Recently we hosted 18 Physicians from 6 countries to enhance our understanding & skill set with regenerative orthopedic procedures including Neural Prolotherapy & Platelet Rich Plasma (PRP). After learning about Dr Lyftgoft’s breakthrough; that simple injections of sterile water (saline) and Dextrose (sugar) beneath the skin surface can provide immediate pain relief, we made arrangements to build a seminar at the Orthohealing Center around this new therapy.
Neural prolotherapy is based on the premise that hundreds of nerves exist just beneath the skin and play a key role in regulating pain & healing. When these small nerves get constricted from trauma they increase pressure & dump chemicals called peptides (substance P & CGRP). This leads to pain and inflammation along with swelling of tissue, loss of type I collagen (tendon degeneration), and limited blood flow. These chemicals also have a proven effect on the brain causing depression & exhaustion. Furthermore the release of these peptides trigger an immune response which leads to cartilage deterioration & osteoarthritis. More & more research has pointed to the immune system as a key player in arthritis. Now we believe that by regulating these nerves just beneath the skin, we can regulate the immune system to potentially heal injuries.
Why Dextrose? Dextrose has been shown to directly block the key regulator of pain & Inflammation: the TRPV-1 or Capsaicin Receptor. Dextrose blocks the increase of sodium & calcium that shuts of the leaking nerves and inflammatory peptides. Within seconds appropriate patients find immediate relief without any anesthetic or cortisone. Often we will have patients “test drive” their pain & see if they can reproduce it in the office. They will transfer from sit to stand on a chair to test their knee or grab objects for their tennis elbow etc.
This outlook is a complete paradigm shift and will certainly change the way we look at pain. For so long patients have pointed to a spot (like the outside shoulder/deltoid or lower knee) & say “it hurts here.” We would explain to them there is nothing there & the pain is referred. Now we know there is something there & these nerves are critical to promote healing. When we examine patients we now look for these nerves which may be swollen. They can’t be seen on an MRI or x-ray but can be felt & follow a specific anatomical pattern.
We have been using this therapy successfully on many patients that have failed almost every treatment we have thrown their way. Neural prolotherapy or NPT is an exciting new therapy that we have just begun to explore its applications. We are also using this before PRP injections to promote healing from the outside in which also decreases pain from injections while limiting lidocaine (anesthetic) usage which may hinder healing.