Neuropathic Pain
Neuropathic Pain
Neuropathic Pain can be caused by damage or injury of nervous system.
It is a kind of chronic pain. Accompanying symptoms are piercing, burning, stabbing, hyper/ hypoalgesia. The treatment of neuropathic pain is a major challenge and very often there is no good result.
One of the latest advancements in the managment of neuropathic pain is Perineural Injection Treatment also called neural prolotherapy.This technique was originally pioneered by New Zealand physician John Lyftogt M.D.
Physiology
There are two kinds of fibres that carry pain signal, A-delta myelinated fibres and non-myelinated C-fibres. When these fibres reach the target they create a dense network of free nerve endings called nociceptors, the sensory receptors for pain. C-fibers are estimated to account for about 70% of all nociceptive fibres. Doctor Lyftogt focused on C-fibres which damage or injury can cause a nueropathic pain. C-fibres are equipped with TRPV-1 receptors which are able to produce substance P and calcitonin gene-related peptide (CGRP) in response to pro-inflammatory signals. Substance P is responsibile for pain sensation while CGRP leads to neurogenic inflammation and inflammation of surronding structures. Dextrose binds the presynaptic calcium channels inhibiting the release of neurodegenerative substance P and CGRP. This leads to pain reduction, regression of inflammation and nerve regeneration.
Perineural Injection Treatment turned out to be effective in the treatment of neuropathic pain caused by
- nerve compression,
- nerve impingement,
- diabetic neuropathy,
- postherpetic neuralgia,
- scar tissue pain.
Dr. Marcin Goczewski is the first doctor from Poland who took part in the Master Class Lyftogt Perineural Injection Treatment applying this treatmet to patients with neuropathic pain with good results.
