Opinion

Pratt: Neural Prolotherapy: A new approach to treating chronic pain

Neural prolotherapy (NPT) is a very effective treatment for most injuries and chronic joint, tendon, ligament and muscle pain.

The treatment involves a series of injections with a dextrose or mannitol solution (sugar molecules), immediately under the skin with a very fine needle, targeting the source of the pain and offers a success rate of greater than 80 per cent for most conditions.

Neural Prolotherapy was developed by Dr. John Lyfogt in New Zealand.

He has been in medical practice since 1978 and has extensive postgraduate training and experience in sports medicine and musculoskeletal medicine.

He has been a full time prolotherapist at the world-famous sports center built for the Commonwealth Games in New Zealand and travels all over the world training doctors in NPT.

Dr. Lyftogt’s early research focused on the treatment of Achilles tendon problems and he has now treated more than 300 Achilles tendons with a success rate of more than 90 per cent.

He has published two level 4 articles on Achilles tendons. The technique developed for the treatment of Achilles tendons differs from Classical Prolotherapy in that the injections are given immediately under the skin while taking great care avoiding contact with the exquisitely sensitive tendon.

This ‘Neural Prolotherapy’ protocol was successfully extended to the treatment of tennis elbow, painful knees, shoulders, neck, hips, ankles, muscle injuries and low back.

Results are consistent and two year follow up studies have shown success rates between 80 to 100 per cent and the treatment is also less invasive than Classical Prolotherapy.

How does it work?

Because Neural Prolotherapy does not target tendons, ligaments or joints the question had to be asked what causes the sometimes dramatic decline in pain levels after even a one treatment.

A working hypothesis was developed that dextrose and mannitol solutions assist in the repair of connective tissue in the nerve trunks under the skin in a similar way as repairing connective tissue in ligaments and tendons with Classical Prolotherapy.

These nerves are known to be responsible for painful conditions generally identified as ‘neuralgias’ or ‘peripheral neuropathic pain’

It is also known that this ‘neurogenic inflammation’ differs from conventional inflammation in that it does not respond to anti-inflammatories or cortisone injections.

This is one of the reasons why these commonly used drugs are proving to be ineffective in many painful conditions in addition to a growing awareness that their use is not without serious side effects.

It is clear from clinical observations on more than 3,000 patients and large case series that neural Prolotherapy effectively reverses ‘neurogenic inflammation’ and resolves neuralgia pain.

Treatment typically involves a four to eight sessions of micro-injections just under the skin with a very small needle.

Additional treatment sessions are sometimes needed if a patient has prior surgeries, moderate to severe whiplash injuries with widespread pain, and/or significant underlying medical illnesses (diabetes, autoimmune disorder or history of cancer).

Treatments are completed within 10 to 20 minutes. At most the patient may have some brief tenderness at the injection site or a small bruise.

Physical activity is not restricted post-injection, with most patients returning to their usual workouts the same day or next day.

More than 98 per cent  of patients tolerate the minimal discomfort associated with the injections without a problem.

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