Neural Therapy for Caesarean Section Scar Healing

I was first introduced to neural therapy by a patient.  She told me that her Naturopathic Doctor had done a series of neural therapy injection treatments along her Caesarean section scar. Since the section-birth of her first child four years earlier, she had suffered from abdominal pains and constipation. It was as if there was an area of her large intestine that was "frozen".  Manual care and nutrition interventions were very helpful but never fully resolved the issue.  After her series of neural therapy injections, her bowels started moving regularly, she responded more consistently to physical and chemical treatments, and her scar looked less bulky and paler.  I was intrigued.

Fast forward.  I had a good bulk of experience with postnatal recovery, including a variety of manual techniques to support healthy scar, fascial, and autonomic healing.  I also had a small number of patients mention neural therapy as a treatment used by their ND but it stayed in the back of my mind.  Then I had my own daughter via section.  Now I had the opportunity to practice what I preach in terms of postnatal rehab and to be my own guinea pig in exploring further treatment options for more complete healing for the moms I work with.

Re-enter neural therapy.  I wanted to experience first-hand what this obscure treatment was and how it worked. I also wanted to help in discerning which of my patients would benefit from it.  I connect with an ND in town who does injections therapies and we did a trial of 6 neural therapy injection sessions along my C-section scar.  Here is what I learned.

What is neural therapy?

Neural therapy is an injection treatment that uses a local anaesthetic (usually subcutaneous) into autonomic ganglia, peripheral nerves, scars, glands, trigger points, and other tissues. It is also known as therapeutic local anesthetia (TLA) and is in the same family as a nerve block. It contains a 0.5-2% solution of procaine (or sometimes lidocaine). Unless there is concern for a methylation or detoxification reaction, most doctors will also include methylated-B12 in the solution. Depending on the practitioner, it seems common to also include various homoeopathic agents based on clinical presentation.

The use of anaesthetics as a therapeutic agent dates back to the late 1800s and focusing on surgical scars has been in practice for almost 100 years. Although during treatment there some physical tearing of adhesions by the needle and a strong stretch of the fascial tissue by the injected fluid, the therapeutic focus of neural therapy is the autonomic nervous system. "The scientific basis of neural therapy rests on a simple neurophysiological truth: injury and illness often result in long-lasting  dysfunction of the autonomic nervous system." (DOSCH) Scars create physical barriers to neural integration, optimal tissue function, and cellular communication; they also create abnormal signal patterns that affect the autonomic nervous system (ANS) and its branches that may have ripple effects far from the originating site. This area within a state of neural irritation may be hypo- or hyper-polarized and is known as an "interference field". An injection of procaine into the exact location where the abnormal impulse starts can neutralize abnormal polarization, restore order to the impacted tissues, and lead to deeper healing.  It is a pattern interrupt that centers around increasing parasympathetic function.

It should be noted that, although the focus of this blog, this is not specific to scar tissue. Physical and chemical injuries, toxicity, and emotional conflicts also impact the ANS via the limbic hypothalamic axis.

My Personal Experience with Neural Therapy

I am not a very "good scarer" (not that that is a word). My scars tend toward keloid forming; they are chunky and restrictive. Even with relatively extensive soft tissue treatments along my section scar, I still had a fair bit of puckering. Three years after the birth of my daughter, I still had a small area of paresthesia north of my scar, which was not bothersome but I was aware of it. I was also made aware, with the help of a physio friend, that I have an area of numbness internally along a portion of my pelvic floor. Beyond that, I would not consider myself a symptomatic patient. I had returned to full activity (including my first triathlon and a small batch of ultra and adventure marathons). I did not have any pain, gastrointestinal, or genitourinary symptoms. One oddity was that, when laying down to read at night, I would always have to pee, even if I had just peed after brushing my teeth. This was inconvenient but hardly worth complaining about. Regarding neural therapy, although I could argue physical restriction, I was not sure whether or not I was a good candidate due to the lack of "problems". I did not have high expectations for notable symptomatic changes. I still wanted to do everything in my control to support full physical and functional recovery after major abdominal surgery.

This is not mine. I was not expecting such a dramatic change in appearance of my scar so I did not think to take a before and after photo.

The biggest takeaway that I had after my first session was that it hurts. It was very painful. I am probably in the middle ground in terms of pain threshold but I do have a history of poor tolerance to needles. When the needle was piercing the skin and when the fluids were being pushed in, I had to brace to stay still. After the first session, the area around my scar was very puffy, swollen, and bruised for three or four days. After each treatment, the swelling would dissipate faster and faster. This is actually what impressed me most about the treatment series; the changes in fascial mobility and fluid dynamics were fairly remarkable. The appearance of my scar has also changed dramatically. I now only have one small area that is thick and puckered; the rest is now smooth and much paler than before. Partially related, I have also been deliberately working on expanding my bladder capacity, which seems to be coming along better than previous attempts and I do not always have to pee when I lay down to read before bed. The pain did go down slightly each treatment but it was always an unpleasant physical feeling during injections for me.

Overview of Neural Therapy

I went in with a vague inclination of the likely structural and fascial implications of neural therapy. I had no idea of the far-reaching impacts and focus on the ANS (which is amusing considering how in line it is with chiropractic principles and therapeutic effect; in fact, the textbook by Kidd referred to early chiropractic and osteopathic influences as important in the progression of neural therapy in North America).

Neural therapy is a procaine injection-based treatment with broad implications based on an autonomic nervous system neutralizing effect. The potential physiologic impacts of this treatment are far-reaching and include balancing dysautonomia, supporting cell membrane integrity, improving fascial glide and mobility, and settling hormonal imbalances.

Depending on the practitioner doing the injections, neural therapy may vary. Some will take a very structural focus while others may depend on muscle testing to assess the area and directions of interference. Neural therapy integrates fluidly with homoeopathic, ayurvedic, and manual medicine. From my reconnaissance, it seems neural therapy is usually done in a batch of three to six treatments. The intention is to continue treatment until the tissue polarization remains neutral.

My motivation for seeking neural therapy was for physical scar release after Cesarean section. Other indications to consider include surgical scars (especially if there was an old infections along the scar), therapy-resistant disorders, chronic candida or UTIs, and hormonal imbalances (including fertility, libido, and PMS struggles). Although not strictly contraindicated, it is not commonly used during pregnancy, especially the first trimester. If you are looking into neural therapy post-section, I have been advised that it is recommended to wait for six weeks to three months after surgery. I also strongly recommend pairing neural therapy scar treatments with manual care. Find a chiropractor, physiotherapist, or massage therapist with experience and training in postnatal rehab for a complete recovery support.

References

  1. Dosch MP. (2003). Atlas of Neural Therapy with local anaesthetics (2nd ed.). New York: Thieme.
  2. Kidd RF. (2005). Neural Therapy: Applied Neurophysiology and Other Topics. Renfrew: Custom Distribution.
  3. Klinghardt DK. (1993). Neural Therapy. J Neurol Orthop Med Surg, 14: 109-114.
  4. Weinschenkab S. (2012). Neural therapy - A review of the therapeutic use of local anesthetics. Acupuncture and Related Therapies, 1(1):5-9.

I did do a brief literature search and was not able to find any English-language peer-reviewed articles examining neural therapy specific to postnatal or section recovery. (If you speak German, you may have much better luck than I did.) This blog is based on a growing understanding of the physiology, the information outlined in the textbooks referenced above, and me haranguing a few NDs in town for their clinical expertise over coffee.

AltaVie's ND Dr Stephanie Schiemann does many things, but injection therapies are not her clinical focus. If you are in Kelowna and looking to explore this further for yourself, I know that Dr Brent Barlow at the Kelowna Wellness Clinic and Dr Audrey Wolter at Mission Naturopathic Clinic are experienced in this technique.

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