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Perineural Injection Therapy

Perineural Injection Therapy (PIT) treats inflamed and injured nerves, often due to trauma, arthritis, sports, overuse, and surgical injuries.  PIT is a series of injections in the layer between your subcutaneous tissue and the muscle where many cutaneous nerves reside. When these nerves are inflamed and irritated, they send signals to your brain that are perceived as pain. 
The solution contains buffered 5% dextrose, which immediately turns off these signals once it comes in contact with the peripheral nerves.  By treating the overactive nerves, acute and chronic neuropathic pain can be safely and effectively eliminated.  As there is no downtime from the injections, patients can receive treatment and can continue to exercise and be active the same day.


How Perineural Injections Work

When cutaneous nerves pierce through both deep and superficial fascial layers to reach the skin, there is a high potential for entrapment.  If entrapment occurs, inflammatory neuropeptides are released, which can cause inflammation and neuropathic pain.  Friction injuries can also arise where cutaneous nerves cross over areas of bone, such as the kneecap, which also results in neurogenic inflammation and neuropathic pain.  Neurogenic inflammation differs from other forms of inflammation in that it does not respond as well to cortisone injections or other anti-inflammatory drugs such as NSAID’s.  Patients are commonly prescribed Lyrica or other neuropathic pain medications, which may or may not be useful. 
When the perineural injection solution is injected in an area where cutaneous nerves are trapped, the pressure from the fluid frees the nerve from these adhesions, resulting in an immediate reduction in pressure and therefore inflammation.  In addition to this, the 5% dextrose modulates two ion channels that contribute significantly to inflammation and sensation of pain.  By modulating these channels, there is a drastic reduction in the number of inflammatory neuropeptides released by the nerve, thereby shutting down neurogenic inflammation.  Lastly, as neurogenic inflammation is associated with low levels of glucose surrounding the nerve (known as glucopenia), injecting dextrose to surround the affected nerves can provide the nerve with the dextrose it needs to function correctly. 


What are the risks and side effects?
Because PIT uses a natural substance (5% dextrose) and superficial injections, side effects and risks are extremely low.
Am I guaranteed results?
Like all medical procedures, PIT procedures have a success and failure rate. An initial consultation with a Physician will determine if you are a good candidate. If you are a good candidate, our success rate is between 70-90% after 4-8 treatments.
How many treatments will I need?
While each person and condition are different, the average number of treatments required for most patients is six to eight. These injections are usually performed every 1-3 weeks.
How soon can I return to activity?
One of the significant benefits of perineural injection therapy is that there is no downtime, and you can return to activity immediately after the injections.
What is the cost?
Because the procedure protocol will vary from person to person and because each person will have a unique condition to be treated, the pricing of procedures can vary considerably from patient to patient. An evaluation will give you a better idea of condition, treatment, and costs specific to your situation.
Does insurance cover this procedure?
Insurance does not cover this procedure, nor is Regenerative Performance contracted with any insurance companies.
How do I get started?
You can get started by booking an appointment with Dr. Timmermans by calling (520) 800-4355.


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