Chronic Illness

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.

2. 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

3. 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.

2. 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.

3. 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.