Global Journal of Medical Research, F: Diseases, Volume 22 Issue 6

neuropathic pain. Some patients have a very thin epidermis, which makes IC injections impossible, so one has to rely on SC injections instead. The injections are usually given 1 cm apart. About 0.5 to 1 mL is given in each spot with a 30 G or 27 G needle. The total volume per session is usually between 2 and 20 mL, depending on the size of the tender region. It often happens that the patient experiences immediate pain relief a few seconds or minutes after the glucose 5% injections. This is rather surprising, as no local anesthetics are added to the glucose. Unfortunately, this pain modulating effect of glucose 5% lasts only for a few hours to a few days. In some patients, the symptomatic improvement only becomes apparent after the second or third session. To obtain long term results, repetition is required until lasting pain relief has been achieved. XII. C onclusion In the search for treatment modalities which are safe, affordable and effective, several clinicians worldwide have experienced that glucose 5% injections are an inexpensive treatment to reduce their patient’s intake of pain medication. This is especially true for mild forms of regional neuropathic pain. More research in this field may confirm their clinical findings. Table-1 Difference PT and GP Prolotherapy Glucopuncture What? Hypertonic Glucose x Local Anesthetics x Glucose 5% in Water x Where? ID x IM x IL x x IA x How? Osmotic Shock x Proliferation x ATP Production x x TRPV1 (Needle Effect) x x Table: Difference between PT (Prolotherapy) and GP (Glucopuncture). ID: Intradermal. IM: intramuscular, IL: intraligamentous, IA: intraarticular Intradermal Glucose 5% Injections for Mild Localized Neuropathic Pain- A New Approach to Reduce Pain Medication 4 Year 2022 Global Journal of Medical Research Volume XXII Issue VI Version I ( D ) F © 2022 Global Journals i Kehlet H, Jensen TS, Woolf CJ. Persistent postsurgical pain: risk factors and prevention. Lancet. 2006 May 13;367(9522):1618-25. doi: 10.1016/S0140-6736(06)68700-X. PMID: 16698416. ii Reddi D, Curran N. Chronic pain after surgery: pathophysiology, risk factors and prevention. Postgrad Med J. 2014 Apr; 90(1062): 222-7; quiz 226. doi: 10.1136/ postgradmedj-2013-132215. Epub 2014 Feb 26. PMID: 24572639. iii Bove GM, Dilley A. The conundrum of sensitization when recording from nociceptors. J Neurosci Methods. 2010 May 15;188(2):213-8. doi: 10.1016/j.jneumeth.2010.02.010. Epub 2010 Feb 18. PubMed PMID: 20171245; PubMed Central PMCID: PMC2854223. iv Bove GM. Epi-perineurial anatomy, innervation, and axonal nociceptive mechanisms. J Bodyw Mov Ther. 2008 Jul;12(3):185-90. doi: 10.1016/j.jbmt.2008.03.004. Epub 2008 May 21. Review. PubMed PMID: 19083672; PubMed Central PMCID: PMC2610338 v Pinho-Ribeiro FA, Verri WA Jr, Chiu IM. Nociceptor Sensory Neuron-Immune Interactions in Pain and Inflammation. Trends Immunol. 2017 Jan;38(1):5-19. doi: 10.1016/j.it.2016.10.001. Epub 2016 Oct 25. PMID: 27793571; PMCID: PMC5205568. vi Chen O, Donnelly CR, Ji RR. Regulation of pain by neuro- immune interactions between macrophages and nociceptor sensory neurons. CurrOpinNeurobiol. 2020 Jun; 62:17-25. doi: 10.1016/j.conb.2019.11.006. Epub 2019 Dec 3. PMID: 31809997; PMCID: PMC7266706. vii Jensen T.S., Baron R., Haanpää M., Kalso E., Loeser J.D., Rice A.S., Treede R.-D. A new definition of neuropathic pain. Pain. 2011; 152:2204–2205. doi: 10.1016/j.pain.2011.06.017 viii Van Hecke O., Austin S.K., Khan R.A., Smith B.H., Torrance N. Neuropathic pain in the general population: A systematic review of epidemiological studies. Pain. 2014; 155:654–662. doi: 10.1016/j.pain.2013.11.013. ix Cavalli E, Mammana S, Nicoletti F, Bramanti P, Mazzon E. The neuropathic pain: An overview of the current treatment and future therapeutic approaches. Int J Immunopathol Pharmacol. 2019 Jan-Dec; 33:2058738419838383. doi: 10.1177/2058738419838383.PMID: 30900486; PMCID: PMC 6431761. x Ellis A, Bennett DL. Neuroinflammation and the generation of neuropathic pain. Br J Anaesth. 2013 Jul;111(1):26-37. doi: 10.1093/bja/aet128. PMID: 23794642. xi Wang C, Gu L, Ruan Y, et al. Pirt Together with TRPV1 Is Involved in the Regulation of Neuropathic Pain. Neural Plast . 2018; 2018: 4861491. Published 2018 Apr 2. doi:10.1155/2018/4861491