Evidence map›Paper›PMID 42541009›Full record

ReviewJournal of anaesthesiology, clinical pharmacology

Effectiveness and safety of dextrose prolotherapy for chronic spinal pain: A systematic review.

Tommy A Nazwar, Farhad Bal'afif, Donny W Wardhana, Fachriy Bal'afif, Christin Panjaitan

Abstract readReview
In one paragraph

Review in Journal of anaesthesiology, clinical pharmacology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

5 authors.

Tommy A NazwarDepartment of Surgery, Division of Neurosurgery, Brawijaya University/Saiful Anwar General Hospital, Malang, East Java, Indonesia.
Farhad Bal'afifDepartment of Surgery, Division of Neurosurgery, Brawijaya University/Saiful Anwar General Hospital, Malang, East Java, Indonesia.
Donny W WardhanaDepartment of Surgery, Division of Neurosurgery, Brawijaya University/Saiful Anwar General Hospital, Malang, East Java, Indonesia.
Fachriy Bal'afifDepartment of Surgery, Division of Neurosurgery, Brawijaya University/Saiful Anwar General Hospital, Malang, East Java, Indonesia.
Christin PanjaitanDepartment of Surgery, Division of Neurosurgery, Brawijaya University/Saiful Anwar General Hospital, Malang, East Java, Indonesia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Chronic spinal pain markedly impairs function and quality of life. Dextrose prolotherapy is a potential treatment thought to induce a controlled inflammatory response, promote connective-tissue repair, enhance spinal stability, and modulate nociceptive signaling. This systematic review synthesised current evidence on its effectiveness and safety. A systematic search was performed in PubMed, ScienceDirect, SpringerLink, and the Cochrane Library up to June 2025. Eligible studies included randomized controlled trials (RCTs), prospective cohort studies, and prospective case series (≥10 patients) reporting outcomes on pain, physical function, quality of life, or adverse events. Risk of bias was assessed using Joanna Briggs Institute tools for nonrandomized studies and the Cochrane Risk of Bias 2 tool for RCTs. Twelve studies were included (six case series, two cohort studies, one quasi-experimental study, and three RCTs), involving chronic low back pain, sacroiliac joint pain, discogenic pain, coccydynia, failed back surgery syndrome, and lumbar disc herniation. Most studies reported pain reduction; intra-articular injections of 25%-50% dextrose were associated with analgesia lasting 6-24 months, whereas 5% epidural dextrose provided rapid relief in radicular pain. Improvements in physical function and quality of life were also reported, with no major complications. Overall, dextrose prolotherapy appears safe and potentially effective for chronic spinal pain, particularly in refractory cases, although outcomes may depend on patient selection, dextrose concentration, and injection technique.

Indexed as

• A favorable safety profile was observed, with no major complications reported across the included studies.• A review of 12 clinical studies suggests that dextrose prolotherapy reduces pain and improves function in chronic spinal pain, including sacroiliac joint pain, discogenic pain, coccygodynia, failed back surgery syndrome, and lumbar disc herniation with radicular symptoms.Chronic spinal paindextrose prolotherapy• Higher concentrations (≥25%) in intra-articular injections appear to provide longer-lasting analgesia, whereas 5% epidural injections may offer rapid relief for radicular pain.• Potential cost-effectiveness and minimal invasiveness may support its consideration as an alternative before surgery in refractory cases.regenerative injection therapysystematic review

Identifiers

PMID42541009
PMCPMC13427298

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Registered trials

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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.