherapy for recalcitrant medial tibial stress syndrome: a prospective case series. Br J Sports Med. 2011 Dec;45(15):A16.
The aim was to evaluate whether ultrasound-guided injection of 15% dextrose for treatment of recalcitrant medial tibial stress syndrome (MTSS) decreases pain and facilitates a return to desired activity levels.
This was a prospective case series.
Participants were nine patients, seven male and two female; (mean age=33.6 years) with MTSS, referred from sports injury clinics across the UK to a specialist centre at a London private hospital, having failed conservative treatment.
An ultrasound-guided subperiosteal injection of 15% dextrose was administered by the same clinician (NP) along the length of the symptomatic area. Typically 1 ml of solution was injected per cm of symptomatic area. A second injection was subsequently administered at four weeks for 4 of the 9 subjects. Pain was assessed using a 10 cm visual analogue scale (VAS) at baseline, short-term, medium-term (mean 18 weeks) and at long-term (mean 1 year) follow-up. Symptom resolution and return to activity were measured using a Likert scale at medium-term and long-term follow-up.
Subjects reported a significant (p<0.01) reduction in median VAS pain score at medium-term follow-up compared to baseline. Median improvement per subject was 5/10. At long-term follow-up, median improvement was 4/10. Subjects rated their condition as ‘much improved’ at medium-term follow-up and ‘no change’ at long-term follow-up. Median return to sport score at medium-term follow-up was ‘returned to desired but not preinjury level’ and ‘returned to sport at an unsatisfactory level’ at long-term follow-up.
There were no reported adverse events. Ultrasound-guided 15% dextrose prolotherapy injection has a significant medium-term effect on pain in MTSS. There is a suggestion that this benefit may be maintained long-term. More robust trials are required to validate these findings.
