Efficacy of 5% Dextrose Water Injection for Peripheral Entrapment Neuropathy: A Narrative Review.

Yung-Tsan Wu,Stanley K H Lam,Daniel Su,Jui-An Lin,Chueh-Hung Wu,Chen-Yu Hung

doi:10.3390/ijms222212358

Abstract

Current non-surgical treatment for peripheral entrapment neuropathy is considered insignificant and unsustainable; thus, it is essential to find an alternative novel treatment. The technique of perineural injection therapy using 5% dextrose water has been progressively used to treat many peripheral entrapment neuropathies and has been proven to have outstanding effects in a few high-quality studies. Currently, the twentieth edition of Harrison’s Principles of Internal Medicine textbook recommends this novel injection therapy as an alternative local treatment for carpal tunnel syndrome (CTS). Hence, this novel approach has become the mainstream method for treating CTS, and other studies have revealed its clinical benefit for other peripheral entrapment neuropathies. In this narrative review, we aimed to provide an insight into this treatment method and summarize the current studies on cases of peripheral entrapment neuropathy treated by this method.

Highlights

Peripheral nerves are prone to entrapment in certain parts of the body, resulting in chronic hypoxia, inflammation, and other pathologies, which in turn will cause symptoms such as numbness, pain, paresthesia, and even muscle atrophy and weakness [1]
This notable effect might be a result of higher HD between the subsynovial connective tissue (SSCT) and median nerve compared to long-axis injection, which mainly hydrodissects the median nerve from the flexor retinaculum as the fibrosis and adhesion of SSCT on the median nerve is an important part of the pathophysiology of carpal tunnel syndrome (CTS) [32]
The results revealed that 88.6% of the patients showed an effective outcome, while 62.7% of patients showed an excellent outcome after a mean of 2.2 injections, and there were no complications in any of the patients

Summary

Introduction

Peripheral nerves are prone to entrapment in certain parts of the body, resulting in chronic hypoxia, inflammation, and other pathologies, which in turn will cause symptoms such as numbness, pain, paresthesia, and even muscle atrophy and weakness [1]. General treatment for peripheral entrapment neuropathy includes both non-surgical and surgical methods, which depends on the severity of symptoms. Non-surgical treatment includes avoiding persistent compression of the nerve, physical therapy, medications with nonsteroidal anti-inflammatory drugs (NSAIDs), local anesthetic, or corticosteroid injections. Surgical decompression is indicated if symptoms persist despite conservative management [5]. In the past few decades, corticosteroid injection has been one of the most commonly used non-surgical treatments for peripheral entrapment neuropathy, but previous studies have revealed its short-term efficacy [6,7]

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