Perineural Injections Therapy

Perineural Injections Therapy (PIT) is a specialized injection treatment that was developed by Dr. John Lyftogt of New Zealand. You can learn more about the technique on his website: Learn More

Dr. Sikora has had the privilege of studying with this world-renowned physician in Europe and has brought this effective treatment to Vero Beach. This treats injured and non-healing sensory nerves which cause inflammation and delay of healing that can manifest as tight muscles, painful joints, and soft tissue pain. The treatment consists of a series of small injections targeting the painful and sensitive nerves with natural substances. NO STEROIDS or ANESTHETIC is used! A series of 3-5 treatments is recommended with an 85% success rate. When sensory nerves are injured they can cause nerve pain or neuralgias commonly felt as chronic pain. With PIT, perineural and pain is relieved

Pain Relief Services

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When a nerve branches if came become inflamed. When it moves back and forth over the surface of a bone, it can become irritated and inflamed such as in ITB friction syndrome, which produces knee pain in runners and cyclists. Nerve endings that become entangled in scar tissue that develop in tendons such as the Achilles or patellar tendon become chronically inflamed and are thought to play a major role in pain that develops from those overuse injuries. The end of the nerve that terminates in the skin and tissue immediately beneath it easily becomes inflamed.

Perineural Injection Therapy involves the physician understanding the anatomy of these sensory nerves as they course throughout the body. A series of injections containing the dextrose solution are placed underneath the skin much in the same way as getting a TB test or a “pin prick.” A very short, small needle is used to treat along the course of the nerve.

"I had a fabulous experience with Dr. Sikora. The office is modern and extremely clean. Her staff is very friendly and the doctor? Wow - thorough, kind, sweet, very gentle, and extremely informative. She doesn’t try to push you into buying anything. She gives you all the options and the cost effectiveness of each. I felt very comfortable and really liked her. I will definitely be back!! "

The number of injections that are given depend on various factors such as the number of different nerves inflamed, how much of the nerve is inflamed, and how long the nerve has been inflamed.

For instance, in a patient that has had a total knee replacement, their pain many only be along the surgical incision and that is a very simple treatment that takes a few minutes. If a patient had a knee replacement and has pain that involves their entire knee, the treatment can be very lengthy and involves all the nerves supplying sensation to the joint. The same would hold true for a patient that has suffered a whiplash injury to the neck.

Most patients will require 3 Perineural Injection Therapy treatments spaced anywhere for 7-10 days to 2-4 weeks apart depending on their condition. No pain meds or local anesthetics are required.
After the first Perineural Injection Therapy treatment, the pain relief only lasts a few hours and the pain returns. After the second treatment there is about a 25% or so improvement and although the pain returns, it may not be as intense, widespread, or frequent as it was prior to treatment.

As the patient receives further treatments, the pain eventually goes away and normal function returns.
There are no medication restrictions for patients receiving Perineural Injection Therapy and well over 85% of patients respond. Anti-inflammatory medicines taken for other conditions do not need to be stopped. Patients taking opiate pain medicine tend not to do as well because the opiate competes with the receptor on the cell and can keep dextrose from getting into the cell.

As far as activity restrictions, patients are encouraged to remain active but only to the point where the given activity does not increase the pain during or after the activity.
Since this is a natural, drug free treatment, and dextrose is a part of normal human function, side effects are rare and including occasional small bruises at the site of injection. Allergy is not an issue. Although infection is a potential side effect anytime the skin is infiltrated, we have not had any occur in our patient population.

Is this treatment covered by insurance?

Insurance companies consider the treatment “unproven” although insurers in the remainder of the world routinely cover these treatments. The cost of the treatment is dependent on the number of nerves treated as well as the complexity of the neurogenic inflammation.