Dr. John Lyftogt, from New Zealand, struggled for years to help find some relief for his chronic pain patients. He eventually developed a treatment that he termed Neural Prolotherapy while working on relieving Achilles tendonopathy. Neural Prolotherapy is an injection therapy with 5% dextrose (sugar) that focuses on treating the nerves in the skin that have become injured and entrapped due to inflammation.
Neural Prolotherapy is an injection therapy with 5% dextrose (sugar) that focuses on treating the nerves in the skin that have become injured and entrapped due to inflammation.
Although the nerves are superficial, the pain they create is often felt in the deeper tissues. The injection of low-dose dextrose changes the pain signaling and stops neurogenic inflammation (what your doctor may have called neuropathic pain). The dextrose solution also has a regenerative effect on the entrapped nerves helping them to heal and preventing recurrence.
How does Neural Prolotherapy treatment work?
Five percent dextrose is injected beneath the skin surface with a tiny needle over the commonly constricted regions of nerves. Patients with nerve pain (neurogenic pain) experience pain relief within seconds. This is often a surprise to the patient!
Patients with nerve pain (neurogenic pain) experience pain relief within seconds. This is often a surprise to the patient!
The 5% dextrose works by immediately blocking the receptor in the nerve (TRPV-1 or Capsacin receptor) which is the principal regulator of pain and inflammation. Changing the receptors in the nerve allow for healing to deeper structures like tendons, ligaments and joints (Hilton’s law). Other substances also can block this receptor like procaine, magnesium and salt which may explain why Epsom salt bath soaks are so popular; however, unlike dextrose these other substances do not reset the receptors, they only temporarily block them. Vitamin D is also being researched for it’s effect on nerve pain.
What is the treatment like?
Dr. Kanwal will track the pain by feeling for inflamed nerves in the skin. These nerves aren’t usually palpable but when they are inflamed and constricted they feel like small taut hoses that can be exquisitely painful to touch.
Once the nerves have been tracked they are injected along their lengths with 5% dextrose.
The number of injections is quite variable but because the nerves are irritated they can be intense – much like a number of small bee stings. Most patients require between 3 – 8 series of injections for complete resolution of pain. It is not uncommon for new areas that were originally masked to have to be treated as well. Because the treatment is diagnostic (a painful injection indicates immediately if there is nerve injury involvement), patients will notice some improvement right away. For some people this relief lasts generally for several days; however, if the injury has been endured for a long period then the length of relief may be short. Subsequent treatments result in progressively longer improvements until complete relief is achieved in most patients.