PERINEURAL INJECTIONS IN ST. GEORGE

What Is Perineural Therapy

Perineural Injection Therapy (PIT) is one of the newest advances in Regenerative Medicine used to treat nerve pain and musculoskeletal pain due to sports injuries or chronic pain conditions.  It involves the injection of natural sugars just below the skin to promote healing of injured nerves, restoration of tissue function and elimination of pain.  PIT was discovered by Dr. John Lyftogt from New Zealand, who has been using this method to treat musculoskeletal injuries and various pain conditions over the last decade with amazing results.

 

Perineural injections, also known as perineural therapy or neural therapy, are medical procedures in which therapeutic substances, such as local anesthetics, vitamins, or homeopathic remedies, are injected into or around peripheral nerves or nerve sheaths.

The goal of perineural injections is to alleviate pain, reduce inflammation, and promote healing of the affected nerves and surrounding tissues.

 

The term “perineural” refers to the area around nerves. Perineural injections target the space where the nerves and their surrounding tissues interact, with the aim of affecting

the function of the nerves and modulating pain signals. The substances injected can help interrupt pain pathways, reduce nerve irritation, and promote nerve healing.

 

Perineural injections may be used for various conditions, including:

  1. Neuropathic Pain: Perineural injections can be used to treat neuropathic pain conditions, such as peripheral neuropathy, nerve entrapment syndromes
    (e.g., carpal tunnel syndrome), and postherpetic neuralgia.

  2. Musculoskeletal Pain: They may be utilized for musculoskeletal pain, including myofascial pain syndromes, trigger points, and soft tissue injuries.

  3. Chronic Pain: Perineural injections might be considered for chronic pain that hasn’t responded well to other treatments.

  4. Scar Tissue and Adhesions: They could help address pain and dysfunction caused by scar tissue or adhesions around nerves.

  5. Migraines and Headaches: In some cases, perineural injections may be used to manage headaches and migraines.

What Other Names Does PIT Go By?

PIT is also known as Neural Prolotherapy (NPT), Neural Regenerative Technique (NRT), Perineual Subcutaneous Injections (PSI), Neurofascial Prolotherapy and The Lyftogt technique.

PIT has revolutionized the treatment of nerve or neuropathic pain.  Dr. Hardy has seen many patients who have “tried everything”, including surgery, and still have persistent pain. 
This is usually due to injured and non-healing sensory nerves that lead to inflammation and delay of healing.  These people tend to respond well to PIT.  PIT is very effective in treating conditions due to inflamed nerves such as trigeminal neuralgia, migraines, diabetic neuropathy, Morton’s neuroma, post herpetic neuralgia due to zoster infection, post-surgical pain, reflex sympathetic dystrophy, fibromyalgia.  PIT is also used to treat pain due to musculoskeletal injuries including shoulder, knee, elbow, neck and low back, ankle, temporal mandibular joint (TMJ), and many other conditions.

How is PIT Different from Prolotherapy?

PIT involves shallow injections of low concentration dextrose or mannitol under the skin to heal injured superficial nerves.  Traditional Prolotherapy involves deep injections using higher concentrations of dextrose to target where ligaments and tendons attach to bone to promote regrowth and repair of these structures. Both techniques are very effective to relieve pain and restore function.

How Does PIT Work?

How is PIT Different from Prolotherapy?

Multiple shallow injections are done under the skin using a very short, thin needle to target painful sensitive nerves with natural substances aimed to stop nerve inflammation, promote healing of injured nerves, restore tissue function and eliminate pain. 

Tissue injury or injury to nerves by stretching, constricting, or cutting them (such as after surgery or due to tight muscle spasms), activate a receptor on nerves called Transient Receptor Potential Cation Channel V1 (TrpV1), also known as the capsaicin or chili pepper receptor.   This results in nerve release of substances that cause inflammation, swelling, burning painful sensations (neuropathic pain) and chronic nerve dysfunction. 

It is postulated that dextrose and mannitol inhibit TrpV1 nerve receptors, preventing this inflammatory cascade and restoring normal nerve function.

PIT involves shallow injections of low concentration dextrose or mannitol under the skin to heal injured superficial nerves.  Traditional Prolotherapy involves deep injections using higher concentrations of dextrose to target where ligaments and tendons attach to bone to promote regrowth and repair of these structures. Both techniques are very effective to relieve pain and restore function.

How Effective is PIT?

How Often Do I Need These Treatments?

Every treatment aims to reduce pain prior to leaving the office.  The pain relief may last hours to days after the first injection.  Then pain will recur but usually in a lesser form.

With subsequent treatments less areas need to be injected and the pain free duration gets progressively longer as the nerves and tissue heal to restore function.  Success rates vary between 80-100% depending on the condition.

The average number of treatments required for most conditions is 6-8 separated by

1 to 2 weeks.  This may vary for each individual depending on how long the injury has been present and the degree of tissue damage.

Is PIT Safe?

Is PIT treatment painful?

PIT is very safe because it is minimally invasive and uses a natural substance. 

Injections are done using a very short, thin needle injected very shallow under the skin.  With proper technique the risk of infection and tissue injury is minimal to none.

Possible adverse effects include local swelling, bruising and mild transient pain. 

PIT is a well-tolerated procedure compared to other types of injections.  No local anesthetic is required because the injections are superficial using a very thin and short needle is used.  Some injection points may cause mild discomfort or a sensation of initial stinging followed by complete resolution of pain.

When can I go back to work or playing sports after a treatment?

Will my insurance cover for PIT?

There is no “recovery time” with PIT because most patients leave the office with reduced pain.  However, depending on where in the course of treatment you are, this pain relief

may last hours, days, weeks or months until the nerves and tissue completely heal. 


Patients can immediately return to normal activity as long as the pain level

is less than 4 out of 10.

Insurance will not cover this procedure.

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