Neural Therapy in the Treatment of Acute Pain and Chronic Pain

Alvin Stein, MD, FACSAlvin Stein, MD, FACS

Neural therapy is a treatment program that works to restore normal function to the autonomic nervous system of the body. Local anesthetic is a major component of Prolotherapy. Its effect in Prolotherapy is the neural therapy aspect of the local anesthetic.

Autonomic Nervous System

The autonomic nervous system is the body’s regulatory system that controls all of the automatic aspects of body function, those that have no voluntary control. The autonomic nervous system works in the background and is involved in such things as fight or flight, temperature regulation, heart rate, and all other behind the scenes activity. It is also analogous to the computer’s hard drive, and it acts as the body’s hard drive keeping a record of toxic insults to the body.

The autonomic nervous system is a very low voltage electrical system operating at somewhere between 40 and 80 nanovolts of electricity. Any type of increased electrical activity over and above that baseline can be a disturbing influence on the autonomic nervous system and create a blockage or interfere with regulation of the autonomic nervous system. This leads to various disease states or pain states in the body.

Well-known interference areas involve scars anywhere on the body, dental foci, toxic autonomic ganglia from various environmental poisons, emotional disturbances, electromagnetic field influence, and things such as multiple chemical sensitivities. In many cases these create serious difficult patient problems for relieving the patient’s discomfort. A scar can generate 1.5 V of electricity and in the presence of a scar the autonomic nervous system is overwhelmed by the electrical output of the scar creating a major interference field. This distorts blood flow to organs and the body’s ability to regulate itself.

Identification of interference fields is one of the goals of proper neural therapy and then the appropriate discharge or release of the interference field will affect normalization of function in the area.

Acute trauma acts as an interference field. An acute injury to an area creates a shock-like state which shuts down circulation through excessive autonomic nervous system impulse release. Arterial blood flow is cut down by spasm and venous drainage is cut down by the inflammatory aspect of an acute injury. This stagnation of blood supply in and out of an injured area leads to several days, perhaps weeks, of pain and discomfort and loss of productivity and work for many individuals. Delay in healing occurs as a result of this.

Local anesthetic appropriately utilized is the mainstay of neural therapy. The local anesthetic is asked to turn off the autonomic nervous system in the area and allows the interference area to clear, and restore normalcy when it turns on again. It is analogous to a computer that freezes. In order to make the computer work, a computer has to be turned off and rebooted for it to work again properly.

Local anesthetic has the effect of turning off the autonomic nervous system ganglia in a damaged or injured area for just a short enough period of time or a long enough period of time to allow for the clearance of the interference field and restarting of the autonomic function in a normal fashion. In an acute injury, the arterial spasm and the stagnation in the blood vessels of the injured area is relieved immediately and circulation returns to and through the damaged area allowing for normal physiological function to follow.

The case for the use of local anesthetic injections is most simply demonstrated in the following cases:

Case #1: A 40-year-old dentist was driving his automobile when he was suddenly confronted with another vehicle that crossed his pathway and he unavoidably strikes the other vehicle. He was wearing his seatbelt and was thrown forward against the restraint of his seatbelt and braces his body with his hand and arm on the steering wheel. After being initially dazed by the effect of the accident, the patient was able to get out of the automobile, but experienced almost immediate neck pain radiating into his left shoulder and down his left arm into the thumb area. The patient’s pain persisted unabated for 24 hours until evaluated in my office. He was unable to work as a dentist in his own practice.

Examination revealed spasm in the cervical spine with restriction of flexion, extension and rotation, and especially lateral bending. He had tenderness at the interspinus ligament at C5-6. Shoulder shrugging was normal. There was an abrasion over the left shoulder at the acromioclavicular joint area from the shoulder harness of his seatbelt. There was exquisite tenderness in the acromioclavicular joint, but no separation. There was pain on movement of the shoulder most prominently at the acromioclavicular joint with no evidence of any weakness in rotator cuff strength or in internal or external rotation activities. Elbow movements were normal and strength was normal.

The left wrist demonstrated tenderness in the area of the distal radius and at the carpometacarpal area of the thumb and second metacarpal. Attempts at grasping with his left hand were halted by the pain in the wrist.

X-rays of the shoulder and wrist failed to show any evidence of fractures, dislocations, or other abnormalities. The diagnosis included significant sprains to the cervical spine especially at C5-6, the left acromioclavicular joint, and the radial side of the wrist joint into the thumb area.

Treatment was neural therapy using 1% procaine with no preservative buffered with sodium bicarbonate for the injections. In the cervical spine three rows of the blebs or wheals were made from the occipital line to the C7-T1 area. One line was in the midline and the other lines were approximately an inch and a half wide off the midline. Approximately 10cc of procaine were used in the neck.

The left shoulder area was similarly injected with wheals around the skin over the acromioclavicular joint and underneath the contusion from the seatbelt injury. A small amount of local anesthetic was injected into the capsule of the acromioclavicular joint. In the left hand around the radial side of the wrist local anesthetic was injected into the skin area and down to the distal end of the radius and the proximal end of the carpal bones at the carpometacarpal joint.

In total the patient received approximately 20 cc of procaine for this procedure. Immediately after the injections, range of motion of the neck improved to 90% of normal. Shoulder range of motion was carried out completely asymptomatically. The left hand movement and finger movement was completely normal with complete restoration of strength and flexibility on grip twisting and turning and other manipulative functions of the left hand and wrist.

No other medication was prescribed, and no other treatment was rendered. Follow up with the patient 48 hours later revealed that the patient was back at work in his office doing a full day’s dental surgery with no symptoms.

Case #2: A 24-year-old law school student was involved in a serious rear end collision in which his head was severely jolted and experienced neck pain into both arms. With inability to clearly think, and the patient expressing that he felt that he was in a fog, the patient was unable to study for his law school examinations. He was seen for his first appointment two weeks after the accident.

Clinical examination was essentially normal with the exception of some local spasm in the neck. The patient was treated with local anesthetic 1% procaine. A crown of thorns was given and local anesthetic was administered to the posterior cervical area. The crown of thorns is local blebs or wheals of procaine in a circumferential fashion about the crown of the head and also along the suture lines on the cranium. Approximately 7-10 cc of local anesthetic is used in total to the crown of thorns.

Because of the cervical spine complaints, the neck was treated with three rows of wheals applied from the occiput to C7-T1, down the midline and approximately an inch and a half on each side of the midline with injections approximately corresponding to each vertebral level. Again approximately 10cc of local anesthetic was used on the neck.

The patient reported almost immediate and complete relief (within five minutes) of the cranial fog and cloudiness. The room became brighter and lighter immediately with the injections. The neck spasm was relieved and range of motion restored to about 80% of normal. The patient reported at the follow-up visit that he was able to go back and resume his studies for his law examination and ultimately passed his examination as a result of getting the treatment. No other treatment was administered except for the local anesthetic in the neural therapy.

Observations

Local anesthetic does not just numb the area. Local anesthetic has a much wider application and is used to open up the autonomic nervous system and restore physiological blood flow in and out of the damaged area, taking away the stagnating aspects of an acute injury and allowing the physiological healing process to move along at an incredibly faster rate and in so doing, alleviate pain and speed the healing process in general.

Our local anesthetic contains no preservatives. The local anesthetic effect of numbness lasts for no more than 20 minutes. The pain relief, opening up the autonomic nervous system, and restoring physiological function is often completely permanent even with one session. However, if the patient gets 6-12 hours of relief with what you do, you are pretty close to being exactly in the right place and need to repeat the treatment several more times. If your therapy relief lasts greater than 12 hours and then recurs, you are exactly in the right place and need to repeat it several more times. If the relief was shorter than six hours, you have to look for additional interference locations or additional injury over and above the autonomic nervous system alone.

We have seen this with fractures of toes, metatarsals, ankle injuries, including sprains and fractures, lower back injuries with accompanying spasm, as well as many other applications of acute pain. We see these beneficial effects almost every day in our practice.

The treatment is 100% benign in everyone except if you are allergic to the specific local anesthetic. There is no down side. There is only major upsides for the patient, more rapid healing, less pain, no need for heavy-duty Narcotics, muscle relaxants, and other mind bending drugs. The body is able to heal itself once the interference is removed.