Pain Relief, Steroid Free

Most of us associate “pain injections” with cortisone (steroid) shots or nerve blocks, common interventions that often work very well for acute pain. These allow physicians to quickly get painful swelling under control, and in some cases better confirm the source and location of the pain. But what happens when the injection fails, or the effect wears off? This is where alternative injections therapies shine, in the management of recurring and chronic pain syndromes.  As mentioned above, sometimes the steroid injections and nerve blocks fail. Even when they succeed, there are limitations to how many you can get. Steroid shots contribute to degeneration, or tissue breakdown, in joints and tissues over time. Nerve blocks can be costly, and your physician may be hesitant to repeat the procedure if it missed the mark the first time.  In these situations, intradermal and intramuscular injections can be administered in a series for longer term pain management. These are steroid free, and don’t require sedation or costly imaging. While there are many options to choose from, we have two favorites specifically for pain: Neural Therapy, and Prolozone Injections. Both of these can provide relief for acute and chronic pain, and most patients report them as being far less painful than the injections mentioned in the first paragraph. Clinically, we see these injections help the most for the following complaints:

• Tension headaches & chronic migraines
• Chronic upper back and neck pain
• Acute muscle spasms
• Fibromyalgia related pain
• Neuropathy
• TMJ
• IBS

Neural Therapy

These are small, mostly superficial injections designed to work on pain through targeting the nervous system, specifically the autonomic nervous system. Neural therapy arose in Europe in the 1900’s and has since become popular throughout the world. It is well understood in modern medicine that nerve function is key in understanding and regulating pain perception, and injections can be used to interact with this connection.  Healthy, resting nerve cells maintain a “membrane resting potential” that keeps them from creating nerve impulses when they shouldn’t. If a nerve cell is damaged, overstimulated or unhealthy for a number of reasons, it may not be able to maintain the proper membrane resting potential. The result is an easily triggered nerve cell, firing pain responses when it shouldn’t be. Injections with local anesthetics like procaine help to restore the normal, healthy membrane potential of the cell. In other words, they can direct the tissues to stop screaming “pain” to your brain when they should not be.  The most amazing thing about Neural Therapy is that it’s not just targeting pain that is skin deep. The autonomic nervous system (ANS) has branches everywhere, from organs to skin. If you’ve ever felt referred pain, like the burning pain in your mid-back during a gallbladder attack, you’ve experienced this first hand. Neural Therapy can target these pathways in reverse to try and target deeper pain and dysfunction like irritable bowel dysfunction (IBS) and migraine symptoms. 

Prolozone Injection Therapy

For pain conditions where inflammation is playing a significant role, Prolozone injections offer an effective combination that targets both the nervous system and localized muscle spasm and inflammation in myofascial tissues. The procedure consists of initial intramuscular injections with procaine (the same anesthetic mentioned above), followed by intramuscular injections with ozone gas generated from medical grade oxygen.  The procaine injections provide pain relief by interacting with the ANS as mentioned above, but also by directly numbing painful, tense muscle fibers referred to as trigger points. The numbing effect allows the muscle to release, reducing pain. The injection sites are then followed with ozone, providing both analgesic (pain-killing) and anti-inflammatory effects. This form of injection therapy is especially helpful following acute injuries and for chronic neck and back pain.  Interested in learning more? Ask your FIM provider about therapeutic injections at your next follow up!