stack of rocks

leaf iconabout neural prolotherapy

healthy vs inflamed nerve

nerves of the neck and shoulder

nerves of the face

nerves of the arm and hand

nerves of the lower leg and foot

nerves of the knee

nerves of the hamstring and heel

nerves of the hip and lower back

What is Neural Prolotherapy?

Neural Prolotherapy (NPT) is used to treat neurogenic pain and injuries in muscles, joints, tendons and ligaments.

Dr. John Lyftgot, MD, from New Zealand developed it for treating chronic pain, successfully helping his wife, a national-level runner, recover from knee surgery and enable her to continue running. For most people NPT decreases or eliminates pain in less than one minute.

In my practice, I have had a patient diagnosed with fibromyalgia, who could not go up and down the stairs, and who burst into tears upon her first treatment, stating it was the first time in 25 years she didn’t feel pain in her knees. After 4 treatments there was an 80 % improvement in pain between treatments, allowing her to dance for the first time in decades. Her lower back, ankle, wrist and elbow pain resolved after 6 treatments.
Another woman who suffered from debilitating migraines and neck pain after an accident also experienced a similar emotional result after her first treatment, saying she finally felt relief. After 2 treatments she said she hadn’t felt so good in decades and is no longer at the mercy of her pain to determine if she can go out that day that formerly caused her a great deal of anxiety and depression.

There is often an emotional component to chronic pain and when the pain is relieved mood and anxiety is lifted.
Another patient I treated was a competitive athlete who had a nagging shoulder injury for the last 15 years, and had tried massage, physiotherapy, and acupuncture, all with limited results. After 2 sessions of NPT, was pain free and had increased range of motion.
I have countless patients that are elite-level runners who have resolved their foot pain, plantar fasciitis and Achilles tendinitis within a few treatments and are out competing again.
As a naturopathic physician, I am able to use NPT to treat my patients, as it follows our principles, such as first do no harm, and utilizing the healing power of nature and prevention.
NPT is a safe procedure that allows the body to heal itself using a natural substance (sugar!) to heal and prevent further injury.

NPT is the treatment of pain by injecting dextrose or mannitol around inflamed nerves. [Dextrose is a sugar solution used intravenously to hydrate you at the hospital. Mannitol is a sugar alcohol used in hospitals to decrease pressure in the head after an injury, to treat acute glaucoma, or for kidney failure.]

Pain is diagnostic tool that tells us there is nerve inflammation or injury.
Through injury or overuse, nerves can become inflamed and entrap substances that cause swelling and pain. This causes an immune response that damages cartilage and can cause arthritis. The inflammation can also cause tendinitis, as well as a feeling of burning, pins and needles, or muscle stiffness.
Neuro prolotherapy immediately blocks the receptor that causes neuropathic pain and inflammation (TRPV-1). By blocking this receptor in the nerve, it allows for healing deep in the muscles, joints, tendons and ligaments. Hilton’s law states that a nerve that innervates a joint also tends to supply the muscles that move that joint and the skin that surrounds.
Even though the pain may be deep, NPT is used to treat the superficial nerves and thus heal and relieve pain of deeper structures.
The treatment will decrease pain and inflammation, allowing entrapped nerves to be released, allowing the nerves to heal, and increasing range of movement.

In the diagrams to the left, the red dot represents where the nerves arise deeper from the body through a fibrous osseous tunnel to the surface. This area is often an area of irritation.  An analogy of why these areas are commonly painful is if the nerve is inflamed it is like trying to get an oversized truck through a fixed space tunnel, damage and irritation will occur.

What can I expect with a neural prolotherapy treatment?

  1. 1. Within 1 min the pain will decrease without anesthetic.
  2. 2. It will help heal the nerves.
  3. 3. The muscles will feel looser and more flexible.

Using a tiny needle, a 5% dextrose and mannitol solution is injected just beneath the skin to treat the nerves that cause pain in muscles, tendons and joints. The pain reported will often feel deep but is resolved by treating nerves just beneath the skin.

What can neural prolotherapy by used for?

Any neuropathic pain, examples being:

  • Migraines and headaches
  • Neck and back pain
  • Muscle aches and pains
  • Sciatica
  • Joint pain
  • Osteoarthritis
  • Vulvodynia or dyspareunia
  • Achilles tendonitis
  • Morton’s neuroma
  • Plantar fasciitis
  • Carpal tunnel syndrome
  • Tennis or golfer’s elbow
  • Post-herpetic neuralgia 
  • Temporal mandibular joint disorder
  • Trigeminal neuralgia
  • Sinusitis
  • Fibromyalgia
  • Complex regional pain syndrome


How long does the pain relief last for? How many treatments do I need?

Pain relief ranges from a few hours to 1 week, but on average 4-5 days. Some people have pain resolution after 1 treatment, but on average 4-8 treatments are needed, depending on the number of areas and extent of the pain or muscle stiffness.
With each treatment the pain in between treatments should decrease.

How is this different than other pain relieving injections such as cortisone or botox?

Neural prolotherapy is different from an anesthetic or steroid injection which just masks the pain. Steroid or cortisone injections are anti-inflammatory, and are often used for back pain and sciatica (which is thought to be due to nerve irritation), but they don’t help heal the nerve. Pain relief occurs in a couple of days but when the anti-inflammatory affect of the cortisone wears off in a few weeks or months, the pain and irritation returns.
Long-term cortisone injections have been shown to damage tendons and cartilage.
With cortisone injections there is also risk of whitening of the skin around the injection site for those with darker skin tones.

Botox is used to paralyze the muscles in the head and neck to treat migraine headaches, but when the Botox toxin wears off the headaches often return. In January 2009, the Canadian government warned that Botox can have the adverse effect of spreading to other parts of the body, which could cause muscle weakness, swallowing difficulties, pneumonia, speech disorders and breathing problems.

Neural prolotherapy will immediately reduce the pain and decrease inflammation, allowing the body to heal the nerves. The person will have increase flexibility and have a feeling that their muscles are relaxed and lighter. When the nerves are healed and no longer inflamed, the pain and swelling will stop.

Can I measure my pain progress?

Using an algometer, I can measure the amount of pressure (in kg/square cm) that is being applied to the skin. Placing the meter on a sensitive nerve or tender spot, I ask when the pain starts. A normal result is 3-4kg/square cm. If the area is inflamed, even light touch can cause pain. 1 minute after a neural prolotherapy injection there will be a change, with the area being able to tolerate more pressure before pain starts. After 15 minutes, greater pain relieving affects are experienced.

This is a safe and very effective treatment for pain and inflammation. It can be safely used with diabetics under the supervision of a doctor.