Neuropathic pain; or nerve pain caused by damage or inflammation of nerve tissue; is most often thought to be related to diabetes, alcoholism, post-chemo or post radiation nerve damage. But as our understanding of pain science evolves, we are finding that chronic pain can also result from inflammation of peripheral nerve fibers just under the skin. Ever used Icy Hot or Tiger Balm? Well they work by distracting a receptor called the capcasian resceptors (TRPV1). As those nerve receptors become more inflamed (often due to trauma --sports injuries-- or tight muscles and fascia) they become increasingly more sensitive, thus producing even more inflammation and pain. The cyclical pain pattern goes on and on and becomes very stubborn and difficult to treat. Neuropathic pain doesn’t respond well to anti-inflammatory medications such as ibuprofen, because the pharmacological pathways in those medications don’t affect nerve fibers.
So what do we do about this? A new treatment called Perineural injection therapy (PIT) can be very effective. With this treatment, low levels of dextrose (sugar) can be injected near these inflamed peripheral nerves. This reduces the signaling and stops the inflammation creating almost instant pain relief. This technique has been studied for post-operative pain, a difficult chronic pain condition called complex regional pain syndrome, as well as carpal tunnel syndrome.
In our practice, we use it for stubborn pain that isn’t responding to other modalities such as acupuncture, physical therapy, chiropractic care or massage. For patients that have chronic neck pain and tension headaches, elbow pain, knee pain, plantar fasciitis, Achilles pain, low back pain, perineural injection therapy is a very effective option to consider.
If you are interested in seeing if PIT would be an effective treatment for you, contact Dr. Chang and schedule an appointment today!