Case Report of Whiplash Related Chronic Neck Pain Treated with Intraarticular Prolotherapy

Introduction. Thirty-seven-year-old male heavy-duty mechanic with two-year history of whiplash related neck pain reached maximum improvement with physiotherapy and extraarticular prolotherapy. He subsequently obtained further temporary relief with radiofrequency zygapophyseal neurotomy before attaining long-term relief with intraarticular prolotherapy.
Methods. Intraarticular prolotherapy was done on four occasions under fluoroscopic guidance by placing 1cc of 20% dextrose and 0.75% lidocaine solution into the zygapophyseal joints. Solution was prepared by diluting D50W with 1% lidocaine.
Results. Pre-treatment neck disability index score was 24. Post-treatment scores were 9 (2 months), 9 (1 year), and 2 (3 years). Visual analogue scale pre-treatment was 4/10 and 0/10 post-treatment. Patient was able to return to work.
Conclusions. Intraarticular prolotherapy was more effective than extraarticular prolotherapy and provided longer lasting relief than radiofrequency zygapophyseal neurotomy.