Sugar Takes the Pain Away

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Chronic pain affects a large percentage of the population and must be taken seriously. In addition to the pain itself, chronic pain can lead to a number of other conditions, including weight gain, insomnia, anxiety, and depression.

A New Zealand physician, Dr. John Lyftogt, has developed a revolutionary technique in the treatment of chronic pain, known as Neural Prolotherapy.

Types of Pain:

Neuroscientists have identified two types of pain: Nociceptive and Neuropathic. Nociceptive pain is characterized as being localized, proportional to the injury, and goes away on its own or with the use of pain medication. Neuropathic pain, in contrast, is characterized as being diffuse, disproportional to the injury, feels deep, and does not go away. This type of pain may be one of the reasons why NSAIDS are not effective in many painful conditions.

Dr. Lyftogt discovered that injections of 5% dextrose under the skin along the length of a nerve caused an improvement in local swelling, a reduction in pain, and an improvement in function. Through his research, Dr. Lyftogt has shown that dextrose selectively blocks neuropathic pain, making it an ideal treatment for this particular type of chronic pain.

What Causes Neuropathic Pain?

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Neuropathic pain results from a condition known as Neurogenic Inflammation. Ligaments, tendons, and joints are innervated by TRPV-1 sensitive C pain fibers. The main role of these fibers is to ensure that every cell is functioning properly. In a healthy state, these nociceptors are silent and do not produce pain. However, when the body is injured, these nerve cells initiate a repair response in order to restore normal function to the body part. They do this by activating their TRPV-1 receptor, which release two neuropeptides: Substance P and Calcitonin Gene Related Peptide (CGRP).

Substance P causes pain, which tells the brain to decrease function in the area affected. CGRP causes cells to become engorged with calcium, which may lead to calcium deposits in areas of chronic inflammation. Together, substance P and CGRP cause dilation and leakage of blood vessels, which creates redness and swelling in the injured area.

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Subcutaneous nerves also have their own nerve supply. These small nerves are known as Nervi Nervorum (NN) and can also cause pain and inflammation when injured. In addition, nerves pass through a number of small holes in fascia. Injury to the fascia can cause these holes to decrease in size and squeeze the nerves passing through. This injures the nerves and when nerves are injured they swell. Swollen nerves then get trapped in these holes, resulting in a Chronic Constriction Injury (CCI). CCI’s further inhibit the healing of nerves by blocking the flow of Nerve Growth Factor (NGF), which is necessary for nerve health and repair,. Furthermore, the injured, swollen nerves activate their TRPV1 receptors, thus producing pain and inflammation.

All of these processes work together to cause Neurogenic Inflammation and can result in pain, swelling and leakiness of blood vessels. “Hilton’s Law” states that the nerve supplying a joint also supplies the muscles that move the joint and the skin that surrounds the joint. This suggests that irritation to a nerve supplying the skin over a joint may cause pain and dysfunction in that joint as well as in the muscles surrounding that joint.

Therefore, as long as the TRPV-1 receptors remain activated, Neurogenic Inflammation will continue, inhibiting healing of the nerve. Eventually, tissues begin to degenerate, resulting in even greater loss of function in that area. Thankfully, research has shown that dextrose blocks TRPV-1 receptors, thereby blocking the release of CGRP and SP. This leads to a reduction in Neurogenic Inflammation and the promotion of nerve health. The end result is decreased pain, improved nerve health, and return of function to muscles and joints.

Difference Between Prolotherapy and Neural Prolotherapy:

Traditional prolotherapy involves a different solution with deeper injections, targeting connective tissue, such as ligaments and tendons. Neural prolotherapy uses 5% dextrose only, involves shallow injections and targets nerve pathways.

The Procedure:
The procedure involves a series of injections just under the skin along the length of a nerve. Your qualified naturopathic physician will use a very small needle to inject 5% dextrose along certain areas. The injections themselves can be painful, but relief of the original pain and discomfort is usually seen within moments after the treatment.

Treatment usually involves 6-8 weekly sessions. Additional sessions may be needed if the patient has had surgery, significant underlying medical illness (history of cancer, autoimmune disease, diabetes) and/or moderate to severe whiplash injuries with widespread pain. Physical activity is not restricted post-injection and most patients are able to return to their normal activity level within a day or two.

Side Effects:
Patients often experience a slight “bee sting” sensation and mild itching in the injection site. This is normal and will resolve within a few hours. Mild bruising may also occur over the treated areas and is nothing to be concerned about.

The majority of patients tolerate the treatment well, with the occasional exception of someone who is needle phobic or quite pain sensitive. In these cases, another treatment method might be preferable.

If you or someone you know is suffering from chronic pain, please see a qualified naturopathic physician who can consider whether neural prolotherapy would be the right treatment for you.

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