Neural Therapy: Part of a Comprehensive Approach to Pain

LINK TO ORIGINAL ARTICLE / Townsend Letter Article October 2017 April 11th
By Jeff Harris, ND; Perry M. Perretz, DO; and Carolina Stephany Gonzalez, MD

“Given the importance of the autonomic nervous system in health and disease, it is surprising how little attention it receives in medical education and practice. When the ANS is overreacting or under-reacting, the question, ‘Why?’ is seldom asked.” Robert Kidd, M.D.

Neural therapy classically involves the injection of local anesthetics into autonomic ganglia, peripheral nerves, scars, glands, trigger points, acupuncture points, and other tissues with the goal of balancing the autonomic nervous system. It takes advantage of the body’s inherent electrical nature to relieve chronic pain and stress. Neural therapy is an important approach to the treatment of pain and many other conditions. This article will attempt to explain some the fundamental concepts of neural therapy, it’s history, and application in the treatment of painful conditions. A quick clinical vignette may help introduce the subject.

A.N. hated doctors, with good reason. She’d had over twenty surgeries in her life, for everything from trigger finger to ulcerative colitis. appendectomy, hysterectomy, and cholecystectomy, among others. Her surgeons had all done admirable work, but she was riddled with pain throughout her body, and no one could find a way to relieve it with medications or exercise. During her first examination it was clear that her scars were acting as “interference fields” that limited her body’s neurological equilibrium. The treatment of choice was neural therapy. After intradermal injections of her scars with 1% buffered procaine she nearly floated off the table with relief. Ranges of motion that had been limited for years returned almost instantly. Her pain was so greatly reduced that she changed her opinion of her doctors.

History

Neural therapy was first developed by the Huneke brothers, in Germany, during the first half of the twentieth century. As the story goes, their sister came to the office one day in 1925 with a migraine headache. They tried a new treatment on her with two products, one for intramuscular injection and another for intravenous delivery. Accidentally, they put the IM product (procaine) into the vein and the migraine went away! Only later did they realize what they had done. Frustrated that their intended intravenous medicine hadn’t worked for other patients, they finally found their mistake; that the solution they used for their sister was the procaine that had originally been intended only for numbing the site of the intramuscular injection! At the time it was thought that injecting procaine into the vein was dangerous, but their error had serendipitously proven it to be safe, and very effective.

With this understanding of procaine, the Huneke brothers advanced neural therapy by studying the past, and by practicing what they had learned. They found that in 1906, Spiess discovered that wounds and inflammatory processes subside more quickly, and with fewer complications, after local anesthetic. Then, in 1931, it was discovered that post-operative pain disappeared immediately after procaine infiltration of the surgical scar. They found that injecting procaine intra-dermally over painful areas treated the pain effectively, regardless of the location. Back pain, abdominal pain, joint pain… anywhere in the body. In 1940, they discovered what came to be known as the Huneke phenomenon, or “lightning reaction,” by injecting a scar on the lower leg with procaine, only to find an instantaneous release of otherwise chronic, intractable pain in the patient’s shoulder.

How does that work? Procaine is a local anesthetic that has some interesting properties. It is a vasodilator, which in the case of migraines is important, as the blood vessels are constricted in areas of pain. It is also numbing, of course, which takes away pain instantly. It is short acting, with a half-life of roughly 20 minutes, so the expectation is that the pain relief should not last longer than the anesthetic effect. But clinically, the effects are often found to be much longer! Why? This may require a little discussion of pathophysiology. Injured tissue loses the integrity of its resting membrane potential, causing its threshold for firing to decrease. As an anesthetic, procaine works to restore a normal resting membrane potential. While the anesthetic effect may be temporary, the restoration of normal resting potential may permanently influence the local tissue’s peripheral communication with the central nervous system.

More than one session may be needed to break a well-established dysfunctional chain of signals such as those responsible for migraines or cluster headaches, but an experienced practitioner will learn to interpret feedback from the autonomic nervous system to help unravel a coherent program of treatment.

The Interference Field

The key to applying neural therapy is finding the “interference field,” or “focus,” which is the region that presents a dysfunctional signal to the autonomic nervous system. All connective tissues are semi-conductors of electricity—most notably, nerves. There are electrically conducted reflexes that travel through the nerves, from the skin to the organs (somato-visceral) and back again (viscero-somatic). In fact, 80% of the sympathetic nerve fibers in the body course through, or near, the skin, making it a potent area for treatment. In neural therapy, we use the surface of the skin and subcutaneous tissues over the painful areas when treating all types of pain, and we utilize the somato-visceral and viscero-somatic relationships to help influence deeper structures. These “segmental” treatments are determined by the level of dermatomal, sclerotomal, or myotomal relationships to the affected areas. In this way, gastritis might be treated with segmental injections over the thoracic nerve roots from T5-T9. Sciatic nerve pain might be treated with segmental therapy to the nerve roots from T12-S2. Segmental therapy is a good option for pain that presents anywhere on the body. Not only does segmental therapy help directly with pain, but it increases the circulation of the treated area, so you get increased uptake of any medications used, and more effective removal of the waste products of inflammation associated with the pain.

Finding the Interference Field

The best way to uncover an interference field is by doing a careful history. Patients will almost always reveal something significant as they tell their stories. The most basic neural therapy question is, “What happened to you just before you had the pain?” If the answer is not immediately forthcoming, the question will often jog the patient’s memory at just the opportune moment to allow for a breakthrough.

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Sometimes, the interference field presents itself during the physical exam, as inspection, palpation, and intuition take over. The application of autonomic response testing, using muscle testing, has become almost indispensable in the practice of neural therapy, helping to quickly identify sources of neurologic dysfunction. This method can also be used to identify the sequence of sites to be treated, cooperating with the patient’s autonomic system in a way that is more likely to contribute grace and ease to the healing process.

Some indicators that an interference field is causing the present(ing) illness are the following:

  • The illness is not responding to other therapies.
  • Another type of treatment has made the illness unexpectedly worse.
  • All symptoms are located only on one side of the body.

(From Klinghardt, 1993.)

Some chronic problems are tied to specific interference fields that are common enough to be approached empirically. Acupuncturists will understand the relationship between an appendectomy scar or a hernia scar and chronic problems with ipsilateral hips or knees because the fascial plane of the stomach meridian has been interrupted in the surgical process. Similar understandings are achieved with regard to sciatic pain and interference fields on the legs—or migraines and issues with tonsils or teeth.

How Is an Interference Field Created?

Imagine what happens to the conduction of nerve impulses when there is an adhesion in the connective tissues, such as a scar. It is remarkable how often scars are tied to chronic pain, and how frequently they are overlooked by physicians who treat pain. Relieving the irritated nerves at the site of scarring has body-wide effects. A simple intra-cutaneous injection of procaine into the scar can make a world of difference.

What causes a scar to become an interference field? It could be from a terrifying event, like an automobile crash, or a surgery that was emotionally traumatizing. An emergency C-section, for instance, for an expectant mother who is shocked to find out that her baby’s life may be at risk. Maybe there is a complication, like poor wound healing from a post-surgical infection, or a retained suture that doesn’t dissolve. In this way, a scar is a more obvious site for an interference field, but interference fields can be triggered by almost any physiologic disturbance. Vaccination sites can become interference fields. Insect bites can cause interference fields. Dental issues can become interference fields.

Perry Perretz, DO: A patient in my practice was infected with Chikungunya virus that presented as a painful frozen left shoulder. It persisted weeks longer than would be expected from such an infection. This was relieved with a combination of local procaine injection to the site of the bite, and a “segmental” injection over the C6 nerve root.

Another patient had erroneously been diagnosed with rheumatoid arthritis, despite negative CCP and RF labs. He had swelling of knees, ankles, elbows, and wrists that added almost fifty pounds of weight to his body. An interference field in a root canal tooth was identified. I considered giving him a diagnostic injection of procaine to determine its importance, but he was already motivated to get rid of the tooth. Once the tooth was extracted his rheumatoid symptoms disappeared overnight, and he lost almost forty pounds within the week.

Emotions create powerful interference fields. In the October 2017 issue of the Townsend Letter, our colleague Michael Gurevich, MD, wrote an excellent article on the use of neural therapy in psychiatry. Clearly, we have begun to understand more about the effects of trauma upon the central nervous system. Other avenues of study have helped us understand more about post-traumatic stress and the induction of autonomic responses that are triggered by the engagement of a traumatic memory.

Jeff Harris, ND: I have worked with many soldiers who have had very severe pain and PTSD. Their pain medications weren’t helping. They were losing their relationships, or already had lost them. They hadn’t been able to sleep for days on end and they were desperate for help, knowing that many of their friends in the same situation had committed suicide. At first, I was nervous to treat them, but neural therapy has been almost magical for them. The very first one I saw had a bomb go off right in front of him while wearing an ordinance disposal suit. He was a star on a military athletic team, a family man with children. He suffered with chest pain and high blood pressure. I first treated the circumference of his head and the area over the left side of his chest, where most of the explosive impact had been absorbed. Immediately following this treatment, he asked if he could leave the office to sleep in his truck. I asked him to come back before he drove off so I could evaluate him. Four hours later, he came back and hugged me! He hadn’t slept for many days before, but he reported that he felt normal for the first time since the explosion. More importantly, he had hope for his future. He has seen me a number of times over the last few years, as he has needed additional treatment, but he says that the PTSD and pain have never returned to the level he felt prior to our first office visit. He has told his medical team on the military base about the treatments he received. He asked them to have me come and talk with them, but so far, they haven’t invited me.

COVID-19 and the “Long-Haulers”

Extreme stress can bring back the memory of trauma. The COVID-19 pandemic represents just such a trauma for some of those who have been infected. As this is a novel coronavirus, we are still struggling to understand the severity of its course for many different populations. We know that it is extremely contagious and that no one is naturally immune. Those infected have been forced to confront their diagnoses much the same as any terminally ill patient. Is this going to kill me? How badly will I suffer? Do I need to say good-bye to my kids? Change my will? Change my medical directives? Will I die alone? There is a subset of COVID-19 survivors who have endured the acute infection, only to find themselves exhibiting symptoms far beyond their “recovery.” They are referred to as “long-haulers.”

Perretz: Recently, I evaluated a long-hauler, infected in March 2020, still suffering symptoms of her viral illness in July, though she had tested negative since April. Her symptoms were pain, heaviness, and tightness in the chest, shortness of breath, and heart palpitations. X-rays, ECG, and labs were all negative. Surgical history included appendectomy, C-section, and breast implants. On physical exam, the lung reflexes were dysfunctional bilaterally, and the heart rhythm reflex was found to be positive. There were trigger points in the bilateral infraspinatus muscles known as the Infraspinatus Respiratory Reflex (IRR), the discovery of which is attributed to the late Dr. Henry Philibert, MD. Scars, in this situation, were not found to be neurologically active. Treatment was delivered with intradermal injections of procaine to the acupuncture points, Lung 1, bilaterally, CV15, for the heart reflex, and Governing Vessel 18. The IRR was injected with procaine, and a touch of Kenalog to increase respiratory ease. Osteopathic manipulation was employed to release the ribs, which had been restricted by coughing. Emotional Freedom Technique was also employed to address trauma. Immediate ease came to her breathing, and by the next day she was symptom-free.

Our colleague, Dr. Stephany Gonzalez, performed a seven-year (2012-2019) retrospective evaluation of neural therapy’s efficacy for chronic pain syndromes in 130 patients. All patients in the study reported pain greater than three months’ duration that had failed to respond to conventional treatment.

Results showed that ALL patients receiving neural therapy treatment reported some improvement after an average of 1.7 visits. Ninety-four point six percent (94.6%) reported decreases in pain by Visual Analog Scale. Sixty-two point three percent (62.3%)reported VAS decreases of 5 levels, or greater. In total, 76% of surveyed patients achieved remission or near-remission of chronic pain with neural therapy treatment.

In summary, neural therapy’s chief application has come as a treatment for chronic pain and illness, and one of its greatest values is that it represents a comprehensive approach to physiology, avoiding some of the reductionistic traps of Western diagnosis. An aspect of its attractiveness is that it can be appreciated by professionals from a wide range of trainings, and it provides the perfect blend of Eastern and Western medicine. A typical Western-trained medical doctor can easily understand the use of anesthetics to neutralize dysfunctions of the autonomic nervous system, but might be surprised at how the application of this model tends to “teach” us how a patient compensates, as an individual, to the experiences of life. A naturopath might be excited to exploit neural therapy’s ability to determine root causes of illness and pain and treat them using the least possible force. An acupuncturist might see neural therapy as a form of medically applied acupuncture, and the dentists will be pleased to see how neural therapy recognizes the influence of the teeth and oral cavity on the health of the entire individual.

Neural therapy is practiced more in Europe and South America than in North America, but it is gaining traction here. Much of the earlier literature is in German, but translations in English and Spanish have been available for years now. Many of us in North America owe a great debt to Dr. Dietrich Klinghardt for his teaching. Within the last three years, a North American Academy of Neural Therapy has been created to encourage leadership and training for professionals of various disciplines. Membership and continuing education opportunities are available through its website, www.NAANT.org.

Resources

Klinghardt DK. Neural Therapy. J Neurol Orthop Med Surg. 1993;14: 109-114.

Kidd RF. Neural Therapy: Applied Neurophysiology and Other Topics. Renfrew, Ontario, K7V 1T6. Self-published rfkidd@onn.aib.com 2005.

Gurevich M. Innovative Approach to Psychiatry: Treating Incurable Psychiatric Patients with neural Therapy. Townsend Letter. October 2017; pp 51-54.

Gonzalez CS, et al. Effective Treatment of Chronic Pain Syndromes Using Neural Therapy. Poster presentation at First Congress of the North American Academy of Neural Therapy, Orlando, FL; Feb 27-Mar 1, 2020.

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