{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T04:50:11Z","timestamp":1791607811531,"version":"4.3.4"},"reference-count":123,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2016,1,1]],"date-time":"2016-01-01T00:00:00Z","timestamp":1451606400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Med\ufffdInsights\ufffdArthritis\ufffdMusculoskelet Disord"],"published-print":{"date-parts":[[2016,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The aim of this study was to systematically review dextrose (D-glucose) prolotherapy efficacy in the treatment of chronic musculoskeletal pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources<\/jats:title>\n                    <jats:p>Electronic databases PubMed, Healthline, OmniMedicalSearch, Medscape, and EMBASE were searched from 1990 to January 2016.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Selection<\/jats:title>\n                    <jats:p>Prospectively designed studies that used dextrose as the sole active prolotherapy constituent were selected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Extraction<\/jats:title>\n                    <jats:p>Two independent reviewers rated studies for quality of evidence using the Physiotherapy Evidence Database assessment scale for randomized controlled trials (RCTs) and the Downs and Black evaluation tool for non-RCTs, for level of evidence using a modified Sackett scale, and for clinically relevant pain score difference using minimal clinically important change criteria. Study population, methods, and results data were extracted and tabulated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Synthesis<\/jats:title>\n                    <jats:p>Fourteen RCTs, 1 case\u2013control study, and 18 case series studies met the inclusion criteria and were evaluated. Pain conditions were clustered into tendinopathies, osteoarthritis (OA), spinal\/pelvic, and myofascial pain. The RCTs were high-quality Level 1 evidence (Physiotherapy Evidence Database \u22658) and found dextrose injection superior to controls in Osgood\u2013Schlatter disease, lateral epicondylitis of the elbow, traumatic rotator cuff injury, knee OA, finger OA, and myofascial pain; in biomechanical but not subjective measures in temporal mandibular joint; and comparable in a short-term RCT but superior in a long-term RCT in low back pain. Many observational studies were of high quality and reported consistent positive evidence in multiple studies of tendinopathies, knee OA, sacroiliac pain, and iliac crest pain that received RCT confirmation in separate studies. Eighteen studies combined patient self-rating (subjective) with psychometric, imaging, and\/or biomechanical (objective) outcome measurement and found both positive subjective and objective outcomes in 16 studies and positive objective but not subjective outcomes in two studies. All 15 studies solely using subjective or psychometric measures reported positive findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Use of dextrose prolotherapy is supported for treatment of tendinopathies, knee and finger joint OA, and spinal\/pelvic pain due to ligament dysfunction. Efficacy in acute pain, as first-line therapy, and in myofascial pain cannot be determined from the literature.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4137\/cmamd.s39160","type":"journal-article","created":{"date-parts":[[2016,7,7]],"date-time":"2016-07-07T17:49:38Z","timestamp":1467913778000},"page":"CMAMD.S39160","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":194,"title":["A Systematic Review of Dextrose Prolotherapy for Chronic Musculoskeletal Pain"],"prefix":"10.4137","volume":"9","author":[{"given":"Ross A.","family":"Hauser","sequence":"first","affiliation":[{"name":"Caring Medical Regenerative Medicine Clinics, Oak Park, IL, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna B.","family":"Lackner","sequence":"additional","affiliation":[{"name":"InQuill Medical Communications, Soquel, CA, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle","family":"Steilen-Matias","sequence":"additional","affiliation":[{"name":"Caring Medical Regenerative Medicine Clinics, Oak Park, IL, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David K.","family":"Harris","sequence":"additional","affiliation":[{"name":"Center for Healing and Regenerative Medicine, Austin, TX, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2016,7,7]]},"reference":[{"key":"bibr1-CMAMD.S39160","volume-title":"Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research.","author":"Institute of Medicine.","year":"2011"},{"key":"bibr2-CMAMD.S39160","volume-title":"With Chartbook on Trends in the Health of Americans.","author":"US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics Health.","year":"2006"},{"key":"bibr3-CMAMD.S39160","author":"National Center for Health Statistics.","year":"2012","journal-title":"National Health Interview Survey."},{"key":"bibr4-CMAMD.S39160","author":"Center for Disease Control and Prevention.","year":"2010","journal-title":"National Ambulatory Medical Care Survey."},{"key":"bibr5-CMAMD.S39160","unstructured":"United States Bone, and Joint Decade. 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