Perineural Injections

Perineural injections are a safe and effective option for treating persistent pain. This therapy aims to reduce neural inflammation associated with conditions such as neuralgia, low back pain, fibromyalgia, headaches/migraines, nerve impingement, and neuropathy. By using this approach, we support the body’s natural healing processes. Perineural therapy involves subcutaneous injections, which are administered just below the skin’s surface. The injections utilize a solution of dextrose or mannitol combined with saline and sodium bicarbonate. This technique targets specific areas of skin above nerve pathways to address pain at its root cause.

Perineural injections deliver a dilute sugar solution directly into the subcutaneous tissue, which can immediately reduce the production of pain-causing substances and help decrease nerve swelling. While the exact cellular mechanism is not fully understood, it is believed that dextrose interacts with TRPV1 receptors, leading to a decrease in substance P and other chemicals associated with pain. Additionally, dextrose may affect ion channels in the affected nerves, further supporting healing at the cellular level.

The goal of every treatment is to alleviate pain. After the first session, patients may experience pain relief lasting from four hours to four days. With repeated treatments—typically 4 to 6 sessions scheduled weekly—there is usually a gradual reduction in overall pain, with the aim of achieving complete resolution (a zero pain score) and restoring full function. Success rates vary depending on the presenting concern and individual history.

As this is a drug-free treatment, side effects are rare. The most common side effects may include occasional small bruises at the injection site or, in rare cases, infection.

Our naturopathic physician, Dr. Sydney Green, performs the perineural injection treatment.