When pain lives in the nervous system, treat the nervous system

Perineural Injection Therapy — also called Lyftogt Perineural Injection Treatment (LPIT) or neural prolotherapy — was developed by Dr. John Lyftogt, a family physician who graduated from Leiden University Medical Faculty in the Netherlands in 1973 and established his practice in Christchurch, New Zealand in 1978.[9]

Drawing on his background in musculoskeletal and sports medicine, Dr. Lyftogt built on traditional dextrose prolotherapy to create a technique specifically aimed at chronic neuropathic pain — becoming, by his own clinic's account, the first to use buffered 5% dextrose (D5W) injections around superficial nerves for this purpose.[9]

Since organizing his first teaching workshop in Christchurch in 2009, Dr. Lyftogt and collaborators have trained more than 3,500 healthcare professionals across over 30 countries, helping establish PIT as a recognized, teachable technique within musculoskeletal and pain medicine rather than a one-clinic method.[9]

Is perineural injection therapy painful?

The injections use a fine needle and a small volume of buffered dextrose solution just beneath the skin. Most patients describe a brief stinging or pressure sensation rather than significant pain, and no sedation is required.

How many sessions does it typically take?

Protocols vary by condition and individual response. Published series often describe roughly weekly sessions during an active treatment phase, with the total number of visits determined by how a patient responds along the way.[4]

How is PIT different from a cortisone or steroid injection?

Cortisone reduces inflammation broadly by suppressing immune activity at the injection site. PIT uses a dextrose solution around the nerve itself, aiming to quiet neurogenic inflammation without the tissue-thinning or repeated-use limitations associated with repeated corticosteroid injections.

Can neural therapy and PIT be combined with prolotherapy?

Yes — they're commonly used together as part of a single treatment plan, since each targets a different tissue (nerve vs. ligament/tendon vs. autonomic ganglia). Dr. Gupta determines sequencing and combination based on your evaluation.

Is fibromyalgia specifically responsive to these treatments?

Because fibromyalgia involves autonomic and central nervous system sensitization, neural therapy's focus on the autonomic nervous system is a relevant, evidence-informed option to discuss — though, as with any fibromyalgia treatment, response varies from patient to patient and it is typically used as part of a broader management plan.[1]

Is this covered by insurance?

Neural therapy, PIT, and prolotherapy are generally billed as out-of-network or self-pay services, as is standard for regenerative and functional injection therapies. Our care team can walk you through costs and any applicable superbill documentation at your consultation.