Perineurial Therapy for Pain

Neural Prolotherapy

Perineurial Therapy for Pain, also know as Neural Prolotherapy, discovered by Dr. John Lyftogt of New Zealand, is a ground-breaking treatment option for pain and musculoskeletal injuries including tendonitis, osteoarthritis, peripheral neuropathy, chronic regional pain sydrome, migraine, frozen shoulder and other pain conditions. Neural Prolotherapy involves subcutaneous injections of a dextrose (sugar) solution in sterile water along the nerve associated with pain.  This treatment has not only reduced or eliminated pain in many patients, but has also resulted in healing and regeneration of tissue.  Neural prolotherapy is a new treatment still being researched, but showing great promise in the area of non-invasive pain control and regenerative medicine. The number of treatments varies from patient to patient, but an average regimen is 6-8 treatments in 6-12 weeks. 

This minimally invasive technique has eliminated the need for surgery or strong medications in many patients. Studies conducted and Dr. Allison Gandre’s clinical results have demonstrated over 80% success rate for pain conditions ranging head to toe. Follow-up studies 2-years out have shown continued pain relief for over 80% of patients.  

Dr. Allison Gandre has completed advanced courses in Neural Prolotherapy with Dr. Lyftogt and is a certified practitioner of the Lyftogt technique of neural prolotherapy. 

Answers to most questions and links to studies can be found at : http://www.doctorliftoff.co.nz/

What Causes Pain?

The perception of pain originates in the peripheral sensory nerves of the body. When the TRPV-1 receptor, (aka capsaicin receptor) on these nerves is activated, inflammation and neuropathic pain pursue. Inflammatory chemicals (neuropeptides) are increased that further irritate these nerves. As inflammatory changes progress in the nerve, swelling and internal pressure increase. Internal nerve “flow” is slowed by this process and will even come to a halt at a pressure of 30 mmHg2. This means that signaling to the tissues for response, synovial fluid output and connective tissue repair is slowed or halted. Compression on a nerve, new injuries, old injuries and overuse can activate the TRPV-1 receptor, inflammation and pain.

Why Dextrose Injections For Pain?

The theory behind using 5% dextrose for pain is that dextrose is an antagonist of the TRPV-1 receptor. When injected near an inflamed, swollen nerve, dextrose reduces activity of the TRPV-1 receptors and subsequent inflammation and pain. The injected fluid also creates a hydrodissection, meaning that the injected fluid surrounds the nerve, creating a cushion from any impinging muscles or bursae which may be compressing the nerve.

Are Perineural Injections Safe?

Perineural injections are remarkably safe when given by a properly trained practitioner. Subcutaneous injections in general are safe as they are deposited just under the skin and absorbed slowly. Dextrose is present in many foods we consume daily and 5% dextrose has been given as an IV solution safely for decades.

How Will I Feel After a Perineural Therapy Session?

Often, patients will have immediate pain relief following a perineural therapy session. The treatment is generally very well tolerated. The needle used is very small, similar to an acupuncture needle. There may be pain at the injection site and bruising is possible. Some patients may take several treatments to reduce their pain.

How Many Treatments Will I Need?

Typically patients will need 6-8 treatments, at a rate of one treatment per week, in order to achieve resolution of their symptoms. Every patient is unique. I have had patients resolve their pain in as little as 2 treatments, while others take longer. Some patients will need on-going maintenance for optimal function and pain-relief.