Long-term results of therapeutic local anesthesia (neural therapy) in 280 referred refractory chronic pain patients

Abstract

BackgroundCan the application of local anesthetics (Neural Therapy, NT) alone durably improve pain symptoms in referred patients with chronic and refractory pain?If the application of local anesthetics does lead to an improvement that far exceeds the duration of action of local anesthetics, we will postulate that a vicious circle of pain in the reflex arcs has been disrupted (hypothesis).MethodsCase series design. We exclusively used procaine or lidocaine. The inclusion criteria were severe pain and chronic duration of more than three months, pain unresponsive to conventional medical measures, written referral from physicians or doctors of chiropractic explicitly to NT. Patients with improvement of pain who started on additional therapy during the study period for a reason other than pain were excluded in order to avoid a potential bias. Treatment success was measured after one year follow-up using the outcome measures of pain and analgesics intake.Results280 chronic pain patients were included; the most common reason for referral was back pain. The average number of consultations per patient was 9.2 in the first year (median 8.0). After one year, in 60 patients pain was unchanged, 52 patients reported a slight improvement, 126 were considerably better, and 41 pain-free. At the same time, 74.1 % of the patients who took analgesics before starting NT needed less or no more analgesics at all. No adverse effects or complications were observed.ConclusionsThe good long-term results of the targeted therapeutic local anesthesia (NT) in the most problematic group of chronic pain patients (unresponsive to all evidence based conventional treatment options) indicate that a vicious circle has been broken. The specific contribution of the intervention to these results cannot be determined. The low costs of local anesthetics, the small number of consultations needed, the reduced intake of analgesics, and the lack of adverse effects also suggest the practicality and cost-effectiveness of this kind of treatment. Controlled trials to evaluate the true effect of NT are needed.

Evaluation of Neural Therapy Effects in Patients with Lateral Epicondylitis: A Randomized Controlled Trial

“…22 NT is not only a local injection, but also includes segmental and supra-segmental injections and the effect of NT in other painful musculoskeletal disorders have been shown in previous studies. 11,12 According to the authors, the effects of NT in patients with LE were shown for the first time in this study, and according to our results, NT is an effective treatment modality for LE.…”

“…The regulatory mechanisms of the nervous system are used mainly on segmental reflector processes and the interference field described as the zone that initiates and/or maintains pain and inflammation, regardless of the related segment. [11][12][13] The effect of NT was previously reported in various painful musculoskeletal disorders. 9,10 The authors claimed that NT is more effective than traditional treatment methods (including rest, bracing, non-steroidal anti-inflammatory drugs) in these patients.…”

“…9,18 Previous studies have demonstrated that NT is an effective treatment modality for painful musculoskeletal disorders. 11,12 Mardani et al reported that local anesthetic injection (only local application) was not as effective as corticosteroid injection in patients with LE. 22 NT is not only a local injection, but also includes segmental and supra-segmental injections and the effect of NT in other painful musculoskeletal disorders have been shown in previous studies.…”

Eficacia de la terapia neural en pacientes con dolor cervical o lumbar, del servicio de medicina física y rehabilitación de un centro hospitalario, 2016

“…Estos resultados coinciden con varios estudios experimentales donde se logró una disminución significativa del dolor durante las primeras semanas de tratamiento 19,20,21 .…”

Neural Therapy Protocols in Musculoskeletal Disorders: Review

“…Nöralterapi lokal anestezik maddelerin vücudun belirli noktalarına enjekte edilmesi ile nörovejetatif sinir sistemi üzerinde etki elde edilmesinin amaçlandığı bir tedavi yöntemidir (1,2). Nörovejetatif sistem vücudumuzun kapiller yapısına kadar ulaşan ve her yeri kuşatan bir network ağı gibi çalışmaktadır.…”