Prolotherapy

Perineural Injection Treatment

Perineural Injection Treatment is also known as "prolotherapy", "regenerative injection therapy," or "proliferative injection therapy".

Clinical conditions that may benefit from Neural Prolotherapy or Perineural injection therapy:

Patients with chronic Neck and Back pain
Injuries to the shoulder, rotator cuff injuries & frozen shoulder
Temporomandibular joint (TMJ) dysfunction
Knee Pain
Ankle impingement syndrome
Tennis elbow
Golfers elbow
Carpal Tunnel Syndrome (CTS)
Iliotibial band syndrome
Buttock pain due to cluneal nerve entrapment or piriformis syndrome
Patients struggling with limited mobility and experiencing joint pain

What do Perineural Injections (Prolotherapy/Regenerative Injections) involve?

It involves injecting an otherwise non-pharmacological and non-active irritant solution into the body, generally in the region of tendons or ligaments for the purpose of strengthening weakened connective tissue and alleviating musculoskeletal pain.

Prolotherapy is hypothesized to reinitiate the inflammatory process that deposits new additional fibers thereby repairing lax tendons or ligaments and to possibly promote the release of local growth factors. However, the precise mechanism of action remains unknown. Once strengthened, the weak areas would no longer send pain signals.

Are these treatments painful?

Nobody likes injections, but Perineural Injection Treatment (P.I.T) treatment is not like having a normal injection. The treatment consists of micro-injections just under the skin, so it is more like having multiple pin-pricks. Once it is done the injection pain disappears almost immediately. The aim of each treatment is to have you walk out of the consultation room with no pain.

How successful is this treatment?

Depending on the body part, how long you have had the injury/pain for, and the individual circumstances, the “rule of thumb” is that 85% of people resolve their pain completely, with many more experiencing a significant improvement.

Is this a cure for chronic pain?

P.I.T. is a very effective treatment for chronic pain. With an experienced practitioner, many people find that once they have completed a course of treatment their symptoms disappear and don’t return.

Can I expect to become pain-free?

Yes. Most people do become free of pain in the long-term. The aim of each treatment session is to get you pain-free then and there; that is how practitioners know they are targeting the correct nerves. Following each session, you should be pain-free for anywhere from four hours to four days. With every session, you remain pain-free afterwards for longer and longer periods until your pain doesn’t come back, which is why you need multiple treatments.

How many treatments will I need? How frequently?

Most people become pain-free after 6-8 treatments. These can be spaced anything from one week to one month apart. In certain circumstances, your practitioner may suggest more or less frequent treatments.

Can I stop my pain medication?

If you are on prescribed medication, discuss this with your practitioner. You can certainly stop your pain medication when you are pain-free, but it is better to decrease the dose carefully and slowly to avoid withdrawal symptoms.

Is it safe? Are there any side effects?

The treatment is very safe with few side effects. Some localized bruising around the injection sites is not uncommon. No allergic reactions have yet been observed. It has been estimated that one in 300,000 injections may result in infection – in other words, extremely low risk.

Who performs this treatment?

Dr. Philip Bloom & Dr Nicholas van Wetering both have significant expertise in performing P.I.T, having attended numerous workshops, as well as hosting a P.I.T workshop here at Sportsmed Biologic in 2017.