Perineural Injections – Non-Steroidal Injections for Chronic and Acute Pain

Chronic and acute pain affecting your daily life can be devastating. For those dealing with conditions such as neuropathic pain, acute injury, or post-surgical discomfort, finding effective non drug treatments can be an uphill battle. Enter Perineural Injection Therapy (PIT)—a promising solution that is helping many regain control over pain and resuming activity in their lives.

Let’s explore what perineural injection therapy is, its benefits, and the types of conditions it can help treat.

What is Perineural Injection Therapy?

Perineural Injection Therapy, sometimes referred to as Neural Prolotherapy or PIT, was developed by Dr John Lyftogt as a minimally invasive treatment aimed at reducing pain and promoting healing in the nerves and surrounding tissues. The therapy involves the injection of a buffered dextrose solution (often with a local anesthetic) near nerves where pain and inflammation are occurring.

The primary goal of PIT is to treat inflammation and pain caused by nerve irritation or injury. It helps reduce the sensitivity of the nerves and promotes tissue healing. By delivering the injection near the affected nerve, PIT targets the root cause of the pain, not just the symptoms.

How Does Perineural Injection Therapy Work?

The solution used in PIT is injected around the nerve, which is why the treatment is called “perineural.” The injection works by feeding the nerve, reducing inflammation, and increasing blood flow to the area.

Here’s a breakdown of the process:

  1. Diagnosis: A doctor will first assess the source of the pain through collecting history, performing physical examination, and in some cases through imaging studies.
  2. Injection: The physician will carefully administer small injections of the sterile PIT solution around the nerves causing the pain.
  3. Pain Relief: The injection reduces inflammation around the nerve, providing immediate and short (hours) to long-term relief (days to weeks) from pain. 
  4. Healing Process: Over time, the nerves begin to heal, leading to reduced pain and improved mobility.

Conditions Treated by Perineural Injection Therapy

PIT is not a one-size-fits-all solution, but it may be effective in treating a wide range of chronic pain conditions, including:

  1. Neuropathic Pain
  • Sciatica: Nerve pain caused by compression of the sciatic nerve.
  • Carpal Tunnel Syndrome: Pain, numbness, or tingling in the hand due to nerve compression.
  • Post-Surgical Pain: Nerve pain that persists even after surgery
    • Fascial/scar treatment: Pain, inflammation, or discomfort in adhesions/scar tissue
  • Herniated Discs: A common cause of lower back pain, where discs bulge and irritate nearby nerves.
  • Facet Joint Syndrome: Inflammation of the joints in the spine, often causing pain in the lower back and neck.
  • Chronic Pain Syndromes: Conditions such as Complex Regional Pain Syndrome (CRPS) or Fibromyalgia that cause widespread pain and discomfort may benefit from PIT.
  1. Musculoskeletal Pain
  • Tendonitis: Pain and inflammation in the tendons, often from overuse or injury.
  • Plantar Fasciitis: Pain in the bottom of the foot, often due to overuse or injury. 
  • Acute ligament or tendon injury/strain
  1. Headaches and migraines fall into neuropathic and musculoskeletal pain categories. PIT and sphenopalatine ganglion baths, a non-injection therapy using PIT solution can be effective for migraines.

Benefits of Perineural Injection Therapy

  1. Non-Surgical/Non-medication Treatment
    One of the biggest advantages of PIT is that it provides an alternative to surgery and can reduce the need for injected cortisone and oral NSAID or opioid pain medication. For many individuals dealing with chronic pain, PIT offers a non-invasive solution that can improve their quality of life without the need for complex procedures or extended recovery times.
  1. Minimal Downtime
    Unlike traditional surgeries, PIT has little to no downtime. Patients can often return to normal activities within a short period of time after the injection, although some rest may be recommended for overuse/acute injuries.
  1. Long-Term Pain Relief
    While results can vary, many patients experience significant, long-term pain relief after successive sessions. In most cases, multiple sessions may be required, but with each injection, the body has the opportunity to heal and function more optimally.

What to Expect During and After Treatment

During the Procedure:
The injections are relatively quick and use a small gauge needle, similar to acupuncture needle size. There is usually minimal pain with added lidocaine/procaine, and the dextrose also acts as an anesthetic.  The number of injections needed will depend on your specific condition.

After the Procedure:
Post-treatment care is usually minimal. You may experience some mild soreness or a tingling sensation near the injection site, but most patients find the recovery process quick and easy. Results can vary; some people experience immediate relief, while for others, it may take a few days or weeks to see significant improvements.

Risks and Side Effects: 

Perineural Injection Therapy is considered a safe procedure with minimal risks. Side effects are rare and usually mild, such as temporary swelling or redness at the injection site.

Is Perineural Injection Therapy Right for You?

If you’re dealing with pain and are seeking an alternative to traditional treatments like medications or surgery, Perineural Injection Therapy may be worth exploring. It’s particularly effective for those with nerve-related pain and inflammation.

However, as with any medical treatment, it’s important to consult with your healthcare provider to discuss whether PIT is a suitable option for your condition. They can assess your pain, review your medical history, and determine the best approach to managing your symptoms.

Welcome Dr. Gabrielle Klein, ND to Hill Park Integrative Medical Center

We are so very excited to announce a new addition to our medical team, Dr. Gabrielle Klein, ND.

Dr. Gabrielle Klein, ND, is a graduate of Bastyr University San Diego. As a Licensed Naturopathic Doctor, she specializes in women’s health, family medicine, and tick-borne illnesses.

Dr. Klein’s clinical specialized interests include pelvic diseases (endometriosis, PCOS, ovarian cysts, uterine fibroids, interstitial cystitis, pelvic pain), hormone imbalances, digestive health, immune support, and chronic conditions with a particular focus on endometriosis and Lyme disease.

A personal health journey inspired Dr. Klein to pursue a career in Naturopathic Medicine. She is ILADS trained in tick-borne disease management, has completed the Applying Functional Medicine in Clinical Practice (AFMCP)™ course through the Institute of Functional Medicine, and is trained in advanced IV nutrient therapy, Craniosacral Therapy, Constitutional and Acute Hahnemannian Homeopathy, Botanical Medicine, Biofeedback, and Constitutional Hydrotherapy. She holds a BA in Sociology from the University of California, Santa Barbara.

Prior to her medical career, Dr. Klein professionally invested nearly 20 years in the dietary supplement industry focusing on marketing, product formulation and development, and helped to introduce several innovative therapies to the integrative nutraceutical industry in the United States from raw material education to complete product formation of now existing products such as CoQ10, Nattokinase, and several specialized probiotic lines.

Alongside her clinical work, Dr. Klein is committed to patient advocacy and expanding the scope of practice for Licensed Naturopathic Doctors in California. She has held leadership roles as the Naturopathic Medical Student Association (NMSA) Chapter President and Vice President of Communications for the Student Government Association while she attended Bastyr University San Diego, helping to inform students of events and expanding networking and professional development opportunities. She continues in her position as Advocacy Relations for the California Naturopathic Doctors Association (CNDA), and serves as an active member of both the CNDA and the American Association of Naturopathic Physicians (AANP).

When not in practice, she enjoys spending time with her cats and dog, connecting with friends and family, exploring nature, and attending live music, theater, and film in her local community.

“Each individual holds a personal roadmap that guides them in their pursuit of wellness. It’s my honor and pleasure to walk alongside every patient on their journey and unlock the mysteries of their health through their individual stories and history.”

Dr. Klein is currently accepting new patients and offering complimentary 15-minute consults to learn more about her practice.

Please contact our staff at 707-861-7300 or [email protected] to schedule an in person or telemedicine appointment or request an appointment through the website.

Welcome Dr. Brandi Holmes, ND to Hill Park Integrative Medical Center

We are very excited to announce a new addition to our medical team, Dr. Brandi Holmes, ND.

Dr. Brandi Holmes is a licensed naturopathic doctor in California and Arizona specializing in personalized, integrative care for active women and athletes. With a passion for optimizing performance, preventing injury, and restoring balance, Dr. Holmes offers a holistic approach that connects the dots between hormones, musculoskeletal health, nutrition, and mindset. Her mission is to empower each patient to feel strong, energized, and in sync—on and off the field.

A lifelong athlete, Dr. Holmes began competing in kindergarten and continued through college with a primary focus in track and field, specializing in sprints and hurdles. She also played softball, lacrosse, tennis, and trained in martial arts. Her competitive drive and “no pain, no gain” mindset led to athletic success—but also a cycle of repetitive injuries, including shin splints, stress fractures, and ankle sprains. These experiences sparked her early interest in injury prevention and whole-body wellness.

Dr. Holmes pursued dual undergraduate degrees in Kinesiology (with a focus on physical therapy) and Cellular & Molecular Biology at San Diego State University. During this time, she gained five years of hands-on clinical experience at a physical therapy practice, where she developed skills in rehabilitative therapies such as aquatic therapy, Pilates, electrotherapeutic modalities, and functional movement assessments.

Her desire to practice integrative medicine led her to Bastyr University California in San Diego, where she earned her Doctorate in Naturopathic Medicine. Her training included botanical medicine, nutritional therapy, targeted supplementation, pharmaceuticals, and lifestyle counseling, as well as advanced physical medicine techniques including soft tissue manipulation, therapeutic exercise, and electrotherapy.

Dr. Holmes takes a systems-based approach to sports and performance medicine, recognizing that true recovery and peak performance require a deeper understanding of how all organ systems interact with the musculoskeletal system. She is especially passionate about supporting hormonal balance, gut health, and metabolic optimization in active individuals.

Dr. Holmes partners with patients to create personalized, evidence-informed plans that support both short-term recovery and long-term vitality. Whether you’re an athlete striving for peak performance or someone ready to feel at home in your body again, Dr. Holmes is here to help you thrive—every step of the way.

“Optimal athletic performance isn’t just about muscle strength and flexibility—it’s a symphony where every body system plays a part, from digestion fueling endurance to hormones fine-tuning recovery. When all systems work in harmony, athletes unlock their true potential.”

Dr. Holmes is currently accepting new patients.

Please contact our staff at 707-861-7300 or [email protected] to schedule an in person or telemedicine appointment or book an appointment through the website.

Restore the Immune System with Microbiome Health

An evening talk with Dr. Heidi Lucas, ND FABNO
Monday, December 2nd at 6:00-7:30 pm

    We know that the immune system – a sophisticated network of organs, cells, and proteins – is crucial for fighting cancer, infection, and disease.

Current research has confirmed the critical role of the microbiome (microbes in the gut) in healthy immune function.

Going through cancer diagnosis and treatment—surgery, chemotherapy, radiation, hormone therapies, and immunotherapy—is taxing for the GI tract and immune system. Come learn how we can restore and heal these systems through nutrition, botanical medicine and lifestyle choices.

Dr. Heidi Lucas is a highly skilled Naturopathic Doctor specializing in integrative cancer care for the past 20 years.

Dr. Lucas has worked alongside oncologists and conventional physicians for the entirety of her career, and is frequently sought by conventional oncologists for her expertise in integrative oncology and natural medicine.

She is an active educator and speaker of integrative oncology at leading cancer centers including the Hearst Cancer Resource Center, Leukemia Lymphoma Society, Oncology Nursing Society, American Cancer Society, Gilda’s Club, Cancer Lifeline, Rooted SB, Bastyr University, and many hospitals around the country.

Welcome Dr. Heidi Lucas, ND FABNO to Hill Park Integrative Medical Center

We are very excited to announce a new addition to our medical team, Dr. Heidi Lucas, ND FABNO.

Dr. Heidi Lucas is a highly skilled Naturopathic Doctor specializing in integrative cancer care for the past 20 years. She combines conventional and natural medicine to provide personalized treatment plans to heal from the side effects of treatments, enhance treatment outcomes, strengthen the body, improve quality of life, and enhance overall health.

Dr. Lucas provides consultations for cancer patients and their families in all stages of cancer from recent diagnosis and active treatment to maintenance phase, as well as those with a strong family history of cancer. Many of her cancer patients continue in her care for ongoing family medicine concerns as Dr. Lucas is known for her depth as a clinician and her commitment to patients’ lifelong wellness.

Dr. Lucas completed her doctorate at Bastyr University and a rigorous two-year oncology based residency at Seattle Cancer Treatment and Wellness Center, where she was invited to continue as a staff physician for 6 years and received her board certification in naturopathic oncology care, earning a position as a Fellow of the American Board of Naturopathic Oncology (FABNO). She continued as an integrative oncology physician associate at Lifespring Cancer Treatment Center. She is a committee member of the Oncology Association of Naturopathic Physicians and an active member of the California Naturopathic Doctors Association.

Dr. Lucas has worked alongside oncologists and conventional physicians for the entirety of her career, and is frequently sought by conventional oncologists for her expertise in integrative oncology and natural medicine. She is an active educator and speaker of integrative oncology at leading cancer centers including the Hearst Cancer Resource Center, Leukemia Lymphoma Society, Oncology Nursing Society, American Cancer Society, Gilda’s Club, Cancer Lifeline, Rooted SB, Bastyr University, and many hospitals around the country.

As a naturopathic doctor, specializing in oncology, Dr. Lucas offers expert care in research and clinically based nutrition, evidence based and historical uses of botanical medicine, mistletoe therapy, integrative oncology IV therapy, individualized meditation instruction, as well as exercise plans and therapeutic yoga to optimize immune function and stress management.

Dr. Lucas believes in nutrient-dense therapies and is a strong advocate of farm to table sustainability, which is advocated in her incredible detail to phytonutrient treatment plans down to specific vegetable varieties. As a certified Therapeutic Yoga and Meditation teacher, Dr. Lucas innately understands the body’s capacity to heal and embodies this practice herself in her own way of life.

“Every patient is an individual with their own story and voice. I use a multifaceted approach to treatment that includes engaging the mind, heart and physical body.”

We are honored and so very excited that Dr. Lucas will be joining our Hill Park team and community. We innately know that her expertise will strengthen our community, her care and knowledge will change the course of life for many of our patients, and that our amazing region will embrace her.

Dr. Lucas is currently accepting new patients starting July 29th.

Dr. Lucas will see patients remotely via telehealth, phone consults, or in-person at our center every 2-3 months. She will be at Hill Park July 29, 30, and 31st to see patients. We are actively scheduling her wait list, please call our Patient Coordinator Gabrielle to learn more about Dr. Lucas’ practice and scheduling.

You can reach us at 707-861-7300 or [email protected] to schedule an in person or telemedicine appointment or book an appointment through the website.