Neural Prolotherapy also called Neurofascial Prolotherapy (NPT), or Perineural Therapy is one of the newest advances in Regenerative Orthopedic Medicine. Neural prolotherapy is a drug free treatment for pain which uses a small amount of %5 dextrose (sugar) in water that is injected superficially into the area surrounding an inflamed nerve. The goal of the treatment is to reduce inflammation, swelling and pain of the affected nerve.
This treatment was originated by Dr. John Lyftogt MD of New Zealand in an attempt to remedy his own Achilles tendinitis. Following his recovery, Dr. Lyftogt has since gone on to a career of teaching neural prolotherapy internationally.
How Does Neural Prolotherapy Work?
Neural Prolotherapy works by targeting subcutaneous nerves that reside just under the skin. These nerves send impulses from their local bone, muscle, and soft tissues and transmit pain signals.
What happens in many chronic pain cases is that the nerve endings are misfiring and sending continuous nerve impulses that the brain then experiences as pain. This constant misfiring causes the nerves to become tender and inflamed. This may happen in a long-standing injury, years after an injury has occurred, or even have an undiagnosed cause.
With Neural Prolotherapy a small amount of dextrose (sugar) water is injected near these inflamed nerves. The dextrose acts on the nerves to block pain channels (specifically TRPV1). This effectively stops the misfiring and reduces inflammation without the use of medication.
Pain caused by nerve inflammation does not respond to anti-inflammatory drugs or cortisone injections, which is why many individuals experiencing “chronic pain” find little relief. Neural Prolotherapy reduces nerve inflammation, the cause of many chronic pain symptoms including neuralgia and neuropathic pain.
What is Neuropathic Pain?
Neuropathic Pain is pain that comes from an injury to a nerve. The perception of pain begins in the body’s peripheral sensory nerves. Ligaments, tendons and joints have a receptor called a TRPV-1 receptor. When the TRPV-1 receptor (aka: capsaicin receptor) of sensory nerve fibers is activated, internal inflammatory changes begin. As inflammatory changes progress in the nerve, internal swelling and pressure increase. Internal nerve “flow” is slowed by this process and will even come to a halt at a pressure of 30 mmHg. New injuries, old injuries and overuse injuries are all contributing factors to excessive activation of the neural TRPV-1 receptor, nerve compression, inflammation and pain.
Neuropathic Pain is pain that comes from an injury to a nerve. The perception of pain begins in the body’s peripheral sensory nerves. Ligaments, tendons and joints have a receptor called a TRPV-1 receptor. When the TRPV-1 receptor (aka: capsaicin receptor) of sensory nerve fibers is activated, internal inflammatory changes begin. As inflammatory changes progress in the nerve, internal swelling and pressure increase. Internal nerve “flow” is slowed by this process and will even come to a halt at a pressure of 30 mmHg. New injuries, old injuries and overuse injuries are all contributing factors to excessive activation of the neural TRPV-1 receptor, nerve compression, inflammation and pain.
These peripheral sensory nerves are within 1/2 inch of the surface of the skin and injections are very well tolerated. Often patients feel immediate pain relief after the injections.