Neural prolotherapy

Just beneath the surface of the skin are hundreds of superficial nerves that we now believe play a major role in controlling pain and inflammation.

by Dr. Fred G. Arnold — 

Neural prolotherapy is a new, exciting breakthrough in the treatment of pain, developed by John Lyftgoft, M.D., a New Zealand physician. Neural prolotherapy combines the treatment principles of both neural therapy and prolotherapy. As in neural therapy, shallow, subcutaneous injections are made along the path of superficial nerves and, like prolotherapy, dextrose, a sugar solution, is used.

Just beneath the surface of the skin are hundreds of superficial nerves that we now believe play a major role in controlling pain and inflammation.

Neuropathic or neurogenic pain 

Neuropathic pain is also referred to as neurogenic (nerve) pain and is the type of pain that lingers after an accident, does not go away and is referred to as chronic pain. Neuropathic pain is a severe and debilitating pain that can render patients unable to walk, sleep or enjoy life.

The pain can be anywhere from head to toe, overlying a tendon, bone or joint. Following a trauma or repetitive overuse, chemical changes affect the involved nerves and trigger a release of chemicals that promote neurogenic inflammation. The release of these chemicals causes swelling, pain, tendon damage (loss of type 1 collagen) and trigger an immune response that leads to cartilage damage and osteoarthritis.

Dr. Lyftgoft’s approach

Neural prolotherapy involves multiple injections of a small amount of 5 percent dextrose (basically sugar water) along the path of tender superficial nerves in the areas of pain. The dextrose solution works by immediately blocking the nerve endings that are responsible for the pain and inflammation with the associated superficial nerves.

Patients with nerve or neurogenic pain may experience relief within seconds and are often shocked and in disbelief when their pain is gone without an anesthetic or cortisone. This leads to healing beneath the nerve to deeper structures like tendons and joints. Immediately after the injection, range of motion and use of the painful area can be improved.

Conditions that may respond to neural prolotherapy include fibromyalgia; headaches and migraines; and neck, shoulder, elbow, wrist, hand, low back, hip, knee, foot and ankle pain. Generally, conditions that involved tendons, arthritic joints, bursitis, sciatica and muscle/ligament injuries are targeted.

What to expect

Patients receive an initial in-office treatment with anywhere from three to 30 small injections of a one-half milliliter solution with a tiny needle (like those used for a TB test), depending on the nature of injury and region. They return weekly for repeated treatments, generally from two to eight times.

Case histories

Case #1: We recently treated a 62-year-old male with chronic shoulder pain and moderate to severe degenerative joint disease. After the initial injections, the patient realized immediate improvement in his pain and range of motion. He was surprised how much better his shoulder felt and how high he could raise it without pain. The patient has received four separate treatments, one to two weeks apart, with improvement after each treatment.

Case #2: This case involves an 87-year-old male with hip pain. An orthopedic doctor told him there was nothing that could be done until the symptoms worsened. He had difficulty walking and rising from a seated to standing position. His hip frequently felt weak, as if it might “give way.” After his first treatment, he reported an immediate reduction in pain with improved stability. He was surprised when he felt immediately better and queried whether there was a narcotic in the injection solution. He has continued to improve 10 to 15 percent with each treatment session.

Summary

Neural prolotherapy is a very effective treatment for chronic painful conditions. Of all the pain treatments, it is probably one of the safest and easiest injection therapies to administer with the least amount of discomfort, due to the fact that a very small diameter needle is used and the injections are very shallow, approximately one-half inch. Patients usually are able to recognize an immediate change in their pain and marked improvement in range of motion.

Neural prolotherapy is a treatment consideration when a patient’s condition is unrelieved by other methods, such as prolotherapy, prolozone, PRP and joint and back surgeries.

References:

Perineural Subcutaneous Injection Workshop, (The Lyftogt Technique), A Neuropathic Pain Treatment, AAOM, 30th Annual Conference and Scientific Seminar, Phoenix, Ariz., April 2013.

John Lyftogt, M.D., A Neuropathic Pain Treatment, AKA Neural Prolotherapy, Regenerative Orthopedic Medicine, Past, Present and Future, Navigating Your Way Through Its Emerging Technologies, Phoenix, Ariz., 2013.

Fred G. Arnold, D.C., N.M.D., has more than 20 years of clinical experience and specializes in pain rehabilitation services. He was one of the first doctors to be trained by Dr. John Lyftgoft and is one of the few physicians in the nation with both a naturopathic medical degree and chiropractic degree. 602-292-2978, phoenixpainrehabilitation.com or prolotherapyphoenix.com.

Reprinted from AzNetNews, Volume 32, Number 4, August/September 2013.