Therapeutic Dextrose Injection: Prolotherapy, Perineural Injection Therapy, and Hydrodissection

In the search for biologically active, disease-modifying treatment modalities for chronic pain, three forms of dextrose injection—prolotherapy, perineural injection therapy, and hydrodissection—have emerged as effective for many conditions. Each is discrete but related by the injectant (dextrose) and the clinical tradition from which each is derived. This chapter reviews the origins of dextrose-related injection therapy, outlines the basic science and clinical evidence behind each, and describes the role of ultrasound guidance in the clinical conduct of each.