I'm excited to share that Dr. Paige Weatherbee-Sakr has expanded her therapeutic offerings to include Perineural Injection Therapy (PIT)—a specialized treatment approach for chronic nerve-related pain. As naturopathic physicians, we're always seeking evidence-informed therapies that address the root causes of our patients' concerns while supporting the body's inherent healing capacity. PIT represents an excellent addition to the comprehensive care we provide at Symmetry.
Understanding Neurogenic Inflammation
When we think about pain, we often focus on tissue damage—injured muscles, inflamed joints, damaged ligaments. And certainly, addressing these tissue-level concerns is crucial. However, there's another important component to chronic pain that we sometimes overlook: the nervous system's own inflammatory response.
When peripheral nerves are compressed, stretched, or injured, they don't just passively transmit pain signals—they actively generate inflammation themselves. This neurogenic inflammation involves the release of neuropeptides like substance P, which perpetuate pain signaling and maintain inflammatory processes even after the original tissue injury has healed.
This is why some patients continue experiencing pain long after we'd expect tissues to have recovered, and why that pain often has a distinctive nerve-related quality: burning, tingling, electrical sensations, or hypersensitivity that seems disproportionate to findings on physical examination.
What is Perineural Injection Therapy?
Perineural Injection Therapy involves the subcutaneous injection of a dilute 2% procaine solution immediately adjacent to superficial nerves that are inflamed or irritated. The mechanism isn't fully understood, but research suggests that the procaine solution may help restore normal nerve function by addressing neurogenic inflammation and supporting nerve healing.
The treatment is quite gentle—injections are shallow, using small volumes just under the skin along the pathway of affected nerves. It's not a deep tissue injection, and it's generally well-tolerated with minimal discomfort.
When Might PIT Be Appropriate?
From a naturopathic perspective, PIT is most valuable when we've addressed foundational concerns—nutrition, inflammation, digestive health, stress—but patients still experience persistent neuropathic pain that limits their function and quality of life.
PIT may help patients experiencing:
Chronic pain with neuropathic characteristics (burning, tingling, shooting, electrical quality)
Pain that follows specific nerve distributions
Superficial pain caused by nerve compression from underlying structural issues
Chronic headache patterns involving nerve irritation
Pain that has persisted despite other appropriate interventions
It's particularly effective for conditions where we can identify specific superficial nerves that are contributing to the pain pattern—occipital neuralgia, certain types of chronic neck and shoulder pain, lateral hip pain involving the lateral femoral cutaneous nerve, and various other presentations where nerve involvement is clear.
The Naturopathic Principle: Treat the Cause
It's worth noting that PIT doesn't replace our commitment to identifying and addressing root causes. If nerve inflammation is occurring, we still need to ask why. Is there structural compression that needs osteopathic or chiropractic attention? Is there systemic inflammation that requires nutritional intervention? Are there biomechanical issues that need physiotherapy? Is there fascial restriction that massage therapy could address?
PIT supports the nerve's healing while we continue addressing these underlying factors. It's not a standalone solution but rather one component of comprehensive care.
Clinical Considerations
Treatment protocols are individualized, but typically involve a series of sessions—often 4 - 8 treatments initially, though some patients respond more quickly. Response is usually gradual, with incremental improvement over several weeks as neurogenic inflammation reduces and normal nerve function is restored.
PIT works alongside other treatments. Patients continue with their physiotherapy, osteopathic care, acupuncture, massage, and naturopathic protocols. This collaborative approach is what creates the best outcomes.
Is PIT Right for You?
Dr. Weatherbee-Sakr is offering free consultations to help patients understand whether this therapy might be appropriate for your specific situation. As always, treatment decisions are made collaboratively, with full consideration of each person's unique health picture, goals, and values.
Moving Forward
The addition of Perineural Injection Therapy strengthens the already comprehensive toolkit available at Symmetry Wellness Centre. It represents another way we can support those dealing with complex chronic conditions—combining cutting-edge therapeutic approaches with the time-tested naturopathic principles of treating the whole person and supporting the body's healing capacity.
If you have questions about PIT or want to discuss whether it might benefit you, please reach out to Dr. Weatherbee-Sakr or book a free consultation.
