Neural Prolotherapy (neurofascial prolotherapy)
Neural Prolotherapy involves injecting a dextrose solution subcutaneously (the fatty layer just under the skin), to treat neurogenic inflammation. In the subcutaneous layer, we find fascia, which is rich in subcutaneous nerves. These nerves can be a source of pain, and it’s thought that by injecting dextrose into this area, previously ‘misbehaving’ nerves start to function better. Once these areas have been injected, swelling and pain are reduced and function improves.
Put simply, nerves can become ‘kinked’ as they penetrate and pass through fascia. This kink will irritate the nerve and cause ectopic impulses to form. These lead to reflex muscular spasm in the area. The irritated nerve will also start to produce Substance P and Calcitonin Gene Related Peptide (CGRP). These two chemicals are responsible for casing pain and swelling in the tissue surrounding the nerve. With the nerve becoming kinked, the flow of fluid within the nerve is impaired (much like a hose-pipe), and this inhibits normal nerve growth and repair.
Neural prolotherapy is thought to work on the basis of Hilton’s Law, which states that the nerve supplying a joint also supplies the muscles that move that joint and the skin covering the joint. So by treating at the subcutaneous level, deeper joint pain can be relieved. It may be that healing in deeper structures will take place spontaneously if the nerves above the deeper structures are returned to normalcy. The dextrose solution used also inhibits the release of the inflammatory factors substance P and CGRP, as the dextrose binds to the pre-synaptic channels, thereby blocking the inflammatory factors and decreasing neurogenic inflammation.
Treatment is recommended 1x weekly