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 few treatments.
A working hypothesis was developed that glucose targets glucose sensitive pain nerves called nociceptors located in nerve trunks immediately under the skin. These nerve trunks may contain up to 30,000 small nerve fibers per mm2. Half of these small nerve fibers are a variety of ‘pain nerves fibers’, technically known as sensocrine nociceptors. When injured these sensocrine nociceptors are thought to be responsible for painful conditions described as ‘neuralgias’ or ‘neuropathic pain’ or more commonly known as ‘chronic pain’.
The protective sheath of the nerve trunk is structurally very similar to tendons and ligaments. It protects small nerve fibers inside the nerve trunks from injury, friction and pressure. Nerve trunks have their own nervous innervation, called ‘Nervi Nervorum’.
The very small nerve fibers, innervating the nerve trunk, identified as unmyelated C-fibers or ‘Nervi Nervorum’ are responsible for pain and swelling of the protective sheath of the nerve trunk. This was already demonstrated 125 years ago by Professor John Marshall from London and called neuralgia. It is now called ‘neurogenic inflammation’.
It is also known that this ‘neurogenic inflammation’ differs from other forms of inflammation in that it does not respond to anti-inflammatory drugs or cortisone injections and this is the reason why these commonly used drugs are proving to be ineffective in 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.
It is clear from clinical observations on more than five thousand patients and large case series that Neural Prolotheapy effectively reverses ‘neurogenic inflammation’ and resolves ‘neuralgia’ and ‘neuropathic’ or chronic pain.
After the success of Neural Prolotherapy with Achilles tendonitis other persistent painful conditions of the neck, back, shoulders, elbows, wrists, knees, ankles and feet have been effectively treated by targeting the local inflamed and painful superficial nerves with micro- injections with low dose Glucose.
More recently Dr Lyftogt has developed effective Neural Prolotherapy treatment protocols for Migraine, ‘Fibromyalgia’, CRPS (Complex Regional Pain Syndrome), compartment syndrome and other difficult to treat persistent painful conditions.
Neural Prolotherapy is an effective novel and evolving treatment for non-malignant persistent pain, based on sound neuroscientific principles.
For a practitioner to be effective in treating persistent pain the first requirement is the ability to make an accurate neuro-anatomical diagnosis and secondly combining this diagnosis with training in specialised clinical skills. This knowledge and skill can only be obtained by attending specific workshops in Neural Prolotherapy. Most Doctors who have attended these workshops will develop confidence and experience over time. It will allow them to approach most chronic painful conditions with understanding and competence.
The veil surrounding the mystery of persistent pain is lifting in the 21st century.