What Are Perineural Injections?
The term preineural refers to the area or structure that surrounds or is adjacent to a nerve.
Perineural injections target neural inflammation. They are a safe and effective treatment for persistent pain, and aim to support the body's natural healing processes.
Who Can Benefit?
The injections aim to help reduce the neural inflammation, such as:
- Neuralgia
- Low back pain
- Shingles
- Fibromyalgia
- Headaches/migraines
- Nerve impingement
- Neuropathy
Perineural injections are commonly used to treat nerve-related or neuropathic conditions such as:
- Carpal Tunnel Syndrome
A compression neuropathy affecting the median nerve in the wrist, causing symptoms such as pain, numbness, and tingling in the hand and fingers. - Lateral Femoral Cutaneous Nerve Syndrome
This condition involves compression or irritation of the lateral femoral cutaneous nerve, leading to symptoms such as tingling, numbness, or burning pain in the outer thigh. Also known as meralgia paresthetica. - Cluneal Nerve Impingement
The compression or irritation of the cluneal nerves, which are sensory nerves in the lower back and buttocks. This can result in symptoms such as low back pain, buttock pain, and referred pain down the leg. - Posterior Interosseous Neuralgia
A condition characterized by compression or irritation of the posterior interosseous nerve, which innervates the muscles of the forearm. This can cause symptoms such as pain, weakness, and numbness in the forearm and hand. - Posterior Femoral Cutaneous Nerve Impingement
This condition involves compression or irritation of the posterior femoral cutaneous nerve, which innervates the skin of the posterior thigh and buttocks. Symptoms may include numbness, tingling, or pain in the affected area. Similar to lateral femoral cutaneous nerve syndrome.
How Does It Work?
Perineural therapy involves injections in the layer of tissue located directly under the skin. This treatment focuses on areas of skin above nerve pathways to address pain at its root cause.
The injection itself is comprised of a solution of dextrose or mannitol in a saline solution combined with sodium bicarbonate. The injected dilute sugar solution helps in shutting off the production of pain-inducing substances, reducing nerve swelling, and potentially working on ion channels within the affected nerves to aid healing at a cellular level.
We don’t know the exact mechanism at the cellular level, but it has been postulated that the dextrose works on the TRVP1 receptors to decrease Substance P and other chemicals that produce pain.
Treatment Process
The treatment process begins with an initial assessment to evaluate your specific condition and determine the most suitable course of perineural injections.
Once a treatment plan is established, the area for injection will be cleaned and sterilized to minimize the risk of infection. Your naturopathic doctor will then carefully administer the perineural injections in the targeted areas using a fine needle, delivering the solution just beneath the skin.
Depending on your response to the initial treatment, follow-up sessions may be scheduled weekly to continue the gradual reduction of pain levels and monitor your progress.
Possible Side Effects & Considerations
As perineural injections are drug-free and dextrose is a naturally occurring substance in the body, the risk of side effects is minimal.
The most common side effect is occasional bruising at the injection site, with allergy issues being rare or non-existent.
Treatment Expectations
The primary goal of perineural injections is to alleviate pain.
Initial treatment may provide relief lasting from 4 hours to 4 days. Subsequent sessions, typically ranging from 4-6 and conducted weekly, aim for a gradual reduction in overall pain levels with the ultimate objective of complete resolution – a zero pain score – and restoration of full function.
Success rates range from 80 to 100%, depending on the specific condition, with a low likelihood of recurrence unless re-injury occurs.
Get Started
Book your appointment today for a non-surgical solution to nerve pain!