Prolotherapy with Very Fine Needle and Low Concentration of Glucose in a Patient with Chronic Lateral Elbow Pain

Prolotherapy is a non-surgical injection treatment method that repeatedly injects small amounts of proliferators into damaged ligaments, tendon, joints and surrounding tissues. The most common proliferator is a high concentration of glucose solution. Glucose solutions with a concentration of 10–25% are commonly used. Prolotherapy using glucose solution has few serious adverse events, but common side effects include post injection pain, stiffness, edema, and mild bleeding. There are many cases of complaining of pain caused by injection during or after prolotherapy. Some patients give up treatment if the pain is severe. A 43-year-old male patient visited the hospital with both elbow pain and left wrist pain, and prolotherapy was performed. In order to minimize pain during procedure and post injection pain of the patient, 10% glucose solution with 0.5% lidocaine was injected using a very fine needle of 30 G. The total number of treatments was eight. The patient did not complain of pain caused by needle insertion during procedure and post-injection pain. Chronic pain that lasted for two years after treatment almost disappeared. The patient was very satisfied with this treatment method and result.