Perineural Injection Therapy
What is Perineural Injection Therapy?
Perineural Injection Therapy (PIT) is the treatment of pain caused by injured nerves by “blocking” them with a diluted Dextrose, a type sugar solution. Many chronic pain conditions develop and persist because of injury to specialized nerve fibers located just under the skin.
What Does Perineural Injection Therapy Treat?
Perineural Injection Therapy can be used to treat any form of chronic pain, which is pain that persists after the original underlying injury has had sufficient time to heal.
The painful conditions treated with the highest success rate include:
- Neck pain
- Shoulder pain
- Back pain
- Buttock pain
- Groin pain
- Pain after surgery
- Chronic regional pain syndromes
- Nerve entrapment syndromes
- Persistent sports injury pain
- Tennis elbow
- Golfer’s elbow
- Achilles tendinosis
How Does Perineural Injection Therapy Work?
Specialized regulatory nerve cells located just under the skin are very sensitive. If injured, they change in ways that cause localized inflammation—a condition called “neurogenic inflammation.” This leads to persistent pain, stiffness, swelling, weakness, and sensitivity to touch. These are all symptoms experienced by people with chronic pain.
When the tissues around these injured regulatory nerve cells are injected with Dextrose, the inflammation reverses. Pain and restricted movement immediately resolve, and, more importantly, repetitive treatments will prevent the inflammation from returning. Your nerve is effectively healed, and your chronic pain will resolve.
What Should I Expect from Perineural Injection Therapy Treatment?
First, a diagnostic injection is given by Dr. Greenberg to see if the pain is responsive to Dextrose. If most or all of the pain resolves instantly with this test injection, the success rate with PIT is around 80% for complete long-term resolution with ongoing treatment. The average number of required treatments is typically between four to eight, depending on how widespread your pain is, and for how long it has been present.
With PIT, the injections are made into the very superficial tissues in the painful region using a tiny needle. These injections may initially be uncomfortable and painful (because of hypersensitivity, which is part of neurogenic inflammation). This will markedly improve as treatment continues. During the course of treatment your pain will go up and down; there will be good days with minimal or no pain, and days when your pain is present. There should be steady improvement, however, with the highest level of the pain lessening and the number of good days progressively increasing. With successive treatments, the response to the Dextrose will be immediate and you should expect to leave a treatment pain-free.
It is imperative that you communicate with Dr. Greenberg about your pain during treatment—managing all the involved nerves and ultimate success requires accurate information and feedback from you!
Learn more about Perineural Injection Therapy