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Lyftogt Perineural Injection Therapy


Lyftogt Perineural Injection Therapy (PIT)

Formerly known as Neural Prolotherapy

Lyftogt Perineural Injection Therapy is a new, innovative way to treat pain. The concept has been fine-tuned by John Lyftogt, MD and other physicians around the world since it was first discovered in 2003.

Pain is sensed by small nerve fibers (peptidergic nociceptors) that are located throughout the body. Some are just underneath the skin and others are concentrated around our joints and internal organs. The role of these nerves is not just to send sensory information to the brain but also to maintain the healthy function of surrounding tissue including tendons, ligaments, bones and muscles. When these nerves are “healthy” and functioning properly, you do not sense pain. But, when the nerves are “sick”, you sense that deep, dull ache that is consistent with nerve pain. These nerves are able to sense mechanical (pressure), heat and chemical stimuli (changes in the acidity and glucose levels around them). These changes in the surrounding acid levels (pH) and glucose levels within the nerves can lead to the nerves emitting chemicals that cause pain and dysfunction of the surrounding tissue. This is called neurogenic inflammation and is perceived in the brain as neuropathic pain.

Neuropathic pain is increasingly viewed as a homeostatic alarm signal indicating critically low levels of energy or glucose in the tissues and in peptidergic small fibers. Lyftogt Perineural Injection TreatmentTM returns tissue and nerve fiber glucose and acidity levels to normal. Thus, eliminating neuropathic pain, reducing neurogenic inflammation and allowing restoration of normal tissue function.

“Neurogenic inflammation” differs from other forms of inflammation in that it does not respond to anti-inflammatory drugs or cortisone injections. This is why these commonly used drugs (e.g. ibuprofen, naproxen) are proving to be ineffective in so many painful conditions. In addition, there is a growing awareness that cortisone and anti-inflammatory drugs are associated with a variety of harmful side effects.

How Does it Work?

Lyftogt Perineural Injection TreatmentTM effectively reverses ‘neurogenic inflammation’ and resolves ‘neuralgia’ and ‘neuropathic pain” by targeting these nerves. A small needle is used to inject the glucose solution around the nerves often leading to immediate decrease in pain and increase in function/movement of the affected area.

If you suffer from chronic pain that affects your ability to “walk, work, sleep or enjoy life”, Perineural Injection Therapy may help.

 

Frequently Asked Questions

How is Perineural Injection Therapy different than traditional Prolotherapy?

Perineural Injection Therapy and Traditional Prolotherapy share many similarities, but also some key differences. Both treatments promote healing and result in pain relief and functional restoration, but each uses different concentrations of dextrose as well as a different technique for injections.

Traditional Prolotherapy uses a higher concentration of dextrose and is injected deeper in the affected area to promote healing and repair of connective tissues such as ligaments and tendons. Perineural Injection Therapy uses a much lower concentration of dextrose and is injected at multiple points just below the surface of the skin to target subcutaneous nerves to reduce neurogenic inflammation. Because it is injected just under the skin, Perineural Injection Therapy is less invasive than traditional Prolotherapy.

What is the solution that is injected?

Perineural Injection Therapy solution contains either 5% Dextrose in sterile water (D5W) or 5% Mannitol in sterile water (M5W). Both Dextrose and Mannitol are sugars originally derived from a plant sources.

Is a Perineural Injection Therapy treatment painful?

Perineural Injection Therapy is generally very well tolerated, even without local anesthetic which is generally required for other types of injections. The injections are administered with very small and short needles just beneath the surface of the skin. Multiple injections are performed along the course of subcutaneous nerves. Some points may result in mild discomfort, and cold spray can be used to make the patient more comfortable..

How will I feel after a Perineural Injection Therapy treatment?

Most patients notice an immediate reduction of pain immediately after the first injection. This initial analgesic effect may last anywhere between hours to days. Pain is generally reduced by 20-25% with each subsequent treatment as the tissue is progressively healed.

How often do I need these treatments?

While each case is unique and treated on an individual basis, most patients respond to 4-6 treatments depending on how long the injury has been present as well as the degree of the damage. Treatments are typically spaced 1-2 weeks apart.

Is Perineural Injection Therapy safe?

Perineural Injection Therapy is considered safe when administered by a properly trained physician. In fact, the solution (D5W) is the same solution used in IV bags in emergency rooms and hospitals. Injections are done under sterile conditions with minimal risk of infection. While uncommon, possible adverse effects include local swelling, bruising and mild temporary pain.

Will my insurance cover Perineural Injection Therapy?

No. Perineural Injection Therapy is still not covered by insurance companies at this time.

What conditions can Perineural Injection Therapy treat?

Perineural Injection Therapy is effective in treating nerve pain associated with injuries to joints, muscles, tendons, and ligaments. Treatment areas include the neck, back, knee, shoulder, hip, elbow, wrist, hand, foot, and ankle.

Perineural Injection Therapy has also been shown to be effective with chronic pain after surgical procedures such as total knee replacements and Failed Back Surgery Syndrome. These patients often find relief when other traditional treatment options have failed.

Dr. Greg Reser

“When you can do what you want without your body slowing you down, it leads to a happier life. In Arizona, our weather is (usually) so sunny that the weather doesn’t slow you down. Your body should be the same way. You shouldn’t have to worry about whether it’s rainy outside or if you body is in pain. Just plan your activity and go for it!”

 

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