Abstract
Chronic musculoskeletal pain syndromes with discordant clinical-radiological findings present significant therapeutic challenges. This study evaluates glucopuncture-a minimally invasive intervention targeting fascial and muscular pain generators-in two refractory cases: an elderly female patient with severe thumb osteoarthritis (Eaton-Littler stage III) and a professional kickboxer with persistent cervicobrachial pain. Both received standardized palpation-guided glucopuncture using 27-gauge needles (subcutaneous: 0.5 mL/site for fascial pain; intramuscular: 1 mL/site for myofascial dysfunction). The geriatric patient achieved 90% pain reduction (Numerical Rating Scale (NRS) 8-9 to 0-1) and functional improvement (Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) 55 to 25) after three sessions, sustained at three-month and one-year follow-ups. The athlete attained near-complete symptom resolution (QuickDASH 56.8 to 11.3; Neck Disability Index (NDI) 77 to 33) after five sessions, enabling full return to training with efficacy persisting at one year. Outcomes exceeded established minimal clinically important difference thresholds. Compared to alternatives, glucopuncture avoids intentional tissue injury (prolotherapy), supplements dry needling with biochemical modulation, and offers cost-effective simplicity versus platelet-rich plasma. Safety was favorable, with transient pain flares in <20% of interventions. These preliminary findings support glucopuncture as a promising therapy for complex pain syndromes unresponsive to conventional treatments. Further randomized trials should evaluate dose optimization, long-term efficacy, and health economic impact.