TITLE:
Ultrasound-Guided Athletic Pubalgia Prolotherapy: A Novel Treatment
AUTHORS:
Dominic Francis O’Shea, Dominic Colman Harmon, Yvonne Maura Murphy
KEYWORDS:
Groin Pain, Athletic Pubalgia, Prolotherapy, Ultrasound, Sports Medicine
JOURNAL NAME:
Pain Studies and Treatment,
Vol.12 No.4,
October
31,
2024
ABSTRACT: Research background: Athletic Pubalgia is a common, debilitating sports condition encountered by athletes who participate in competitive sports requiring pivoting movements. Athletic Pubalgia is often multifactorial with several pathologies overlapping to cause groin pain. Soft tissue disruptions at the insertions of adductor longus and rectus abdominis to the pubic symphysis are often encountered. Prolotherapy is the method of injecting an irritant solution into a joint space, ligament or tendon insertion site. The solution is thought to induce a regenerative response in the affected area through several mechanisms, including the induction of inflammation and vascular reconfiguration. Research objectives: The use of prolotherapy to treat Athletic Pubalgia has not been reported. The aim of this study was to assess ultrasound-guided prolotherapy as a therapeutic option in the treatment of Athletic Pubalgia. Methods: A case report, with informed consent (human material or human data were performed in accordance with the Declaration of Helsinki), involving a 24-year-old female presenting with Athletic Pubalgia. The patient presented with severe chronic right groin pain sustained while playing camogie. Conservative management options, including rest and rehabilitation with physiotherapy had failed to control this pain. Through dynamic ultrasound scanning, focal lesions were identified in the insertions of rectus abdominis and adductor longus to the pubic symphysis. Prolotherapy with 5% dextrose to the affected areas was performed. Assessment of analgesic and rehabilitation response was planned. Results: A sustained analgesic effect was observed at clinical follow-up at 6 weeks. Patient returned to full sporting activity. Conclusions: Ultrasound-guided prolotherapy has not yet been described as a treatment option in Athletic Pubalgia. In this case report, it was an effective pain-relieving therapy with improved rehabilitation. Larger studies are required to evaluate its efficacy.