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What is the evidence for prolotherapy for achilles tendinopathy?


Patient Population:

5 studies (4 case series, 1 single-blinded RCT), 338 participants with painful achilles tendinopathy


Subcutaneous injection of 1-5ml of 10-25% dextrose +/- lidocaine


Eccentric loading exercises in 1 study, and no control in 4 cases series


Pain – Non-statistical trend towards Prolotherapy v. eccentric loading exercises alone

Patient satisfaction – Variable scales used but generally reported to be high (ranging from 50-90%)

Sonographic evidence – Inconclusive

Safety – 3 studies did not report adverse events, 1 study reported NO adverse events and 1 study (RCT) reported one calf-tear in the group with eccentric loading.

Guideline Recommendations

Source Recommendation
ACOEM Not recommended

Outcomes Assessed

  • Benefit
  • Harm
  • Inconclusive

Prolotherapy for Achilles Tendinopathy


Patient Satisfaction


Relevant Clinical Info

This study also reviewed the evidence for prolotherapy for Plantar fasciopathy (2 studies), and Osgoode-schlatter disease (1 study).  Although the results favoured pain reduction in the prolotherapy group, the low power and quality of these studies make it difficult to draw definitive conclusions.  Pooling all the study data (433) for safety did not reveal any adverse effects directly from prolotherapy.

Participant Information


of participants
were Male

the sample size was 338 (4 studies reported M:F breakdown)

Mean age of 47-54 years.

their were 5 studies used.

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