Our body has many different types of sensory nerves. Some allow us to feel sharp, shooting pain. Others help us feel light touch. Others help us feel vibration and pressure, while others help us know where our body is in space.
Neural Prolotherapy: How does it work?
Small nerve fibers called “peptidergic c-fibers” are found throughout our body and are responsible for feeling dull, achy pain. In addition to pain sensation however, peptidergic c-fibers are unique in that they also help maintain tissue health by releasing proteins and various growth factors into areas that the nerve fibers sense are damaged. Sometimes these nerve fibers can become constricted in the various fascial layers as they travel from deep inside the body into the superficial skin. Just like a dam in a river, if a nerve gets constricted, the entire length of nerve downstream from that constriction point can become unhealthy and can consequently affect the health of the tissue that that nerve subserves. In addition to constriction injuries, a chronically irritated nerve (simply from being in a state of chronic pain) will begin to lose its ability to regulate the delicate balance of growth factors that it releases making an already injured area even sicker.
It has been shown that peptidergic c-fibers have receptors that are responsive to dextrose (a simple sugar). Near nerve injections of dextrose can immediately begin to properly regulate the release of growth factors from the nerve as well as reduce swelling at sites of constriction. By targeting the tender areas of cutaneous nerves all along their known pathways, many patients will experience an almost immediate reduction or even resolution of their pain. The immediate pain reduction only lasts for a couple of hours or at most a couple of days, but the real work continues to take place at the level of the injured tissue as the growth factors slowly begin to facilitate healing of all the deeper structures beneath the nerves.
What conditions may benefit from Neural Prolotherapy?
Almost any musculoskeletal or nerve related injury may benefit from a trial of neural prolotherapy. This is a relatively new treatment that has only been around for the last several years and we continue to learn new ways in which NPT may be helpful. One of our LRMC providers actually developed the protocol for aborting acute migraines with NPT with a success rate that exceeds 90%.
Contraindications to Neural Polotherapy
Infection at the injection site
How Often Do I Need to Have the Treatment?
Injections are optimally spaced about 1 week apart and often 8-12 sessions are required before an area is completely healed, though improvements in pain should be noticeable throughout the treatments.
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