Mannitol or dextrose is injected beneath the skin surface in areas associated with constriction nerves. After receiving neural prolotherapy, patients with severe nerve pain (neurogenic pain) experience relief within seconds.
The mannitol or dextrose works by immediately blocking the principle regulator of pain and inflammation, the TRPV-1 or Capsaicin receptor. This alteration in the nerve receptors allows for healing to deeper structures like tendons, ligaments and joints (Hilton’s law).
Other substances, such as anesthetics also can block this receptor. Magnesium salts can also do this, which is why Epsom salt bath soaks help to relieve pain. However, unlike dextrose and mannitol, these other substances do not reset the receptors, they only temporarily block them.
What is the treatment like?
Inflamed nerves due to constriction feel like small taut hoses that are painful to touch. Dr. Hamilton will track the nerve pain by feeling for inflamed nerves in the skin. Once the nerves have been tracked they are injected along their lengths with 5% mannitol or dextrose.
The number of injections is quite variable. Many patients require between 3 – 8 series of injections for complete resolution of pain, but some (especially migraine sufferers) find relief with just one treatment. It is not uncommon for new areas that were originally masked to have to be treated as well.
Because the treatment is diagnostic, improvement of symptoms will be known right away. For some people this relief lasts generally for several days. However, if the injury has been endured for a long period then the length of relief may be shorter. Subsequent treatments result in progressively longer improvements until complete relief is achieved in most patients.
Are there any side effects to Neural Prolotherapy?
Normal daily activity is not restricted post-injection and most patients returning to their usual activities the same day. Most patients tolerate the minimal discomfort associated with the injections without a problem. At most the patient may have some brief itchiness, tenderness, and/or bruising at the injection site.
What conditions may benefit from Neural Prolotherapy?
Migraines, headaches, fibromyalgia, post-herpetic neuralgia, whiplash, neck pain, shoulder pain, elbow pain, wrist pain, hand pain, low back pain, hip pain, knee pain, foot pain, ankle pain; tendinitis, arthritis, bursitis, sciatica and muscle/ligament injuries also benefit from neural prolotherapy. If indicated, Dr. Hamilton does a thorough evaluation before recommending neural prolotherapy along with prolotherapy and PRP (Platelet Rich Plasma) because she wants to make sure the treatment has the best chance possible to relieve your pain effectively.