Sweet relief: the role of glucopuncture in neuropathic pain management

Neuropathic pain remains a major challenge in pain management because of its complex mechanisms and suboptimal response to conventional treatments, which often provide incomplete relief and carry the risk of adverse effects. Injections of 5% glucose in water (D5W) delivered via intradermal, subcutaneous, fascial, or perineural glucopuncture have emerged as a minimally invasive and safe therapeutic option. Although the exact mechanism has not been fully elucidated, the proposed pathways include transient receptor potential vanilloid 1 modulation, suppression of neurogenic inflammation, and stabilization of C-fiber excitability. Clinical studies, ranging from case reports to randomized controlled trials, have suggested the efficacy of this approach in postherpetic neuralgia, entrapment neuropathies, chronic tendinopathies, and fascial pain, with minimal complications. Unlike prolotherapy, glucopuncture uses isotonic glucose (D5W), and primarily exerts neuromodulatory rather than regenerative effects. Current evidence, while limited, indicates meaningful and sustained pain relief in selected neuropathic conditions with a favorable safety profile and low procedural complexity. This review outlines key mechanisms, clinical outcomes, differences between related interventions, and clinical considerations.