Mannitol Injection Therapy
A new approach for eliminating neuropathic pain and neuralgia
A new treatment for chronic pain has emerged from “Down Under” that is dramatically effective for most types of pain, including joint, muscle and nerve pain. The protocol involves using a substance called mannitol. The solution is injected in the subdermal space (under the skin) with a very fine (30ga) needle, addressing the source of the pain. Overall, the success rate after a series of injections is 85%. Restated, the technique can alleviate 100% of pain and restore 100% of the function in up to 85% of patients with most conditions.
The new technique, Neural Prolotherapy, was developed by John Lyftogt, MD in New Zealand. He has been in practice since 1978, with extensive postgraduate training and experience in sports medicine and musculoskeletal medicine. Dr Lyftogt’s early research focused on the treatment of Achilles tendon problems. His technique differs from classical prolotherapy, which injects a solution into the tendons to stimulate cell regeneration, great care is taken to avoid needle contact with the exquisitely sensitive tendon. He has now treated more than 300 Achilles tendons with a success rate of more than 90%. Dr John has published 4 studies in the Australasian Journal of Musculoskeletal Medicine since 2005.
The neural prolotherapy protocol (MIT) has also been used to successfully treat painful joints, low back and neck pain, and a variety of muscle injuries. The unique therapy addresses the overlooked cause of most pain: injury to the superficial nerves. This new treatment is for neuropathic pain, a type of pain originating in the superficial nerves coursing between the skin and the muscles. Results are consistent and two year follow up studies have shown success rates between 85 and 100%.
Because the technique is NOT prolotherapy (tendon injections) and it is NOT neural therapy (scar injections), at Tenpenny Integrative Medical Center, we have adopted the name of M.I.T., mannitol injection therapy.
How Does It Work?
Since M.I.T. are not targeted towards tendons, ligaments or spinal discs, the parts of the anatomy classically thought to cause pain, why do the injections lead to such a dramatic decrease in pain in only a few treatments? One hypothesis is that glucose assists in the repair of the disrupted myelin sheath which covers the nerve trunks. The nerves coursing under the skin nerves are now known to be responsible for pain originating from the nerves, called neuralgias or peripheral neuropathic pain.
There is compelling scientific evidence that the very small nerves that innervate the nerves, known as nervi nervorum are responsible for inflammation of connective tissue, the myelin sheath and other tissues that surround a nerve trunk. Surprisingly, this medical observation has been known for more than 125 years but is both unrecognized and ignored by current pain management programs.
It is also well known that neuropathic pain is difficult to treat and does not respond to typical anti-inflammatory medications or cortisone injections. It is clear from Dr. John’s clinical observation of more than three thousand patients that neural prolotherapy (M.I.T.) effectively reverses neurogenic inflammation and resolves neuralgia pain.
Treatment typically involves a series of micro-injections, injecting mannitol just under the skin with a very small needle. A patient will have multiple, nearly painless injections during a single session. On average, it takes 6 to 8 sessions to have full relief of pain. Occasionally, up to 15 session may be needed if the patient has had prior surgeries, a severe whiplash injury with widespread pain, and/or significant underlying medical illnesses (diabetes, autoimmune disorder or history of cancer.)
Treatment sessions are completed within approximately 15 minutes. At most, the patient may have some brief tenderness at the injection site or a small bruise. A few patients may have a temporary pain-flair within 72 hours after a session, but this can be controlled by anti-inflammatory supplements or pain medications. The flair is temporary, lasting less than 24 hours. Physical activity is not restricted post-injection, with most patients returning to work the same day. They can resume a workout routine, at approximately 75% of maximum, the next day.
Patients tolerate the minimal discomfort and many patients experience an immediate decrease in pain, often reporting that the pain has gone from a 10 to 3 (or even to zero!), within minutes.