Perineural Injection Therapy™ and Prolotherapy

Dextrose Prolotherapy is the original form of Prolotherapy originating in the 1930’s. Concentrated dextrose (sugar water) is used as an irritant to stimulate a mild inflammation which “tricks” the body into thinking the area is injured and to begin healing again. Dextrose Prolotherapy raises growth factor levels or effectiveness to promote tissue repair, reducing or eliminating musculoskeletal pain.

Dextrose Prolotherapy is practiced by physicians and Podiatrists worldwide and has been shown effective in treating many musculoskeletal conditions - such as tendinopathies, ligament sprains, back and neck pain, tennis/golfers elbow, ankle pain, joint laxity and instability, plantar fasciitis, shoulder, knee pain and other joint pain. It is commonly referred to as simply “Prolotherapy”.

Prolotherapy works by causing a temporary, low grade inflammation at the injection site, activating fibroblasts to the area, which, in turn, synthesize precursors to mature collagen and thus reinforce connective tissue. It has been well documented that direct exposure of fibroblasts to growth factors (either naturally occurring or added) causes new cell growth and collagen deposition. Inflammation creates secondary growth factor elevation. The inflammatory stimulus of Prolotherapy raises the level of growth factors to resume or initiate a new connective tissue repair sequence which had prematurely aborted or never started. Animal biopsy studies show ligament thickening, enlargement of the tendon/bone junction, and strengthening of the tendon or ligament after Prolotherapy injections. 

We have found this to be a useful adjunct treatment with no known side effects. We have found this as a good alternative to send off for cortisone.

Perineural Injection Therapy does not target tendons, ligaments or joints.  With the improvements with subcutaneous injection the question had to be asked what causes the often dramatic decline in pain levels after even a few treatments.

A working hypothesis was developed that glucose targets glucose sensing pain nerves called nociceptors located in nerve trunks immediately under the skin. These nerve trunks may contain up to 30,000 small fibers per mm2. Half of these small fibers are a variety of ‘pain fibers’, technically known as sensocrine or peptidergic nociceptors. These fibers are able to sense a large range of chemical, physical and thermal impulses and respond by releasing neuropeptides or neurohormones. This hormonal or endocrine function serves tissue homeostasis or steady state. It is essential for ongoing tissue maintenance and repair. Under normal conditions the homeostatic or steady state function does not cause pain or inflammation. However when injured or irritated these peptidergic nociceptors are activated and thought to be responsible for painful conditions described as ‘neuralgias’ or ‘neuropathic pain’ or more commonly known as ‘chronic pain’. 

It is clear from clinical observations on more than five thousand patients and large case series that Perineural Injection Therapy™ effectively reverses ‘neurogenic inflammation’ and resolves ‘neuralgia’ and ‘neuropathic’ or chronic pain.

Nobody likes injections, but PIT treatment's are not like having a normal injection. The treatment consists of micro-injections just under the skin, so it is more like having multiple pin-pricks.

Once it is done the injection pain disappears almost immediately. The aim of each treatment is to have you walk out of the consultation room with no pain.

Depending on the body part, how long you have had the injury/pain for, and the individual circumstances, the “rule of thumb” is that 85% of people resolve their pain completely, with many more experiencing a significant improvement.

Perineural Injection Therapy™ is a very effective treatment for chronic pain. With an experienced practitioner, many people find that once they have completed a course of treatment their symptoms disappear and don’t return.

Yes. Most people do become free of pain in the long-term. The aim of each treatment session is to get you pain-free then and there; that is how practitioners know they are targeting the correct nerves. Following each session you should be pain free for anywhere from four hours to four days. With every session, you remain pain-free afterwards for longer and longer periods until your pain doesn’t come back, which is why you need multiple treatments.

Most people become pain free after 6-8 treatments. These can be spaced anything from one week to one month apart. In certain circumstances your practitioner may suggest more or less frequent treatments.

If you are on prescribed medication, discuss this with your practitioner. You can certainly stop your pain medication when you are pain free, but it is better to decrease the dose carefully and slowly to avoid withdrawal symptoms.

The treatment is very safe with few side effects. Some localised bruising around the injection sites is not uncommon. No allergic reactions have yet been observed. It has been estimated that one in 300,000 injections may result in infection – in other words, extremely low risk.

Perineural Injection Therapy™ is used by over 1500 doctors in Argentina, Australia, Canada, Germany, Italy, Mexico, the Netherlands, the Philippines, Taiwan and the United States. We are the only clinic in Queenstown using this treatment, in fact only one of a few in New Zealand.

For more information search www.lyftogtmed.com