Nociceptive vs. Neuropathic Pain

Pain is not all the same. Understanding the difference is key to finding effective treatment:

• Nociceptive pain occurs when tissues are damaged by physical or chemical agents such as trauma, surgery, or burns. The damaged tissues send pain signals to the brain.
• Neuropathic pain is different. It comes from dysfunction in the nerves themselves. Instead of a clear injury, the nerves are compressed, swollen, or starved of oxygen and nutrients (especially glucose). This suffocation leads to abnormal pain signaling.

Common causes of neuropathic pain include:

• Tissue swelling (edema)
• Nerve swelling in response to exercise
• Muscle swelling that compresses nearby nerves
• Tight anatomical passages (fascia tunnels, bony canals)
• Chronic constriction injuries (CCI)
• Entrapment at Valleix points — locations where nerves are vulnerable (against bone, piercing fascia, branching, or exiting canals).

This kind of pain is often described as:

• Burning
• Stabbing
• Crushing
• Worse at night
• Triggered by normally harmless stimuli like light touch or cold

Neuropathic pain is one of the most debilitating forms of chronic pain, often robbing people of sleep, work, and quality of life.

Why Standard Treatments Fall Short

Conventional approaches — painkillers, nerve blocks, antidepressants, physical therapy, even surgery — often provide only partial or temporary relief. That’s because they don’t address the underlying problem: the injured and inflamed nerves themselves.

PIT and Dextrose: How It Works

Perineural Injection Therapy (PIT), pioneered by John Lyftogt, MD, directly targets the small sensory nerves (nociceptors and nervi nervorum) that drive neuropathic pain.

The treatment uses gentle injections of a natural sugar solution (dextrose) just beneath the skin, around affected nerves.

Clinical effects of Dextrose:

• Transient elimination of neuropathic pain
• Reduction in neurogenic inflammation

Hypothesized mechanisms:

• TRPV1 channel modulation: Dextrose appears to reconfigure the TRPV1 channel (a key nerve pain receptor), lowering abnormal pain signaling back to normal thresholds.
• Sodium/Calcium current modulation: Helps nerves fire normally rather than excessively.
• Reduced NGF production: NGF (nerve growth factor) drives inflammation and hypersensitivity; PIT seems to calm this process.
• Hydrodissection: The injected solution physically separates tight tissues, relieving pressure on nerves.
• Nutrition: Glucose feeds the starving nerve, restoring normal function.

In simple terms:

PIT reduces the “suffocation and starvation” of nerves, restoring their health and stopping the abnormal pain signals.

The Results

Clinical experience shows that PIT relieves pain in 80–90% of cases of neuropathic pain. Patients often notice improvements in walking, sleeping, and returning to activities they thought they had lost forever.

As Dr. Lyftogt summarizes:

“Full and effective regeneration of the peripheral nervous system usually extinguishes this pain.”

Key Insight: “Pain due to Nervi Nervorum”

The nervi nervorum are tiny nerve fibers that supply the outer coverings of nerves themselves. When compressed, stretched, or inflamed, they generate severe pain signals.

French physician François Valleix (1841) described specific tender points along nerve trunks, now called Valleix’s Points, where pain is most likely:

• Where nerves lie against bone or fascia
• Where they pierce through tissue layers
• Where they split into branches
• Where they emerge from bony canals

These are the exact places where PIT is most effective.

A Patient Story

One patient came in with chronic low back pain that had been present for years.

• They had already tried surgery and many different kinds of injections, but the pain was still constant at about 6/10.

Here’s what happened with PIT:

• After the first treatment: pain relief the same day — pain dropped and shifted to another spot.
• One week later: the pain was only 2–3/10 and came and went instead of being constant.
• Next visit: pain was around a 2/10 in another area, but it was much less frequent.
• Final visit: only a few very mild new spots (1–2/10), and then no pain at all.

This pattern is common: pain gets lighter, less constant, and more scattered until it fades completely.

Why PIT is Different

Unlike conventional pain treatments that mask symptoms, PIT works at the root cause of neuropathic pain: injured, inflamed, and starved nerves.

• Safe, natural solution (dextrose)
• Gentle, precise technique
• High success rates (80–90%)
• Restores quality of life without dependence on drugs or surgery

 Conclusion:
If you suffer from burning, stabbing, or crushing pain that doesn’t respond to typical treatments, you may have neuropathic pain — and PIT offers a proven path to relief by restoring nerve health and function.