Prolotherapy is not superior to control or placebo-based conservative treatments for rotator cuff tendinopathy: a systematic review and meta-analysis

This systematic review and meta-analysis aimed to assess the efficacy of prolotherapy compared to control or placebo-based treatments. A comprehensive search of PubMed, Ovid, and Scopus was conducted up to April 2025. Inclusion criteria encompassed clinical studies comparing prolotherapy with contro...

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Published in:Clinics in shoulder and elbow pp. 446 - 456
Main Authors: Thamrongskulsiri, Napatpong, Vitoonpong, Timporn, Itthipanichpong, Thun, Limskul, Danaithep, Tanpowpong, Thanathep, Kuptniratsaikul, Somsak
Format: Journal Article
Language:English
Published: Korea (South) 대한견주관절학회 23.10.2025
Subjects:
정형외과학
Control
Prolotherapy
Dextrose
Rotator cuff
Placebo
ISSN:2288-8721, 2383-8337, 2288-8721
Online Access:Get full text
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Summary:This systematic review and meta-analysis aimed to assess the efficacy of prolotherapy compared to control or placebo-based treatments. A comprehensive search of PubMed, Ovid, and Scopus was conducted up to April 2025. Inclusion criteria encompassed clinical studies comparing prolotherapy with control or placebo treatments and evaluating outcomes such as pain, function, and range of motion. Eight studies involving 431 participants met the inclusion criteria. Patient-reported outcomes, including pain visual analog scale and Shoulder Pain and Disability Index, showed no statistically significant differences between prolotherapy and controls. Prolotherapy demonstrated a small but statistically significant improvement in shoulder abduction (mean difference, 7.08°; 95% CI, 2.49°-11.66°). Other range of motion measures, such as forward flexion, internal rotation, and external rotation, showed no significant differences. Radiographic outcomes, including tendon thickness and elasticity, suggested potential structural benefits but did not consistently translate to clinical improvements. Prolotherapy is not superior to control treatments for rotator cuff tendinopathy. While it offers minor gains in shoulder abduction, its clinical benefits are limited. Level of evidence: III.
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http://www.cisejournal.org/journal/view.php?doi=10.5397/cise.2025.00570
ISSN:2288-8721
2383-8337
2288-8721
DOI:10.5397/cise.2025.00570