Treatments > Perineural Therapy

Perineural Injection Therapy for Persistent Pain Support

Perineural therapy involves targeted injections of therapeutic substances, such as local anesthetics or dextrose, near nerves. By focusing treatment around affected nerves, this technique may help modulate pain signals and support care for nerve-related pain and inflammation as part of a personalized treatment plan.

Perineural Therapy

Perineural injections may be considered as part of a care plan for persistent pain.

The injections are intended to help address nerve-related inflammation and symptoms that may be associated with neuralgia, low back pain, shingles-related nerve pain, fibromyalgia, headaches or migraines, nerve impingement, or neuropathy. Suitability depends on a patient’s assessment, health history, and care goals.

Perineural therapy involves shallow injections below the skin’s surface. It may use dextrose or mannitol in a saline solution combined with sodium bicarbonate. The injections are placed near nerve pathways to help address pain signals and inflammation in targeted areas.

Treatment for Chronic Pain and Inflammation

Perineural therapy may be used as part of chronic pain care, particularly for nerve-related pain and inflammation concerns.

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Neuropathic Pain

Neuropathic pain is a type of pain associated with damage or dysfunction of the nervous system. It can be related to conditions such as diabetes, shingles, nerve compression, or traumatic injuries. Perineural therapy may be considered for some types of neuropathic pain, such as sciatica, peripheral neuropathy, or post-herpetic neuralgia, depending on a patient’s assessment and care plan.

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Musculoskeletal Pain

It may be used to address pain associated with musculoskeletal conditions, including injuries and inflammation around nerves.

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Joint Pain

Some practitioners use perineural therapy to address pain in or around joints, particularly when nerve involvement is suspected.

Benefits of Perineural Therapy

Perineural therapy may offer targeted support for chronic pain and inflammation as part of a personalized treatment plan.

Targeted Pain Support

Perineural therapy aims to provide targeted support by delivering medications, such as local anesthetics or dextrose, near affected nerves. This may be helpful for localized pain associated with nerve irritation, nerve damage, or inflammation.

Reduced Inflammation

The injections used in perineural therapy may help address inflammation near affected nerves, which may contribute to pain symptoms. Inflammation can be one factor involved in some chronic pain conditions.

Improved Nerve Function

By addressing inflammation around nerves, perineural therapy may support nerve-related pain care. This may be relevant for some patients with neuropathic pain, depending on their assessment and treatment plan.

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How Perineural Therapy Works

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Skin Preparation

The patient will be positioned appropriately based on the target area for treatment. This may involve lying down or sitting, depending on the location of the affected nerves.

The skin over the injection site will be cleaned and sterilized to reduce the risk of infection. In some cases, a local anesthetic may be applied to numb the skin and underlying tissues at the injection site, helping to minimize discomfort during the procedure.

Needle Insertion

A thin needle is inserted through the skin and into the perineural space near the affected nerves. The needle may be guided by ultrasound or fluoroscopy to ensure accuracy.

Medication Injection

The selected medication, such as a local anesthetic, dextrose, or another substance, is injected into the perineural space. The choice of medication depends on the healthcare provider's judgment and the specific goals of the therapy.

Reasons to Get Perineural Therapy

Perineural therapy may be considered as a treatment option for patients experiencing chronic pain or inflammation concerns.

Localized Pain

When pain is localized to a specific area and is associated with nerve involvement, perineural therapy may be considered. This localized approach allows for targeted treatment of the affected nerves.

Failed Conservative Treatments

Patients who have not experienced sufficient improvement from conservative treatments such as medications, physical therapy, or other interventions may discuss whether perineural therapy is a suitable alternative or complementary option.

Chronic Musculoskeletal Pain

Perineural therapy may be used for chronic pain associated with musculoskeletal conditions, especially when nerves are implicated. This includes conditions like sciatica or pain around joints.

FAQ

Is perineural therapy painful?

Discomfort during the procedure can vary from person to person. A local anesthetic may be used to help minimize discomfort. After the procedure, some patients may experience temporary soreness or mild discomfort at the injection site.

How many sessions of perineural therapy are typically needed?

The number of sessions varies based on the patient's response and the nature of the condition being treated. Some patients may notice improvement after one session, while others may need a series of treatments. Your practitioner can discuss an appropriate treatment plan based on your assessment.

What are the side effects or risks associated with perineural therapy?

Potential side effects may include temporary soreness, bruising, or infection at the injection site. Less common but more serious risks may include nerve irritation or damage, allergic reaction, or other complications. Your practitioner should review risks and suitability before treatment.

Can perineural therapy be combined with other treatments?

Perineural therapy may be used as part of a broader pain-management plan. Depending on the patient's needs, it may be combined with treatments such as physical therapy, medications, and lifestyle changes.

How long do the effects from perineural therapy last?

The duration of symptom relief can vary from person to person. Some patients may notice changes sooner, while others may require multiple sessions before assessing benefit. Periodic follow-up or maintenance treatments may be discussed based on response and care goals.