Effectiveness of 5% Dextrose Water (D/W) versus Corticosteroid Injection for Pain Management of Sacroiliac Joint Dysfunction

Abstract

Background: Corticosteroid injections have been a cornerstone in the management of sacroiliac joint dysfunction (SIJD)-related pain. Recently, alternative approaches to pain management have garnered attention, particularly the use of 5% dextrose water (D/W) injections, which are believed to promote tissue healing and regeneration. Objective: The purpose of this study was to evaluate the efficacy of 5% dextrose water (D/W) compared to corticosteroid injections for pain management in patients with sacroiliac joint dysfunction (SIJD). Methods: This experimental study was conducted at Chaudhary Muhammad Akram Teaching and Research Hospital, Lahore, from October 2023 to May 2024. A total of 120 participants aged 18-65 years with clinically diagnosed SIJD were randomly assigned to two groups. Group A (N=60) received three weekly injections of 5% D/W solution, while Group B (N=60) received corticosteroid injections administered weekly over six weeks. Participants were excluded if they were pregnant, breastfeeding, had a history of allergy to the treatment components, or had received SIJ injections within the last three months. Pain intensity, functional disability, and quality of life were assessed using the Visual Analogue Scale (VAS), Oswestry Disability Index (ODI), and a standardized quality of life questionnaire, respectively. Data were analyzed using SPSS version 25, with within-group comparisons made using the Wilcoxon Signed Ranks Test and between-group comparisons using the Mann-Whitney U Test. Results: Significant improvements were observed in both groups. The VAS scores in the dextrose water group decreased from 5.28 ± 1.71 to 2.58 ± 0.94 (p < 0.001) and in the corticosteroid group from 5.57 ± 1.85 to 3.15 ± 1.33 (p < 0.001). ODI scores improved from 34.27 ± 1.26 to 17.02 ± 3.15 in the dextrose water group (p < 0.001) and from 34.17 ± 1.12 to 19.95 ± 6.11 in the corticosteroid group (p < 0.001). Quality of life scores also showed significant enhancement, improving from 14.43 ± 1.79 to 7.64 ± 0.99 in the dextrose water group (p < 0.001) and from 14.57 ± 1.85 to 8.49 ± 1.98 in the corticosteroid group (p < 0.001). Conclusion: Both 5% dextrose water and corticosteroid injections significantly reduced pain and improved function and quality of life in patients with sacroiliac joint dysfunction. While corticosteroid injections demonstrated a slightly greater benefit, 5% dextrose water injections are a promising alternative with fewer potential side effects. Further research is recommended to explore long-term outcomes and compare these treatments with other emerging therapies.