What is Perineural Therapy?
Perineural Therapyis a minimally invasive, drug-free, pain management option that targets the nerves that cause pain. Perineural Therapy uses a small isotonic (neutral) amount of dextrose (plant-based sugar) in water, which is injected using a tiny needle around peripheral, often superficial inflamed nerves. It is absolutely safe to use even for diabetic patients (which are the most common of all to have Diabetic Neuropathy).
Most of injections administered subcutaneously in contrast to traditional Prolotherapy. The later targets deeper structures, mostly sites of ligament’s attachment to bone. Dr Lutskovsky often combines Prolo and Perineural Therapy to cover complex pain origins in every patient.
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 in 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, providing “soothing” effect.
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 (a few 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. Ultimate goal is to continue injections until pain is relieved permanently.
Majority of clients can enjoy elimination of pain in the long-term after several treatments. Some clients do not experience full pain elimination, due to more complex nature of their pain, they will require additional tools on their way to recovery. Each patient is different so we will work with you in your unique case to ensure maximum results with this treatment.