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Centre for Natural Medicine, Calgary AB
Centre for Natural Medicine, Calgary AB

















































































Neural Prolotherapy

  1. What is Neural Prolotherapy?
  2. How does Neural Prolotherapy work?
  3. What conditions does Neural Prolotherapy treat?
  4. Frequently Asked Questions

  1. What is Neural Prolotherapy?

    Neural prolotherapy is a technique used in our Calgary clinic to treat pain by using superficial injections to improve nerve function. Acute and chronic pain come from many sources - such as car accidents, sports injuries or repetitive use. Neural prolotherapy involves a series of superficial injections that target small pain conducting nerves at the surface of the body. Trauma and overuse can cause these nerves to become inflamed leading to lasting neurogenic pain (pain from nerves). Neural prolotherapy aims to reduce nerve inflammation and restore healthy nerve function. In doing so, pain that is resistant to other treatments can often be managed. Treatments are spaced 1-2 weeks apart with most people finding maximal benefit in 6-8 treatments in our Calgary clinic.


  2. How does Neural Prolotherapy work?

    Neural prolotherapy involves superficial injections along nerve pathways that are aimed at shifting unhealthy or damaged nerves into normal healthy nerves. Specifically, neural prolotherapy targets sensocrine nerves that, when healthy, release anti-inflammatory and healing molecules (somatostatin, galenin)that help to repair and heal surrounding tissue. When diseased or damaged these nerves instead secrete substances that stimulate pain and inflammation (substance P, calcitonin gene-related peptide). Neural prolotherapy targets the TRPV1 receptor on the nerve surface to shift damaged nerves out of “inflammatory mode” and back into “healing” mode”.

    How are nerves damaged?

    Nerves may be damaged through a variety of ways. Some common causes of nerve damage include nutrient deficiencies (e.g. B12), nerve compression or overuse injuries such as carpal tunnel, direct trauma or surgery, disease states such as diabetes, and certain medications or drugs. Nerve damage and inflammation can also occur by more subtle means. Tight inflexible muscles can compress nerves enough to cause dysfunction. Repetitive movements can cause nerves to rub against other structures causing damage. When the damage is significant or chronic the nerves can get stuck in “pain” mode long after the offending stimulus is gone.

    What is the procedure like?

    Neural prolotherapy involves a series of microinjections just below the surface of the skin. Tender points along nerve pathways are identified and injected. Following the initial injections the patient is asked to identify any remaining tender points which are then treated as well. Most patients experience significant pain reduction during the first treatment. While some of the injections may sting, patients generally report minimal discomfort and frequently encourage the clinician to fine-tune certain points during the procedure.


  3. What conditions does Neural Prolotherapy treat?

    Neural prolotherapy can treat many of the same conditions that traditional prolotherapy has been utilized to treat including:

    Achilles tendon pain
    Hamstring pain
    Shoulder pain
    Tennis elbow
    Compartment Syndrome
    Groin pain
    Knee pain
    Neck pain
    Back pain

    Neural prolotherapy addresses the nervous system – the system which transmits pain – and as such virtually any type of pain may benefit from neural prolotherapy.. Fibromyalgia, post-herpetic neuralgia, headaches, migraines, whiplash, neck pain, shoulder pain, elbow pain, wrist pain, hand pain, low back pain, hip pain, knee pain, foot pain, ankle pain, tendinitis, arthritis, bursitis, bunions, sciatica and muscle/ligament injuries may also benefit from neural prolotherapy.


  4. Frequently Asked Questions

    How many treatments are required?

    Most patients require between 3-8 treatment sessions for a resolution of pain and most often report a 10-20% improvement in pain with each session. While the first neural prolotherapy treatment provides temporary relief, subsequent treatments are required to remain pain-free. Typically, theses treatments are spaced 1 week apart for about 1 month. As you remain pain-free for longer periods of time treatments are spaced farther apart at once every other week for 2 months or so.

    What can I expect from the treatment itself?

    The initial session involves an assessment of the painful areas to determine which points need to be injected. Treatment involves multiple 5-15 injections just below the skins surface per painful area. The initial session usually dramatically reduces pain almost immediately and improvement should be seen by the end of the visit. This effect will generally last 4 hours to 4 days. Subsequent treatments are roughly 30min in length. It is not uncommon to unmask and address new areas of pain during the course of treatment.

    When Can I return to work/exercise?

    Depending on the nature of the activity a return to work or exercise can occur the same day as treatment or the day after.

    Is it safe? What are the risks?

    Neural prolotherapy treatments are generally very well tolerated. At most some patients may experience some brief tenderness, itching and/or bruising at the injection site. The injections and solutions are very safe. Allergic reaction to the solution are rare but have been reported. It is important to inform your doctor about any allergies you may have. On the whole, complications are uncommon and every attempt to minimize these risks will be taken.

    What are the chances I get better? Worse?

    To my knowledge, no treatment is effective 100% of the time. With neural prolotherapy you can expect improvement 85% of the time. Certain areas of the body tend to have higher or lower success rates.

    Are the treatments painful?

    Most neural prolotherapy treatments are almost painless as the needle used is very small. Some areas of the body may be more sensitive than others. Neural prolotherapy can actually provide immediate pain relief. Treatments are generally well tolerated with patients experiencing minimal discomfort.

    Do I need a referral?

    No referral is necessary. But often other healthcare practitioners will refer patients for neural prolotherapy if other treatments have been unsuccessful or surgery is undesired.

    Is neural prolotherapy for me?

    Because all pain has some degree of nerve involvement neural prolotherapy has potential benefit in many types of pain. The goal of the initial few sessions is to determine whether neural prolotherapy will be beneficial to your particular case and whether it is likely to improve your pain by 10% or by 100%. Neural prolotherapy is expected to produce pain reduction after just the first visit. This can last anywhere from 4 hours to 4 days. If your pain returns within the first hour it is unlikely that neural prolotherapy will work for you.

    Neural prolotherapy is an attractive option for patients for whom traditional prolotherapy is not appealing and/or indicated. It can address many of the same conditions as traditional prolotherapy and is less invasive. Treatments may also be combined to provide maximal benefit.


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