Researchers at the Lahey Clinic, in Burlington, Massachusetts, compared prolotherapy vs corticosteroid injection to treat tennis elbow (chronic lateral epicondylosis).

Prolotherapy involves injecting an otherwise inactive irritant into the body to strengthen weakened connective tissue and alleviate pain.

First, the details.

  • 24 people with chronic (at least 3 months) lateral epicondylosis were randomly assigned to a treatment group.
    • Prolotherapy injection to start, followed by a second injection 1 month later
    • Corticosteroid injection
  • Pain intensity was significant enough to prevent participation in activities, such as playing racquet sports or lifting heavy objects.
  • Measures of response included a visual analog scale (VAS) self-rating of pain, quadruple visual analog scale (QVAS), and the Disabilities of the Arm, Shoulder, and Hand questionnaire (DASH) taken at the start and at 1, 3, and 6 months follow-up.

And, the results.

  • Prolotherapy: Significant improvements in VAS and DASH at 3 and 6 months and in the QVAS from baseline to 3 months.
  • Steroid injections: Clinically and statistically significant changes for DASH only at 3 and 6 months follow-up.
  • Prolotherapy vs steroids: No significant differences for changes in VAS, QVAS, or DASH.
  • 83% of participants were satisfied with their overall improvement during the course of the study, with no significant differences between groups.
  • Aside from injection-associated pain, no side effects were reported.

The bottom line?

The authors concluded, “Both prolotherapy and corticosteroid therapy were generally well tolerated and appeared to provide benefit of long duration.”

But the number of people who completed the study (17) was too few to permit definitive conclusions. The authors agree and recommend more study.

9/2/11 20:18 JR

Hi, I’m JR

John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at, a complementary and alternative medicine website.