Evidence map›Paper›PMID 28920043›Full record

ArticleAnesthesiology and pain medicine2017

Short Term Analgesic Effects of 5% Dextrose Epidural Injections for Chronic Low Back Pain: A Randomized Controlled Trial.

Liza Maniquis-Smigel, Kenneth Dean Reeves, Howard Jeffrey Rosen, John Lyftogt, Cassie Graham-Coleman, An-Lin Cheng, David Rabago

3 registry-linked trialsOpen access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Anesthesiology and pain medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 3 registered trials, which are not on this map. Cited by 32 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
32citing papers in PubMed, 5 pooled it
4.3field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03515720 nacompletednot on this mapstarted 2018, after this paper: background citation

Effectiveness of Neuroprolotherapy With Home Physical Therapy Against Isolated Physical Therapy for the Treatment of Patellar Chondromalacia

TypeinterventionalSponsorInstituto Mexicano del Seguro SocialRan2018 to 2020Enrolled50ConditionsChondromalacia PatellaeArmsProlotherapy
NCT07129681 nanot yet recruitingnot on this mapstarted 2025, after this paper: background citation

A Comparison of the Outcomes Following Intra-articular Dextrose 5% Injection Versus Arthrocentesis in Patients With Anterior Disc Displacement With Reduction of the Temporomandibular Joint.

TypeinterventionalSponsorCairo UniversityRan2025 to 2026Enrolled42ConditionsTMJ Disc DisorderArmsdextrose 5%, Arthrocentesis/Saline
NCT07296653 early_phase1recruitingnot on this mapstarted 2025, after this paper: background citation

Efficacy of Prolotherapy in Acupoints in Chronic Non-specific Low Back Pain (cLBP) - A Randomized Control Trial

TypeinterventionalSponsorNational and Kapodistrian University of AthensRan2025 to 2027Enrolled60ConditionsChronic Non-specific Low Back PainArmsDextrose 15% and lidocaine 1% infiltration, Lidocaine 1% infiltration
3 · Its place in the literature

Who cites it

32 citing papers in PubMed, 5 syntheses or guidelines pooled it, 74 citations in OpenAlex.

  1. Pooled it
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  11. Dextrose injections for failed back surgery syndrome: a consecutive case series.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2019
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  18. Dextrose neuroprolotherapy and occlusal splint treatment outcomes in occlusal trauma: Evaluation through ultrasound imaging.Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES · 2024
    Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Liza Maniquis-SmigelPrivate Practice PM&R and Pain Management, Hilo and Honolulu, Hawaii, U.S.A.
Kenneth Dean ReevesPrivate Practice PM&R and Pain Management, Roeland Park, Kansas, Past Clinical Assistant/Associate Professor (1986-2015) University of Kansas Department of PM&R, Kansas City, Kansas.
Howard Jeffrey RosenPrivate Practice Anesthesiology and Pain Management, Anaheim and Monterey, California, U.S.A.
John LyftogtChristchurch, New Zealand.
Cassie Graham-ColemanP.O. Box 351, Kurtistown, HI 96760.
An-Lin ChengDepartment of Biomedical and Health Informatics, University of Missouri-Kansas City School of Medicine, 2411 Holmes Street, Kansas City, MO, 64108.
David RabagoDepartment of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, 1100 Delaplaine Court, Madison, Wisconsin, U.S A. 53715.
University of Kansas · USUniversity of Missouri–Kansas City · USUniversity of Wisconsin–Madison · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHypertonic dextrose injection (prolotherapy) is reported to reduce pain including non-surgical chronic low back pain (CLBP), and subcutaneous injection of 5% dextrose is reported to reduce neurogenic pain, hyperalgesia and allodynia. The mechanism in both cases is unclear, though a direct effect of dextrose on neurogenic pain has been proposed. This study assessed the short-term analgesic effects of epidural 5% dextrose injection compared with saline for non-surgical CLBP.

methodsRandomized double-blind (injector, participant) controlled trial. Adults with moderate-to-severe non-surgical low back pain with radiation to gluteal or leg areas for at least 6 months received a single epidurogram-confirmed epidural injection of 10 mL of 5% dextrose or 0.9% saline using a published vertical caudal injection technique. The primary outcome was change in a numerical rating scale (NRS, 0 - 10 points) pain score between baseline and 15 minutes; and 2, 4, and 48 hours and 2 weeks post-injection. The secondary outcome was percentage of participants achieving 50% or more pain improvement at 4 hours. RESULTS AND

conclusionsNo baseline differences existed between groups; 35 participants (54 ± 10.7 years old; 11 female) with moderate-to-severe CLBP (6.7 ± 1.3 points) for 10.6 ± 10.5 years. Dextrose participants reported greater NRS pain score change at 15 minutes (4.4 ± 1.7 vs 2.4 ± 2.8 points; P = 0.015), 2 hours (4.6 ± 1.9 vs 1.8 ± 2.8 points; P = 0.001), 4 hours (4.6 ± 2.0 vs 1.4 ± 2.3 points; P < 0.001), and 48 hours (3.0 ± 2.3 vs 1.0 ± 2.1 points; P = 0.012), but not at 2 weeks (2.1 ± 2.9 vs 1.2 ± 2.4 points; P = 0.217). Eighty four percent (16/19) of dextrose recipients and 19% (3/16) of saline recipients reported ≥ 50% pain reduction at 4 hours (P < 0.001). These findings suggest a neurogenic effect of 5% dextrose on pain at the dorsal root level; waning pain control at 2 weeks suggests the need to assess the effect of serial dextrose epidural injections in a long-term study with robust outcome assessment.

Indexed as

AnalgesiaAnesthesiaCaudalDextroseEpidural

Identifiers

PMID28920043
PMCPMC5554430
OpenAlexW2560014184

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.