Sometimes referred to as Neural Prolotherapy but we use the more commonly used Perineural Injection Therapy to differentiate it from Prolotherapy which uses higher concentrations of dextrose and focuses on proliferation of tissue rather than neurogenic inflammation.
How do trapped nerves cause pain?
See that part to the right of the image of a healthy nerve? It looks nice & healthy, the sheath around it is able to move smoothly around the nerve as you move your body. Then there's that great big lump right in the middle, the nerve is inflamed and stuck because the sheath around it isn't moving the rest of the nerve to the left is stretched and very sensitive to motion. If you stick your finger in a clamp and try to walk away you might understand how having things going in two directions might not be too comfortable.
Neurogenic inflammation often doesn't respond to anti-inflammatory medications or steroid injections, but oddly enough pain can be relieved immediately with sugar. Most painful conditions respond well to perineural treatments but they are specifically effective at treating pain due to nerve entrapments, complex regional pain syndromes, chronic constrictive injuries, neuralgia, neuropathy or neurogenic pain.
What gets injected?
We use a mixture of buffered 5% Dextrose with vitamin B12 and a 1% Procaine solution. Dextrose was discovered to have analgaesic properties in the 1950's but research was largely set aside as new medications were synthesised and those pesky wars came to an end which reduced the demand for affordable pain treatments.
Procaine is our local analgaesic of choice because it breaks down in the local tissues, as opposed to the liver, and generally carries less risk of adverse effects. It helps reduce some of the discomfort during the treatment as well as any soreness afterwards.
There are a few different forms of B12, one is better for issues with muscles while another is better for the nerves; we choose which is appropriate for the treatment.
All of the solutions we use are sterile and preservative free.
How does it work?
Dextrose doesn't work on the nerve endings (which sense pain) but rather on the TRPV1 receptors involved in neurogenic inflammation, and it works almost instantly. TRPV1 receptors are involved with inflammatory processes and are associated in neuropathic pain, joint inflammation, inflammatory bowel disease and other conditions. It is becoming more understood that neuropathic pain is a signal from peptidergic fibres indicating critically low sugar levels. These dilute sugar injections seem to completely block Substance P and other chemicals associated with pain and also physically free the nerves so they move and slide through the fascia as they're supposed to.
How well does it work?
Dextrose injected around entrapped nerves has an instant analgaesic effect which often lasts from 4 hours to 4 days (up to 2 weeks). Much like acupuncture treatment we like to get a few treatments close together to get the inflammation down before tapering off as the pain disappears. Sometimes an issue can be resolved within just a few treatments but can often take 6-8 treatments. You'll know after just a couple of treatments if this therapy is right for you because you will notice results very quickly.
Our goal with any treatment is always to get the pain down to zero.
Will it hurt?
Needles used for perineural treatment are very thin, not as thin as acupuncture needles but still much thinner than intramuscular needles. Injections are done into the fascia and tissues between the skin and muscles. The sugars in the solution work immediately to relieve the inflammation and the procaine also helps to numb the area so this treatment focuses on the opposite of hurt. There might be a small piece from the needle, as with any acupuncture treatment.
We will do everything possible to make your treatment comfortable.
What are the risks?
Shallow point injections carry the same risks that accompanies any gentle acupuncture or needling treatment.
From mild to serious, potential risks include:
These are separate therapies but are closely related to neural therapy and don't need their own pages.
This is a therapy which is related to both German neural therapy as well as traditional acupuncture and is used to treat both pain and organ dysfunction. Usually tiny procaine injections are introduced just under the skin over the affected tissues to normalise autonomic innervation with the goal of reducing pain & inflammation and improving tissue function & local circulation.
The same treatment we use to clear adhesions in the fascia around nerve can be used to free tissues which are stuck to scar tissue. If you're having pain, discomfort or poor circulation around an area of significant scarring then it's worth considering some treatment for it. Pain can exist around the scar as well as further along the nerve; either way these superficial treatments around and under the scar are very effective.
Before you come for treatment: