Perineural injection therapy (PIT), also known as “neural prolotherapy” is an injection therapy targeted for resolving neurogenic pain and neurogenic inflammation. PIT involves subcutaneous injections (just below the skin) along the small superficial peripheral branches of the nerves. PIT injections use 5% dextrose, 1% procaine, or a combination of the two, injected along the superficial nerve branches to reduce inflammation, which will reach the deeper nerve branches and nerve roots, resulting in immediate pain relief and improved quality of life.
How does it work?
When nerves are injured, hypersensitive, or damaged, they will persistently overproduce local inflammatory markers, resulting in neurogenic inflammation. The presence of neurogenic inflammation can result in chronic pain, stiffness, swelling, weakness, paresthesia, and hypersensitivity to touch. Often times, chronically tight muscles or fascia, traumatic injury, or underlying tendon and ligament dysfunction can be an underlying cause or contributor to the neurogenic pain. Addressing any underlying root cause is essential for long term pain relief, and often perineural injections can be combined with standard prolotherapy treatment to treat both the acute pain as well as the underlying causative dysfunction in the deeper connective tissues.
What is the course of treatment?
Initial assessments are standard 60 minute initial appointments in order to complete a full orthopaedic assessment of the affected area, as well as general health history taking. Follow-up injection appointments are 30 minutes to allow for repeat orthopedic assessment to monitor progress and administration of the injections. Injections are ideally administered once weekly for 3-4 weeks, then as needed until symptoms subside.
What conditions do Perineural injections help?
- Chronic pain
- Cervical radiculopathy
- Nerve entrapment or impingement
- Sciatic pain
- Joint pain
- Post-surgical pain & paresthesia
- Altered sensation of scar tissue
- Persistent sports injury pain
- Complex regional pain syndrome (CRPS)/Reflex sympathetic dystrophy (RSD)
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