How does Neurofascial Prolotherapy work?
How does Neurofascial Prolotherapy work?
Dr. Lyftogt found that a 5% dextrose solution injected subcutaneously (versus at the fibro-osseous junction) could completely eliminate a person's pain immediately; though the treatment often has to be repeated 5-8 times for complete pain resolution. The injections are given just underneath the skin at the location of sensitized nerves. These nerves are sensitized because of trauma or injury and represent sites of neurogenic inflammation. Injections of 5% dextrose at these sites can completely eliminate pain from neurogenic inflammation. Dr. Lyftogt believes that these specific nerves are the ones that are involved in the health and renewal of tissues such as ligaments, tendons and cartilage. When the nerves regain their health, they can again function to restore health to injured ligaments, tendons, and cartilage.
What are nociceptor peptidergic sensory nerves?
Peptidergic sensory nerves maintain the health of tissues such as ligaments and tendons. When ligaments and tendons become degenerated, the peptidergic sensory nerves are needed to "renew" them back to health. Peptidergic sensory nerves thus are involved in the health maintenance and renewal of joints and the soft tissue structures around the joints. Without nerve support, tissues such as ligaments and tendon degenerate. Dr. Lyftogt believes that injured or inflamed peptidergic nerves lead to chronic pain (nociception) and ultimately to degenerated ligaments, tendons and joints. They are not the sole cause but a primary cause. To restore ligament, tendon and joint health, the peptidergic sensory nerves have to be brought back to health by subcutaneous Neurofascial Prolotherapy. The goal of both Neurofascial Prolotherapy and Hackett-Hemwall Prolotherapy is the same: elimination of pain through the restoration of ligament and tendon function.
What injures the peptidergic sensory nerves?
The peptidergic nerves pierce the fascia to get to the subcutaneous tissues including the ligaments, tendons and skin. As the peptidergic nerves pierce the fascia they can become compressed and the axonal flow in them restricted. Once the pressure in the nerve (nervi neurvorum) rises above 30mmHg, axonal flow can stop. It is often repetitive motions or repetitive strains that pinch the peptidergic nerves as they exit the fascia. This neurogenic inflammation then stops the nerves from providing health and renewal to the tissues they support, thus ligaments and tendons can degenerate. To regenerate these tissues, NFP is done to the sites of nerve restriction and inflammation, ultimately causing the nerves to heal, leading then to ligament and tendon health and renewal.
What is chronic constriction injury?
The peptidergic sensory nerves pierce the fascia when they go from their deep location to just underneath the skin (subcutaneous). It is at the points that they cross the fascia that they can become chronically constricted. In this chronic constriction injury, axonal flow can stop and the nerve suffers from neurogenic inflammation. A 5% dextrose solution injected at areas of chronic constriction injury not only relieves the inflammation but also relieves the chronic constriction injury. This typically takes 5 to 10 weekly sessions, but can be curative.
Is inflammation neuritis a new term?
While the above information on subcutaneous Neurofascial Prolotherapy and neurogenic inflammation may all seem new, the concept of inflammation on the nerve causing pain and even degeneration of tissues is an old one. All one has to do is read Prolotherapy articles in the 1950s and 1960s from Dr. George Hackett, the person who coined the term Prolotherapy, and he explains inflammation neuritis.4,5,6 So it appears that he was the one that actually coined the term. He noted that "inflammation neuritis and other antidromic impulses are transmitted to blood vessels in nerves and surrounding tissues stimulating a release of excess neurohumoral mediator substance which cause a neurovascular vasdilation-edema-sterile inflammation neuritis…This accounts for the pain and tenderness of inflamed nerves we find in the arm with neuritis originating at the cervical vertebra and in the thigh and leg with sciatic neuritis originating in the 4, 5 lumbar vertebra and pelvis in sacroiliac-piriformis-sciatica.6 This neurogenic inflammation can also lead to ligament weakness and bone decalcification."7,8 See figure below:
Hackett GS. Ligament Uninhibited reversible antidromic vasdilation in brochiogenic pathophysiologic disease. Lancet. 1966; 86:398-404.
Hackett GS. Ligament relaxation and osteoarthritis, loose jointed versus close jointed. Rheumatism. 1959; 15:28-33.
Hackett GS, Huang TC, Raftery A. Prolotherapy for Headache. Pain in the Head and Neck and Neuritis. Headache. 1962; 3-11.
Hackett GS, Huang TC. Prolotherapy for sciatica from weak pelvic ligaments and bone dystrophy. Clinical Medicine. 1961; 8:2301-2316.
Hackett GS. Uninhibited reversible antidromic vasdilation in pathophysiologic diseases: arteriosclerosis, carcinogenesis, neuritis and osteoporosis. Angiology. 1966; 17, 2-8.