Neural Therapy: Part of a Comprehensive Approach to Pain


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 underreacting, the question, ‘Why?’ is seldom asked.”  Robert Kidd, M.D.

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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 intradermally 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:

  1. The illness is not responding to other therapies.
  2. Another type of treatment has made the illness unexpectedly worse.
  3. 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.