Prolotherapy for pain in iliocostal friction syndrome

Che Ku Bahirah, Che Ku Mat and Anwar, Suhaimi and Chai, Chau Chung (2022) Prolotherapy for pain in iliocostal friction syndrome. electronic-Perak Medical Journal, 2 (suppl1). p. 9. ISSN 2682-8596

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Abstract

INTRODUCTION AND OBJECTIVE Iliocostal friction syndrome (ICFS) is a rare painful condition due to friction of lower ribs against iliac crest leading to irritation of soft tissues in contact with these structures. Structures damaged by iliocostal friction includes the inserting tendons and muscles. The treatment for ICFS mentioned in literature are rib compression belt, orthosis, prolotherapy and surgical removal of lower ribs. This case report illustrates the use of prolotherapy in pain management for ICFS. CASE PRESENTATION This is a case report of an 82-year-old lady with degenerative thoracolumbar scoliosis and osteoporotic vertebral compression fracture of L1. She presented with clinical features of ICFS. Her main complaint was severe pain at right pelvic region with standing and walking. Prolotherapy was done at the tender area of right iliac crest and right lower rib with ultrasound guidance for pain relief. Prolotherapy was done using 4cc hypertonic dextrose 12.5% and 1cc 1% lignocaine. 2.5cc of this solution deposited at tender area of right iliac crest and right lower rib each. Procedure was done under ultrasound guidance. Significant pain relief reported by patient which is measured by Numerical Rating Scale (NRS). The effect of pain relief persists one month post injection. CONCLUSION Prolotherapy with hypertonic dextrose 12.5% and 1% lignocaine HCl is an effective treatment for pain cause by irritation of inserting tendon at the iliac crest and lower rib in ICFS.

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