Glucopuncture (GP) is a new injection technique for doctors who are looking for a safe and easy-to-learn injection technique for the treatment of nonrheumatic musculoskeletal pain. We typically apply dextrose 5% (or glucose 5% in Europe) injections into fascia, muscles and ligaments as an alternative for cortisone injections, oral pain medication or even surgery. This technique is designed to manage regional pain (musculoskeletal pain as well as regional neuropathic pain) by giving local injections. A conventional diagnosis is obviously required to exclude major pathologies which cannot be treated with glucopuncture such as pain related to organ failure, bacterial infections or cancer. GP is originally designed for doctors / patients who have no access to MRI, ultrasound-guided hydrodissection, and state of the art surgery. We want to introduce GP in low-income countries for doctors who work with very limited means in remote regions. Projects in Africa, Asia and America are about to start. A free e-course (200 slides, 20 videos) is now available on that website (Sweet Solution for Medics) for such doctors.
But we also want to introduce GP in countries where modern medical facilities are abundant because the GP method is safe, ecological and easy to apply. GP is obviously less powerful than steroids to suppress inflammation immediately. The injection techniques themselves are also different from conventional orthopedic injections with steroids. Some patients have pain in the right knee, but the pain is actually referred from trigger points in the right quadriceps muscle. Such points can only be found during regional palpation. So these days, family physicians first apply a series of weekly glucopuncture sessions in those trigger points to deal with that knee pain. If, however, those injections are not successful, they refer their patient for knee replacement, for example. Some patients have pain in the elbow, while the pain is actually referred from trigger points in superficial fascia in the lateral upper arm. So one can first apply glucopuncture in those fascial trigger points above the elbow (as a test), before giving steroid injections into the elbow itself. Some athletes have chronic pain in the Achilles tendon, while ultrasound is normal. In some cases, the doctor can identify trigger points in the calf muscle. Doctors trained in GP typically apply their injections into the fascia near the Achilles tendon as well as in the trigger points in the calf muscle. One can also apply Glucopuncture for vague regional pain where there is no clear pathology found on MRI or ultrasound, such as shin splints, pain in the trapezius region or postherpetic neuralgia. Over the last decade, more research has found how glucopuncture seems to work (TRPV1, substance P) and how important fascia is to explain the clinical effects of glucopuncture. It is obvious that more research and clinical studies are warranted to confirm our anecdotal findings and to convince our colleagues. Unfortunately, there is not much support to finance such studies so far. Glucopuncture is especially becoming more popular in Asia over the last few years. On PubMed, there are now five high-level studies where dextrose 5% shows excellent long term results for carpal tunnel syndrome (CTS) when applied perineurally. First applying GP can prevent those patients with CTS from steroid injections or even surgery. Additional studies are needed to further explore the apparent pharmacological mechanisms of dextrose (or glucose) 5% in CTS and its optimal dosage and frequency for ultrasound-guided CTS injection. In contrast to steroid injections, local side effects related to the sugar water are very unlikely. On top of that, the total dose is so low (95% of the injectate is water), that it can be applied repeatedly to diabetics.
Lam KHS, Wu YT, Reeves KD, Galluccio F, Allam AE, Peng PWH. Ultrasound-Guided Interventions for Carpal Tunnel Syndrome: A Systematic Review and Meta-Analyses. Diagnostics (Basel). 2023 Mar 16;13(6):1138
Nasiri A, Rezaei Motlagh F, Vafaei MA. Efficacy comparison between ultrasound-guided injections of 5% dextrose with corticosteroids in carpal tunnel syndrome patients. Neurol Res. 2023 Jun;45(6):554-563.
Ozge O, Derya G. Perineural 5% dextrose versus corticosteroid injection in non-surgical carpal tunnel syndrom treatment. Ideggyogy Sz. 2024 Mar 30;77(3-4):121-129
Oh MW, Park JI, Shim GY, Kong HH. Comparative Efficacy of 5% Dextrose and Corticosteroid Injections in Carpal Tunnel Syndrome: A Systematic Review and Meta-analysis. Arch Phys Med Rehabil. 2024 Jul 18:S0003-9993(24)01122-5
Eyvaz N, Adar S, Akçin Aİ, Dündar Ü, Toktaş H, Eroğlu S. Comparison of Ultrasound-Guided Hydrodissection with Various Volumes of 5% Dextrose for Carpal Tunnel Syndrome: A Prospective Randomized Controlled Double-Blind Trial. Am J Phys Med Rehabil.
Kersschot J, Treatment of Sports Injuries with Glucopuncture. Archives in Biomedical Engineering & Biotechnology 2021, 5(1)
Kersschot J, Management of Lateral Elbow Pain with Glucopuncture. Global Journal of Orthopedics Research 2021, 3(1)
Kersschot J, Treatment of Dorsal Back Pain with Glucopuncture. Med Case Rep Rev, 2021 (4) 1-4.
Kersschot J, Treatment of Sports Injuries with Glucopuncture. Archives in Biomedical Engineering & Biotechnology 2021, 5(1)
Kersschot J, Management of Lateral Elbow Pain with Glucopuncture. Global Journal of Orthopedics Research 2021, 3(1)
Kersschot J, Intradermal Glucose Injections for Mild Localized Neuropathic Pain - A New Approach to Reduce Pain Medication, Global Journal of Medical Research 2022, 22 (6) 1-6
Mulder B, Kersschot J, Glucopuncture for Traumatic Periostitis of the Tibial Crest. An Alternative for NSAIDs? World Journal of Advanced Research and Reviews, 2022, 15(03), 092-097
Kersschot J, Borms J, Isotonic glucose injections for anterior knee pain: A Clinical Case Study, World Journal of Advanced Research and Reviews, 2022, 15(01), 391-395
O'byrne A, Kersschot J, Glucopuncture for Achilles Tendinopathy: A Descriptive Review, World Journal of Advanced Research and Reviews, 2022, 15(02), 314-321Kersschot J, Glucopuncture for Rotator Cuff Related Shoulder Pain: An Alternative for Cortisone?, Clin Rev Cases. 2022; 4(2): 1-4
Kersschot J, Treatment of Tension Headache, World Journal of Advanced Research and Reviews, 2022, 14(03), 682-686
*Kersschot J, Karavani I. Isotonic Glucose Injections for Postherpetic Neuralgia in the Elderly. Cureus. 2022 Sep 29;14(9):e29740
*Kersschot J, Mathieu T. Treatment of Painless Nodules With Glucopuncture in Dupuytren's Disease in Men: A Clinical Case. Cureus. 2022 Nov 13;14(11):e31445
Ferrie J, Kersschot J, Treatment of Lateral Ankle Pain with Glucopuncture: A Clinical Case. World Journal of Advanced Research and Reviews, 2023, 19(01), 1012?1016
Kersschot J, Laverde D, Treatment of Grade 1 Hamstring Injury with Glucopuncture: A Clinical Case, World Journal of Advanced Research and Reviews, 2023, 19(03), 1084?1089
Kersschot J, Glucopuncture: A Clinical Guide to Regional Glucose 5% Injections, B P International (India/UK), ebook May 2023
Nurhasanah L, Kersschot J, Lam KHS, Suryadi T, Suhaimi A, Kesoema TA, Ratnawati W, Injections of Dextrose 5% in Water (D5W) for hip joint pain and stiffness, Korea Anesthesia Congres, Seoul, October 13, 2023
Kersschot J, Intra-articular Glucose Injections for Orthoregeneration of Frozen Shoulder. A Clinical Case. Medical Research Archives 2023, 11(8), 1-5
Kersschot J, Lam KHS, Teinny S, Nurhasanah L, Kesoema TA, Treatment of Failed Back Surgery Syndrome with Regional Sugar Water Injections: A Clinical Case. Medical Research Archives, dec 31, 2023, online 11[12]
Kersschot J, History of Glucopuncture, World Journal of Advanced Research and Reviews, 2024, 21(01), 1925?1933
Kersschot J, Glucopuncture for Treatment of Fascial Pain in the Thumb. A Clinical Case, ISAR J Med Pharm Sci, 2584-0150, April 2024
*Lam K, Kersschot J, Suryadi T, A Novel Treatment of Fascial Pain With Glucopuncture: Three Clinical Cases. Cureus May 2024.
https://pubmed.ncbi.nlm.nih.gov/36324341/
https://www.oatext.com/treatment-of-dorsal-back-pain-with-glucopuncture.php
https://wjarr.com/sites/default/files/WJARR-2022-1125.pdf
For details and clinical examples: See the book on Glucopuncture published by B P International (India, UK) February 2023 :
According to prof Lam (Hong Kong) and Wu (Taiwan), the effects of 5% sugar water injections on regional neuropathic pain include stabilization effects on neural activity, normalization of glucose metabolism, and a decrease in neurogenic inflammation.
Two Major Effects of Glucopuncture |
Glucopuncture has been speculated to indirectly inhibit capsaicin-sensitive receptors (e.g., transient receptor potential vanilloid receptor-1) and block the secretion of substance P and calcitonin gene-related peptides, which are pro-nociceptive substances involved in neurogenic inflammation.
Mechanisms of Action (Reduction Neurogenic Inflammation) |
Lam K.H.S., Hung C.Y., Chiang Y.P., Onishi K., Su D.C.J., Clark T.B., Reeves K.D. Ultrasound-Guided Nerve Hydrodissection for Pain Management: Rationale, Methods, Current Literature, and Theoretical Mechanisms. J. Pain Res. 2020;13:1957–1968
Wu Y.T., Chen Y.P., Lam KH S., Reeves K.D., Lin J.A., Kuo C.Y. Mechanism of glucose water as a neural injection: A perspective on neuroinflammation. Life. 2022;12:832. doi: 10.3390/life12060832
Prolotherapy (PrT) is an American technique which involves injecting an irritant solution (such as phenol or dextrose 15%) into pathologic ligaments, bands, entheses, or tendons to evoke a local inflammatory reaction in order to stimulate local regeneration and thickening of connective tissue. Glucopuncture (GP), however, does NOT create local cell destruction and subsequent inflammation. GP is defined as the application of injections of glucose 5% (G5W) or dextrose 5% (D5W) to modulate pain, to support tissue repair and to optimize fascial integrity. The 5% solution supports regional cell metabolism. Perineural Injection Therapy (PIT) uses blind injections along superficial nerves with dextrose 5% (D5W). PIT injection according to Lyftogt is different from PrT because only superficial injections are applied. Typically, multiple injections along a particular nerve are applied. PIT injections are based on anatomical knowledge of peripheral nerves and are applied subcutaneously. PIT and GP both use D5W injections, but a major difference between PIT and GP is that PIT does not target injections into, for example, fascia, joints, muscles or ligaments.
Treatment | PrT | GP | PIT |
---|---|---|---|
D5W | - | + | + |
D15W/D25W | + | - | - |
Phenol/ P2G | + | - | - |
Local Anesthetics added | + | - | - |
Inflammatory Response | + | - | - |
Thickening of Connective Tissue | + | - | - |
Glucose Effect in the Cell | - | + | + |
Effect on Fascintegrity | - | + | - |
SC injections | - | + | + |
IF injections | - | + | - |
IM injections | - | + | - |
IL injections | + | + | - |
IA injections | + | + | - |
All content of this website is for medical professional use only. Patients should seek personalized advice from a professional regarding their specific medical situation. The glucopuncture course, whether followed online or learned during a medical congress, including its text, drawings, photographs and videos, is for educational purposes among licensed physicians only. The injectates are dextrose 5% or glucose 5%, without adding an anesthetic or steroids. The videos and cases are provided by different doctors who practice in different continents. Some of these videos are more than 10 years old but are still actual in certain cases. It must be clear that the clinical cases described here are only experiences by one of the doctors and are not presented as a proof of the efficacy of glucopuncture, we all know that we need RCTs for this. We do not intend for the content to be a substitute for professional medical advice, counseling, diagnosis, or treatment. Our content doesn?t engage visitors into a professional relationship. Before posting any content, we do our best to ensure the accuracy and completeness of the information. Just in case we accidentally missed something, we do not warrant or assume any legal liability or responsibility for the completeness, accuracy or usefulness of any information, product, or process disclosed. It is obvious that any patient who might benefit from these techniques, must first be diagnosed properly by one or several physicians to exclude those diseases which cannot be treated with glucopuncture such as cancer, heart disease, rheumatic arthritis, tbc, and so forth. It is also up to the treating physician if he or she has enough experience and skills to address a certain patient with pain. In general, the risk benefit ration of glucopuncture is better than steroid injections, but more research is required to confirm this. However, we typically need more sessions when using dextrose 5% or glucose 5%. The major research is done with ultrasound guided glucopuncture for carpal tunnel (several RCTs). In this course, the focus is on landmark and palpation guided glucopuncture. This is especially interesting for doctors with no access to ultrasound equipment. However, after following this course, physicians are encouraged to follow more sophisticated palpation-guided glucopuncture techniques (dr Cavallino, dr Janze) or US-guided glucopuncture (dr Gharaei, prof Lam, prof Moriggl, dr Kimura, dr Suryadi, and many others). Some of these doctors still use the old term (20th century) of prolotherapy, but that is ok. Most doctors go for the next level of Glucopuncture as soon as they realize the potential of regional glucose 5% or dextrose 5% injections. The information provided in the training courses is intended for physicians with a license to give these injections. Those physicians must respect and follow strictly all local rules and regulations when they intend to apply glucopuncture. The information provided during any glucopuncture course, including this one, is of a general nature only and is not intended to address the specific circumstances of any particular individual or entity. We are not providing any professional or legal advice (if you need specific advice, you should always consult a suitably qualified professional). It is obvious that this glucopuncture course is designed to teach as many physicians worldwide as possible, especially in low income communities. This website may not necessarily be comprehensive, complete, accurate or up to date. Please note that it cannot be guaranteed that a document available on-line exactly reproduces an officially adopted text. Only European Union legislation published in paper editions of the Official Journal of the European Union is deemed authentic. The legal jurisdiction and the governing law under which disputes will be resolved in Dutch and are limited to Flanders, Belgium. Contact Information: write to Kersschot J, Kamersveld 10, Aartselaar 2630, Belgium. Reproduction of the training courses is authorized, provided the source is acknowledged (www.glucopuncture.com) and terminology is not altered. It is prohibited to re-sell copies of the courses or parts of them. Further distribution of the training courses are encouraged, especially in low-income populations, but must remain free of charge. The goal is to spread an easy and safe method for pain management. However, prior permission must be obtained for the partial reproduction or use of text and multimedia information (sound, images, software, etc.), such permission shall cancel the above-mentioned general permission and shall clearly indicate any restrictions on use. It is obvious that the developer of this course and those spreading the glucopuncture course among colleagues in the future are not liable for any harm or damage arising from the use of the information provided on this website. The users of this website should not use the information to self-diagnose or treat themselves without consulting a healthcare provider first and discussing the options with her or him. It must be clear that the content of this course is subject to change without immediate notice.