Comparison of Clinical Outcomes of 5% and 15% Dextrose Prolotherapy in Chronic Lateral Epicondylitis: A Retrospective Study

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Abstract
Objective: This study aimed to compare the clinical effectiveness of 5% and 15% dextrose prolotherapy (PrT), combined with exercise therapy and bracing, versus exercise therapy alone in patients with chronic lateral epicondylitis (LE). Methods: This retrospective study included patients with LE, and participants were divided into three groups: exercise only ( n = 29), 5% PrT + exercise ( n = 30), and 15% PrT + exercise ( n = 36). PrT was performed under ultrasound guidance at weeks 0, 3, and 6 targeting the forearm extensor muscles and annular ligament entheses. All patients used an epicondylitis brace and followed a 12-week home exercise program. Pain [visual analog scale (VAS)], function [patient-rated tennis elbow evaluation (PRTEE)], and grip strength were measured at baseline, week 6, and week 12. Results: All groups showed significant within-group improvements in VAS, PRTEE, and grip strength. Both PrT groups had significantly greater improvements in pain and function than those of the exercise-only group at weeks 6 and 12. Grip strength in flexion was significantly higher in both PrT groups than that in the exercise group at week 12. No significant differences were found between the 5% and 15% PrT groups in extension and pinch grip strength across groups. Conclusion: 5% and 15% dextrose prolotherapy are both more effective than exercise alone in improving pain, function, and grip strength in chronic LE. The increased handgrip strength at week 12 suggests that prolotherapy may aid muscle strength recovery. The absence of significant differences between the prolotherapy groups indicates that higher concentrations of dextrose may not be necessary to achieve clinical improvement.

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