Dextrose Prolotherapy หรือ DPT (การฉีดสารละลายกลูโคส) Ep. 2

What is Glucose (Dextrose) Prolotherapy? Part 2
           Currently, glucose prolotherapy are increasingly used in the treatment of chronic pain conditions. The use of glucose prolotherapy can be divided into two main types:

           1. Dextrose Prolotherapy: This involves injecting a concentrated dextrose solution to stimulate the repair of tendons and ligaments.

           2. Perineural Injection Therapy: This technique targets nerve-related pain by injecting dextrose solution around the nerve.

           In the previous discussion, we covered Dextrose Prolotherapy, which involves injecting concentrated glucose to stimulate tendon repair. In this section, we will explore Perineural Injection Therapy, which involves injecting a glucose solution around the nerve to treat nerve-related pain.

What is Nerve-related (Neuropathic) Pain?

Nerve-related (Neuropathic) pain is pain caused by abnormalities in small nerves, making pain from bones and muscles more difficult and prolonged to treat. For example, patients with osteoarthritis who still experience pain despite taking various medications might have untreated small nerves around the joint, causing persistent pain. Neuropathic pain is often overlooked, leading to inadequate treatment and making the pain more complex and difficult to manage.

Perineural Injection Therapy
 
          This method involves injecting a 5% glucose solution around the nerve. Initially, the pain was located using palpation, but with modern technology, we can now use ultrasound to identify the exact location of the nerves causing the pain. Patients usually experience improvement after the first glucose injection, but multiple injections may be required for ongoing relief. This technique was discovered by Dr. John Lyftogt, who proposed that nerves reflect problems with tissue homeostasis and that pain is due to decreased glucose level and reduced blood supply in the surrounding area. Low blood sugar activates pain receptors in the nerves via TRPV1 receptors, leading to release of inflammation mediators. Therefore, glucose injection helps alleviate nerve pain caused by these issues.

Benefits of Perineural Injection Therapy:

            - Safety: Glucose solution is commonly used in hospitals and does not contain any drugs or steroids.

            - Effectiveness: Pain generally improves after injection, though chronic pain may require multiple injections, typically spaced about one week apart. Pain should gradually improve with each injection.