Abstract Objective: The objective of this study was to compare the clinical effectiveness of dextrose prolotherapy injection (DPI) versus methylprednisolone acetate injection (MPI) in patients with chronic lateral epicondylitis (CLE). Methods: In this single-blind, randomised, parallel-group trial, 70 adults with CLE were allocated equally to receive either DPI (16% dextrose solution prepared from 25% stock dextrose + lidocaine) or MPI (80 mg methylprednisolone + lidocaine) through peritendinous injection at the extensor carpi radialis brevis origin. Injections were administered under aseptic conditions, with ultrasound guidance selectively applied. Pain intensity (Visual Analogue Scale VAS) and upper limb disability (Quick Disabilities of the Arm, Shoulder and Hand QuickDASH) were assessed at baseline, 1 month and 3 months. Patient satisfaction and adverse effects were recorded. Results: Both groups showed significant within-group improvements in VAS and QuickDASH scores over 3 months ( P < 0.001). Between-group analysis revealed significantly greater reductions in VAS for DPI compared with MPI at all intervals (baseline–1 month: −1.60 vs. −0.49; 1–3 months: −1.91 vs. −0.97; total: −3.51 vs. −1.46; all P < 0.001). Functional recovery was also superior with DPI (baseline–3 months QuickDASH change: −26.80 vs. −14.91; P < 0.001). High satisfaction (score 3) was reported by 51.4% in both groups. Adverse effects were minimal, with fewer events in the DPI group (8.6% vs. 22.8%). Conclusion: Dextrose prolotherapy produced superior and sustained improvements in pain and function compared with methylprednisolone injection in CLE, with a favourable safety profile. Prolotherapy represents an effective regenerative alternative to corticosteroids in chronic tendinopathy, particularly for high-demand patients.
Bhardwaj et al. (2026) studied this question.