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Dextrose + lidocaine is a combination therapy being investigated by the National and Kapodistrian University of Athens for the treatment of chronic pain in patients with knee osteoarthritis. This treatment approach, known as perineural prolotherapy or neural prolotherapy, involves the ultrasound-guided injection of a solution containing 5% dextrose and 1% lidocaine around the genicular nerves (superomedial, superolateral, inferomedial, and recurrent peroneal). Lidocaine serves as a local anesthetic by blocking voltage-gated sodium channels, providing immediate pain relief. Dextrose is hypothesized to act as a prolotherapy agent that modulates neurogenic inflammation and potentially downregulates the TRPV1 receptor on nociceptors, leading to prolonged analgesic effects and improved joint function compared to local anesthetic alone.
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