Neural Prolotherapy (NPT) is a new therapy used to treat neuropathic pain, a major component of chronic pain and musculoskeletal injuries. Neural Prolotherapy is the injection of a medical-grade sugar, 5% dextrose in sterile water (D5W), just below the skin to promote healing of injured nerves and restoration of tissue function.
When tissue is injured, it causes a release of pro-inflammatory substances that activate a channel on nerves. When this channel is turned on, it results in the release of substances that cause inflammation leading to swelling, hypersensitivity, and painful sensations.
It is postulated that dextrose , the active ingredients of Neural Prolotherapy, binds to and inhibits the nerve receptors, preventing this cascade and restoring normal nerve function. Also the fluid in the injection helps to hydrate connective tissue. Dehydrated connective tissue can add to nerve pain by pressing tightly on the nerve passing through it.
Neural Prolotherapy is generally very well tolerated, even without local anesthetic which is generally required for other types of injections. The injections are administered with very small and short needles just beneath the surface of the skin. Multiple injections are performed along the course of subcutaneous nerves. Some points may result in mild discomfort but generally the discomfort only last a few minutes.
Most patients notice an immediate reduction of pain immediately after the first injection. This initial analgesic effect may last anywhere between hours to days. Pain is generally reduced by 10-20% with each subsequent treatment as the tissue is progressively healed.
While each case is unique and treated on an individual basis, most patients respond to 5-8 treatments depending on how long the injury has been present as well as the degree of the damage. Treatments are typically spaced 1-2 weeks apart.
Neural Prolotherapy is considered safe when administered by a properly trained physician. In fact, the solution (D5W) is the same solution used in IV bags in emergency rooms and hospitals. Injections are done under sterile conditions with minimal risk of infection. While uncommon, possible adverse effects include local swelling, bruising and mild temporary pain.
No. Neural Prolotherapy is still not covered by insurance companies at this time.
Neural Prolotherapy is effective in treating nerve pain associated with injuries to joints, muscles, tendons, and ligaments. Treatment areas include the neck, back, knee, shoulder, hip, elbow, wrist, hand, foot, and ankle.
Neural Prolotherapy has also been shown to be effective with chronic pain after surgical procedures such as total knee replacements and Failed Back Surgery Syndrome. These patients often find relief when other traditional treatment options have failed.