What is Perineural Therapy?
Perineural Therapy is a minimally invasive, drug-free, pain management option that targets the nerves that cause pain. Perineural Therapy uses a small amount of dextrose (plant-based sugar) in water, creating a solution similar to IV’s, which is then injected using a tiny needle just under the skin into subcutaneous nerves. Perineural Therapy is different than traditional prolotherapy in that Perineural Therapy targets inflamed nerves that cause pain just under the skin, while traditional prolotherapy goes deep into tissues to regenerate soft tissues such as tendons and ligaments. The doctor will discuss which procedure is best for your individual needs based on what is the cause of your pain.
The subcutaneous nerves targeted by Perineural Therapy are responsible in pain transmission and are called sensocrine nociceptors. It is thought that these sensocrine nociceptors are responsible for painful conditions described as ‘neuralgias’ or ‘neuropathic pain’ or more commonly known as ‘chronic pain’.
How Does Perineural Therapy Work?
Perineural Therapy 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.
Perineural Therapy injects a small amount of glucose water 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. Perineural Therapy reduces nerve inflammation, the cause of many chronic pain symptoms including neuralgia and neuropathic pain.
What Can A Patient Expect?
An initial consultation with Dr. Andrey is the first step to determine whether Perineural Therapy is right for you, or if another therapy would be most beneficial.
The procedure is a relatively short (20-60 minutes) outpatient procedure. The visit will include gathering of medical history, examination, marking, and injections. The doctor will make a few small injections of dextrose solution just under the skin to target the subcutaneous nerves. The patient may experience some soreness or bruising in the area which should resolve itself within a day or two. There is no down-time with this procedure.
Injections will target the nerves related to the chronic pain and will often include several injections in the area per treatment. Generally, the first treatment will result in diminished pain lasting anywhere from a few hours to a few days after the treatment- this is a good sign and shows that the patient is responding positively to the treatment.
However, one treatment is not enough and the patient will have to return for follow-up procedures. Each time, the results will be compounded resulting in longer and longer periods without pain. The ultimate goal is to continue injections until pain is relieved permanently.
The majority of clients are able to enjoy elimination of pain in the long-term after 6-10 treatments, others may take as much as 20. Some clients do not experience full pain elimination but do enjoy significantly reduced pain that allows them to enjoy their daily lives. Each individual is different so we will work with you in your unique case to ensure maximum results with this treatment.