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Published on: March 24, 2023
A Prospective Nonrandomized Comparison of Wet Needling Versus Prolotherapy in Myofascial Pain
Neehara K Jacob1,2, Ravi Sankaran1
1Physical Medicine and Rehabilitation, Amrita School of Medicine, Kochi, IND.
Objective:
The objective was to analyze the difference between prolotherapy and wet needling (WN) for myofascial trigger points (MTrPs) for the Visual Analog Scale (VAS), Oswestry Disability Index (ODI), Clinical Global Impression (CGI), and MTrP count.
Methods:
Patients with myofascial pain for 1.5 years were included based on convenience sampling after a pilot study for sample size calculation. The WN group received an injection of bupivacaine 0.5% into the trigger points with WN. Participants in the dextrose prolotherapy (DPT) group received dextrose (25%) plus bupivacaine (0.5%) (1:1) into the same. Outcome measures were recorded at baseline immediate post-injection, one month, three months, and 24 months.
Results:
Among the 200 participants, there was no significant difference in the baseline VAS score between the two groups nor for immediate post-VAS. At three months of follow-up, the mean VAS was 6.34 ± 1.44 in the WN group and 1.99 ± 0.89 in the DPT group (p = 0.03). The mean VAS score significantly changed in both groups but favored the DPT group (p = 0.001) and again at 24 months (p = 0.001). The ODI showed a similar trend favoring the DPT group at all intervals. On correlating the VAS score with the ODI score, a statistically significant correlation was seen at one month, favoring the WN group, and at the end of the third month, favoring the DPT group.
Conclusion:
Both modalities are effective at one month. At three and 24 months, the DPT was significantly more effective in improving the VAS and ODI.
