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Information For Patients – Neural Prolotherapy/Perineural Injection Treatment

What is Neural Prolotherapy?

It is a treatment consisting of injecting sugar substances near nerves that carry the pain signals to the brain and also reduces nerve swelling that causes pain. It was developed by an amazing Sports Medicine physician in Christchurch New Zealand, Dr. John Lyftogt.

What is injected?

Usually a neutralized 5% dextrose solution is injected just under the skin (subcutaneous) near the affected nerves. When nerves are irritated they often cause pain, especially when bunches of nerves go through connective tissue windows over bony edges or through boney holes. Other substances that have been tried include glycerin or mannitol.

What condition does this treat?

This treatment treats any condition associated with nerve injury such as diabetic neuralgia, other neuralgias, whiplash injuries, frozen shoulder, Morton’s Neuromas, other neuromas or any nerve pain in any area of the body. If your pain increases when you press on an area, chances are good that it will respond to the treatment.


Bruising occurs frequently. These injections are done with very small needles so they cause little pain but many injections are done in a single treatment along the affected nerves. It is rare for an allergic reaction but this can happen especially if you are allergic to corn. There is also a very rare risk in infection. Injection into a nerve may cause temporary pain but should not cause any log term damage.

Reasons not to have Trigger Point injections

  1. Open sores (increased risk of infections)
  2. Infections such as upper respiratory tract infections, as the body system is weakened and needing rest
  3. Anxiety about the procedure

Prior to Treatments

  1. Be well rested and always eat a light meal before your treatment
  2. Cancel your appointments is you are ill or are extremely tired
  3. Avoid smoking and drinking coffee prior to treatments
  4. Eat well or consider taking vitamins to ensure you are nutritionally fit
  5. Remember stress management!

About the Treatments/After Treatments

  1. Injections containing pH neutralized 5% dextrose, sometimes mixed with xylocaine ( freezing) are injected near irritated nerves and particularly near blobby areas called neuromas. These are very temporarily tender and usually resolve within a few minutes.
  2. The treatment will be 10—20 minutes long and I usually like to only treat one area of the body, as you will receive several injections until we both feel the pai is reduced
  3. Do not swim for two days afterwards as the risk of infections following several injections is increased.
  4. When I inject near the chest cavity there is a very small risk that I puncture the lung. If you feel short of breath please go to the Emergency Department to have a chest Xray.
  5. Treatments are done weekly. After the first treatment the relief may only last 1-4 hours but with continued treatments the relief and improvement of function usually increases with each treatment.
  6. When feeling better treatments are spaced out further until you may need only rare booster or not at all, or we will need to reassess your pain and consider other treatments.