Treatment of fascial pain in the knee fold: A clinical case

Family physicians and sports medicine practitioners frequently encounter patients with musculoskeletal (MSK) pain that does not conform to specific diagnostic patterns. One potential explanation for such ambiguous pain syndromes is soft tissue injury, including fascial damage, which may not yet be detectable on imaging studies. The fascial system (FS) is an intricate network comprising both superficial and deep layers. Over the last decade, its dysfunction has been increasingly linked to MSK disorders and regional pain syndromes [1-3]. As a biomechanical structure and a major sensory organ, the FS houses numerous sensory receptors, making it crucial for both structural integrity and sensory modulation [4, 5].

Glucopuncture (GP) involves the administration of 5% glucose (G5W) or 5% dextrose (D5W or D-glucose) injections into fascia, muscles, ligaments, or joints. Particularly multiple superficial fascia injections have gained popularity as a treatment for poorly localized pain syndromes [6-8].

This article describes the case of a 75-year-old woman with a three-month history of pain in her left knee fold, successfully managed with palpation-guided GP. Interestingly, in this case, the injections targeted trigger points that are distant from the pain region, illustrating the potential for this method to address referred pain caused by superficial fascial dysfunction. GP represents an accessible, cost-effective, and eco-friendly approach for clinicians with limited access to advanced imaging or ultrasound. Further research is needed to confirm its efficacy and safety in treating vague MSK pain [9, 10].