Management of Medial Tibial Stress Syndrome with Glucopuncture. A Clinical Case.

Main Article Content

Jan Kersschot H Gharaei T Mathieu J Ferrie

Abstract

Medial tibial stress syndrome, sometimes referred to as shin splints, is an overuse injury of the lower extremities. It is commonly managed conservatively, but there is lack of consensus on the application of new treatment options such as regional dextrose 5% injections in regional superficial fascia. Over the last decade, regional dextrose 5% injections are popular for the treatment of orthopedic complaints and sports injuries because of easy application, low cost and excellent safety profile. This article describes a 25-year-old runner suffering from pain in both shins for several years. His pain level went from 7/10 to 0/10 after three sessions of dextrose 5% injections in the superficial fascia, and he recovered permanently after five sessions. This case report is an invitation to design more studies to confirm whether this novel approach may become one of the new tools for athletes suffering from shin splints.

Keywords: Medial Tibial Stress Syndrome, Glucopuncture, Tensegrity, Sports Injury, Fascia

Article Details

How to Cite
KERSSCHOT, Jan et al. Management of Medial Tibial Stress Syndrome with Glucopuncture. A Clinical Case.. Medical Research Archives, [S.l.], v. 12, n. 5, may 2024. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/5299>. Date accessed: 30 june 2024. doi: https://doi.org/10.18103/mra.v12i5.5299.
Section
Case Reports

References

1. McClure CJ, Oh R. Medial Tibial Stress Syndrome. 2023 Aug 8. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–

2. Tarabishi MM, Almigdad A, Almonaie S, Farr S, Mansfield C. Chronic Exertional Compartment Syndrome in Athletes: An Overview of the Current Literature. Cureus. 2023 Oct 27;15(10):e47797

3. Bosnina F, Padhiar N, Miller S, Girotra K, Massoura C, Morrissey D. Developing a diagnostic framework for patients presenting with Exercise Induced Leg Pain (EILP): a scoping review. J Foot Ankle Res. 2023 Nov 21;16(1):82

4. Okunuki T, Magoshi H, Maemichi T, Liu Z, Tanaka H, Matsumoto M, Hoshiba T, Kumai T. The prevalence and effect of the sites of pain in female soccer players with medial shin pain. J Sports Med Phys Fitness. 2023 Jan;63(1):111-120

5. Bouché RT, Johnson CH. Medial tibial stress syndrome (tibial fasciitis): a proposed pathomechanical model involving fascial traction. J Am Podiatr Med Assoc. 2007 Jan-Feb;97(1):31-6

6. Menéndez C, Batalla L, Prieto A, Rodríguez MÁ, Crespo I, Olmedillas H. Medial Tibial Stress Syndrome in Novice and Recreational Runners: A Systematic Review. Int J Environ Res Public Health. 2020 Oct 13;17(20):7457

7. Naderi A, Bagheri S, Ramazanian Ahoor F, Moen MH, Degens H. Foot Orthoses Enhance the Effectiveness of Exercise, Shockwave, and Ice Therapy in the Management of Medial Tibial Stress Syndrome. Clin J Sport Med. 2022 May 1;32(3):e251-e260

8. Bhusari N, Deshmukh M. Shin Splint: A Review. Cureus. 2023 Jan 18;15(1):e33905

9. Kakouris N, Yener N, Fong DTP. A systematic review of running-related musculoskeletal injuries in runners. J Sport Health Sci. 2021 Sep;10(5):513-522

10. Mattock JPM, Steele JR, Mickle KJ. Are Leg Muscle, Tendon and Functional Characteristics Associated with Medial Tibial Stress Syndrome? A Systematic Review. Sports Med Open. 2021 Oct 9;7(1):71

11. Running-related musculoskeletal injuries (RRMIs), especially stemming from overuse, frequently occur in runners. This study aimed to systematically review the literature and determine the incidence and prevalence proportion of RRMIs by anatomic location and specific pathology.

12. Winters M. The diagnosis and management of medial tibial stress syndrome: An evidence update. Unfallchirurg. 2020 Jan; 123(Suppl 1):15-19.

13. McClure CJ, Oh R. Medial Tibial Stress Syndrome. 2023 Aug 8. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–

14. Bove GM. Partial mixed neuropathy of the fourth lumbar spinal nerve misdiagnosed as "shin splints". J Can Chiropr Assoc. 2023 Aug;67(2):186-193

15. Winters M. The diagnosis and management of medial tibial stress syndrome: An evidence update. Unfallchirurg. 2020 Jan;123(Suppl 1):15-19

16. Milgrom C, Tsur N, Eshed I, Milgrom Y, Beyth S, Spitzer E, Gofman I, Finestone AS. Significance of tibial MRI findings of special forces recruits at the onset of their training. BMJ Mil Health. 2024 Jan 25;170(1):9-14

17. Velasco TO, Leggit JC. Chronic Exertional Compartment Syndrome: A Clinical Update. Curr Sports Med Rep. 2020 Sep;19(9):347-352

18. Deshmukh NS Jr, Phansopkar P, Wanjari MB. A Novel Physical Therapy Approach in Pain Management and Enhancement of Performance in Shin Splints Athletes: A Case Report. Cureus. 2022 Jul 9;14(7):e26676

19. Deshmukh NS, Phansopkar P. Medial Tibial Stress Syndrome: A Review Article. Cureus. 2022 Jul 7; 14(7):e26641.

20. Deshmukh NS, Phansopkar P. Medial Tibial Stress Syndrome: A Review Article. Cureus. 2022 Jul 7;14(7):e26641

21. Kim MY, Na YM, Moon JH. Comparison on treatment effects of dextrose water, saline and lidocaine for trigger point injection. J Korean Acad Rehab Med 1997;21:967-973

22. Kersschot J, History of Glucopuncture, World Journal of Advanced Research and Reviews 2024, 21(01), 1925–33

23. Kersschot J, Mathieu T, Treatment of Painless Nodules with Glucopuncture in Dupuytren's Disease in Men: A Clinical Case, Cureus 2022, 14(11): e31445

24. 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]

25. Pandey N, Priyanka N, Vijendra G, Kersschot J, Glucopuncture: A novel injection therapy for non-specific low back pain, World Journal of Advanced Research and Reviews, 2022, 16(03), 426–432

26. Waluyo Y, Kersschot J, Perineural Injection Therapy, Malaysian Association of Rehabilitation, Jan 30, 2024, USM Health Campus

27. Kersschot J, Treatment of Fascial Pain with Glucopuncture, International Journal of Science and Research Archive Feb 2024, 11(01), 1227–1234

28. Safiullina A, Application of Glucopuncture, Medical Congres October 28, 2023, Kazan, Russia

29. Maniquis-Smigel L, Dean Reeves K, Jeffrey Rosen H, Lyftogt J, Graham-Coleman C, Cheng AL, Rabago D. Short Term Analgesic Effects of 5% Dextrose Epidural Injections for Chronic Low Back Pain: A Randomized Controlled Trial. Anesth Pain Med. 2016; 6 (1): e42550

30. Pandey N, Nayak P, Gahnolia V, A Randomized Control Trial on Efficacy of Analgesic Effect of 5% Dextrose Caudal Epidural Injection for Non-specific Low Back Pain. International Journal of Scientific Research, 2021, 10 (9), 11-13

31. Lam KHS, Hung CY, Chiang YP, Onishi K, Su DCJ, Clark TB, Reeves KD. Ultrasound-Guided Nerve Hydrodissection for Pain Management: Rationale, Methods, Current Literature, and Theoretical Mechanisms. J Pain Res. 2020 Aug 4;13:1957-1968

32. Chen LC, Ho TY, Shen YP, Su YC, Li TY, Tsai CK, Wu YT. Perineural Dextrose and Corticosteroid Injections for Ulnar Neuropathy at the Elbow: A Randomized Double-blind Trial. Arch Phys Med Rehabil. 2020 Aug;101(8):1296-1303

33. Safiullina A, Kersschot J, Glucopuncture (глюкопунктуру), Russia, October 28, 2023

34. Kersschot J, History of Glucopuncture, World Journal of Advanced Research and Reviews 2024, 21(01), 1925–33

35. Schleip R, Stecco C, DriscollM, Fascia: The Tensional Network of the Human Body, 2nd Edition, The science and clinical applications in manual and movement therapy, Elsevier 2021

36. Kersschot J, Treatment of Fascial Pain with Glucopuncture, IJSRA 2024, 11(01), 1227–1234

37. Bordoni B, Zanier E. Skin, fascias, and scars: symptoms and systemic connections. J Multidiscip Healthc. 2013 Dec 28;7:11-24

38. Lam KHS, Lai WW, Ngai HY, Wu WKR. Practical Considerations for Ultrasound-Guided Hydrodissection in Pronator Teres Syndrome. Pain Med. 2022 Jan 3;23(1):221-223

39. Fischhoff C, Vincent K Ultrasound-guided Glucopuncture in the Management of Saphenous Nerve Entrapment in Ultra-trail Runner. A Clinical Case. WJARR 2023 Dec

40. Ho TY, Chen SR, Li TY, Li CY, Lam KHS, Chen LC, Md YW. Prognostic factors in carpal tunnel syndrome treated with 5% dextrose perineural injection: A retrospective study. Int J Med Sci. 2021 Mar 3;18(9):1960-1965

41. Gharaei H, Fast and Frugal Pain Injection Decision-making, Volume 2, Aryateb Publishing 2022

42. Dinsuhaimi F, Suryadi T, Lam SKH , Suhaimi A, Proximal median nerve hydrodissection: a case series of a novel approach, Abstracts of Roma Pain Days 2023. Signa Vitae RDP 2023

43. Gharaei H, Clinical Pearls in Interventional Pain Management, Atlas of Interfascial plane hydrodissection, Volume 3,Aryateb Publishing, 2024

44. Reeves KD, Shaw J, McAdam R, Lam KHS, Mulvaney SW, Rabago D. A Novel Somatic Treatment for Post-traumatic Stress Disorder: A Case Report of Hydrodissection of the Cervical Plexus Using 5% Dextrose. Cureus. 2022 Apr 7;14(4):e23909

45. Kobayashi T, Kimura H, Zenita Y, Imagita H, Hydrorelease of Fascia. In: Schleip R, Stecco C, DriscollM, Fascia: The Tensional Network of the Human Body, 2nd Edition p.609-617

46. Lam KHS, Hung CY, Chiang YP, Onishi K, Su DCJ, Clark TB, Reeves KD. Ultrasound-Guided Nerve Hydrodissection for Pain Management: Rationale, Methods, Current Literature, and Theoretical Mechanisms. J Pain Res. 2020 Aug 4;13:1957-1968

47. Solmaz İ, Akpancar S, Örsçelik A, Yener-Karasimav Ö, Gül D. Dextrose injections for failed back surgery syndrome: a consecutive case series. Eur Spine J. 2019 Jul;28(7):1610-1617

48. Chen LC, Ho TY, Shen YP, Su YC, Li TY, Tsai CK, Wu YT. Perineural Dextrose and Corticosteroid Injections for Ulnar Neuropathy at the Elbow: A Randomized Double-blind Trial. Arch Phys Med Rehabil. 2020 Aug;101(8):1296-1303

49. Buntragulpoontawee M, Chang KV, Vitoonpong T, Pornjaksawan S, Kitisak K, Saokaew S, Kanchanasurakit S. The Effectiveness and Safety of Commonly Used Injectates for Ultrasound-Guided Hydrodissection Treatment of Peripheral Nerve Entrapment Syndromes: A Systematic Review. Front Pharmacol. 2021 Mar 5;11:621150

50. Huang CY, Lai CY, Reeves KD, Lam KHS, Li TY, Cheng CI, Wu YT. Volume Effect of Nerve Hydrodissection for Carpal Tunnel Syndrome: A Prospective, Randomized, and Single-Blind Study. J Ultrasound Med. 2024 Jan;43(1):161-169

51. Wu YT, Ho TY, Chou YC, Ke MJ, Li TY, Tsai CK, Chen LC. Six-month Efficacy of Perineural Dextrose for Carpal Tunnel Syndrome: A Prospective, Randomized, Double-Blind, Controlled Trial. Mayo Clin Proc. 2017 Aug;92(8):1179-1189

52. 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

53. Wu YT, Ke MJ, Ho TY, Li TY, Shen YP, Chen LC. Randomized double-blinded clinical trial of 5% dextrose versus triamcinolone injection for carpal tunnel syndrome patients. Ann Neurol. 2018 Oct; 84(4):601-610.

54. 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

55. Huang CY, Lai CY, Reeves KD, Lam KHS, Li TY, Cheng CI, Wu YT. Volume Effect of Nerve Hydrodissection for Carpal Tunnel Syndrome: A Prospective, Randomized, and Single-Blind Study. J Ultrasound Med. 2024 Jan;43(1):161-169

56. Ho TY, Chen SR, Li TY, Li CY, Lam KHS, Chen LC, Md YW. Prognostic factors in carpal tunnel syndrome treated with 5% dextrose perineural injection: A retrospective study. Int J Med Sci. 2021 Mar 3;18(9):1960-1965

57. Hung CY, Lam KHS, Wu YT. Dynamic Ultrasound for Carpal Tunnel Syndrome Caused by Squeezed Median Nerve Between the Flexor Pollicis Longus and Flexor Digitorum Tendons. Pain Med. 2022 Jul 1;23(7):1343-1345

58. Wu YT, Wu CH, Lin JA, Su DC, Hung CY, Lam SKH. Efficacy of 5% Dextrose Water Injection for Peripheral Entrapment Neuropathy: A Narrative Review. Int J Mol Sci. 2021 Nov 16;22(22):12358

59. Chao TC, Reeves KD, Lam KHS, Li TY, Wu YT. The Effectiveness of Hydrodissection with 5% Dextrose for Persistent and Recurrent Carpal Tunnel Syndrome: A Retrospective Study. J Clin Med. 2022 Jun 27;11(13):3705

60. Josephson S.A. Injection of 5% Dextrose for Carpal Tunnel Syndrome More Effective Than Corticosteroid Injection. In: Kasper D., editor. Harrison’s Online Updates. McGraw-Hill Education; New York, NY, USA: 2018

61. Lam KHS, Hung CY, Chiang YP, Onishi K, Su DCJ, Clark TB, Reeves KD. Ultrasound-Guided Nerve Hydrodissection for Pain Management: Rationale, Methods, Current Literature, and Theoretical Mechanisms. J Pain Res. 2020; 4 (13):1957-1968

62. D'Agnelli S, Gerra MC, Bignami E, Arendt-Nielsen L. Exosomes as a new pain biomarker opportunity. Mol Pain. 2020 Jan-Dec;16:1744806920957800

63. Hua T, Yang M, Song H, Kong E, Deng M, Li Y, Li J, Liu Z, Fu H, Wang Y, Yuan H. Huc-MSCs-derived exosomes attenuate inflammatory pain by regulating microglia pyroptosis and autophagy via the miR-146a-5p/TRAF6 axis. J Nanobiotechnology. 2022 Jul 14;20(1):324

64. Immke DC, Gavva NR. The TRPV1 receptor and nociception. Semin Cell Dev Biol. 2006 Oct;17(5):582-91

65. Han DS, Lee CH, Shieh YD, Chang CT, Li MH, Chu YC, Wang JL, Chang KV, Lin SH, Chen CC. A role for substance P and acid-sensing ion channel 1a in prolotherapy with dextrose-mediated analgesia in a mouse model of chronic muscle pain. Pain. 2022 May 1;163(5):e622-e633

66. Cherng J-H, Chang S-J, Tsai H-D, Chun C-F, Fan G-Y, Reeves KD, Lam KHS, Wu Y-T. The Potential of Glucose Treatment to Reduce Reactive Oxygen Species Production and Apoptosis of Inflamed Neural Cells In Vitro. Biomedicines. 2023; 11(7):1837

67. Li L, Ru Q, Lu Y, Fang X, Chen G, Saifullah AB, Yao C, Tolias KF. Tiam1 coordinates synaptic structural and functional plasticity underpinning the pathophysiology of neuropathic pain. Neuron. 2023 Jul 5;111(13):2038-2050.e6

68. Lam KHS, Biotensegrity and Fascintegrity for neuromuscular pain, Webinar Indonesia Malasia Regenerative Medicine Study Group, November 19, 2023

69. Kersschot J, Application of Glucopuncture for Pain Management, 12A Webinar IMRSG, Malaysia, Feb 11, 2024

70. Kersschot J, Glucopuncture: A Clinical Guide to Regional Glucose 5% Injections, B P International (India/UK), 2023, p.69

71. Fischhoff C, Vincent K Ultrasound-guided Glucopuncture in the Management of Saphenous Nerve Entrapment in Ultra-trail Runner. A Clinical Case. WJARR 2023 Dec

72. Zeviani M, Viscomi C. Mitochondrial Neurodegeneration. Cells. 2022 Feb 11;11(4):637

73. Kersschot J, Perineural Injection Therapy, Malysian Association of Rehabilitation Physician, Online Webinar, Jan 30, 2024

74. Kersschot J. Low-Dose Dextrose Prolotherapy as Effective as High-Dose Dextrose Prolotherapy in the Treatment of Lateral Epicondylitis? A Double-Blind, Ultrasound Guided, Randomized Controlled Study. Arch Phys Med Rehabil. 2023 Jul;104(7):1154-1155

75. Hsu C, Vu K, Borg-Stein J. Prolotherapy: A Narrative Review of Mechanisms, Techniques, and Protocols, and Evidence for Common Musculoskeletal Conditions. Phys Med Rehabil Clin N Am. 2023 Feb;34(1):165-180

76. Kersschot J, Low-Dose Dextrose Prolotherapy as Effective as High-Dose Dextrose Prolotherapy in the Treatment of Lateral Epicondylitis? A Double-Blind, Ultrasound Guided, Randomized Controlled Study, J.Arch Phys Med Rehabil. 2023 Jul; 104(7):1154-1155.

77. Kersschot J, Karavani I, Isotonic Glucose Injections for Postherpetic Neuralgia in the Elderly. Cureus 2022, 14(9): e2974077

78. Kersschot J, Application of Glucopuncture for Pain Management, 12A Indonesia Malysia Regenerative Medicine Study Group, Online Webinar, Feb 11, 2024