Neuro Prolotherapy for Sciatica – How Perineural Injection Therapy Treats Sciatic Nerve Pain

August 12, 2026

Sciatica is one of the most common and most debilitating pain conditions we treat at Proback Clinic. The shooting, burning, electric pain that travels from the lower back through the buttock and down the leg is instantly recognisable to anyone who has experienced it – and for many patients it becomes a chronic, life-limiting condition that conventional treatment struggles to resolve.

At Proback we offer a comprehensive sciatica treatment programme that combines multiple approaches to address every component of the condition simultaneously. One of the most important – and least well known – of these is Neuro Prolotherapy, also known as Perineural Injection Therapy or PIT. In this post we explain what Neuro Prolotherapy is, how it works for sciatica specifically and why it is often the missing piece for patients who have not found lasting relief through other approaches.

What Is Neuro Prolotherapy?

Neuro Prolotherapy – developed by New Zealand physician Dr John Lyftogt – is a technique that uses precise subcutaneous micro injections of natural 5% dextrose solution along the superficial pathways of hypersensitised peripheral nerves. The dextrose solution reduces neurogenic inflammation – the chronic inflammatory process occurring around the nerve itself – and restores normal nerve function by calming the hypersensitised nerve pathway rather than blocking or suppressing it.

Unlike standard Prolotherapy which targets ligaments and deeper soft tissue structures, Neuro Prolotherapy works at the superficial nerve level – targeting the small unmyelinated C fibres and thinly myelinated A-delta fibres that are responsible for pain signalling and that become chronically sensitised in conditions like sciatica.

Why Does Sciatica Become Chronic?

Understanding why sciatica becomes chronic is essential to understanding why Neuro Prolotherapy is so relevant. Sciatica begins as a structural problem – a herniated disc, spinal stenosis, piriformis compression or sacroiliac dysfunction compresses or irritates the sciatic nerve root. The nerve becomes inflamed and begins generating pain signals.

In many cases, even after the structural compression partially resolves – or is treated with Spinal Decompression, physio or other interventions – the pain continues. This is because the nerve has become chronically sensitised. The peripheral nervous system has essentially learned to generate pain signals independently of the original structural cause. This neurogenic sensitisation is a separate problem from the original disc or joint issue and requires a separate treatment approach.

This is precisely why so many sciatica patients reach a plateau with structural treatments alone – the structural cause has been addressed but the neurogenic sensitisation driving the ongoing symptoms has not been.

How Neuro Prolotherapy Treats the Sciatic Nerve Pathway

For sciatica specifically Neuro Prolotherapy targets the superficial pathways of the sciatic nerve and its branches along the full course of the nerve – from the lower lumbar nerve roots through the gluteal region, down the back of the thigh, through the popliteal fossa and into the calf, ankle and foot.

Precise micro injections of 5% dextrose solution are placed subcutaneously at regular intervals along the nerve pathway – typically every two to three centimetres. The dextrose reduces the neurogenic inflammation around the nerve, calms the hypersensitised C fibres that are generating the burning and shooting pain and gradually restores normal nerve function along the entire length of the sciatic pathway.

The procedure is relatively comfortable – the needles are extremely fine and the dextrose solution itself does not cause the discomfort associated with deeper injection techniques. Most patients notice a meaningful reduction in their sciatic symptoms within the first one to three sessions.

Neuro Prolotherapy as Part of a Comprehensive Sciatica Programme

At Proback we rarely use Neuro Prolotherapy in isolation for sciatica. It is most effective when combined with treatments that address the structural components of the condition simultaneously. Our typical sciatica programme combines:

Spinal Decompression Therapy – addressing the disc herniation or stenosis that is compressing the nerve root
Prolozone and Prolotherapy – reducing inflammation around the disc and nerve root and strengthening the surrounding spinal structures
Hydro-Release – releasing fascial adhesions or soft tissue restrictions along the sciatic pathway where entrapment is contributing to symptoms
Neuro Prolotherapy – calming the hypersensitised sciatic nerve pathway from root to foot

This comprehensive approach addresses the mechanical, regenerative and neurogenic components of sciatica simultaneously – which is why we see consistently strong results where structural treatment alone has reached a plateau.

Who Benefits Most from Neuro Prolotherapy for Sciatica?

Neuro Prolotherapy is particularly beneficial for patients with:

Chronic sciatica where structural treatment has helped but symptoms persist
Burning, electric or hypersensitive sciatic pain – particularly where the nerve feels irritable and easily triggered
Post surgical sciatica – where scar tissue and residual nerve sensitisation are maintaining symptoms after disc or spinal surgery
Sciatica with distal symptoms extending into the calf, ankle or foot
Small fibre neuropathy or peripheral neuropathy alongside sciatic involvement

The Evidence for Perineural Injection Therapy

The clinical evidence for Neuro Prolotherapy and perineural injection therapy has been growing significantly over the past decade. Dr Lyftogt’s published clinical series demonstrated consistent pain reduction across multiple peripheral nerve pain presentations. More recently a double blind RCT published by Mansiz-Kaplan et al 2022 demonstrated significantly better outcomes for 5% dextrose injection compared to corticosteroid injection for ulnar neuropathy – directly supporting the mechanism of dextrose as a neurogenic anti-inflammatory agent. The broader Frontiers in Pharmacology systematic review on hydrodissection also supports the role of dextrose in nerve pain presentations.

Why Choose Proback for Neuro Prolotherapy for Sciatica in London?

Proback is the official UK training partner of the European School of Prolotherapy and our practitioners have extensive specialist training in perineural injection therapy alongside our full regenerative injection programme. All procedures are performed under clinical assessment with ultrasound guidance where appropriate.

We are based in Victoria, Central London – five minutes from Victoria station – and are consistently rated Excellent on Trustpilot with over 560 verified patient reviews.

Give us a call on 0207 976 6648 or email victoria@proback.co.uk. Initial consultation £110 – reduced from £270.

Proback Clinic, 4 Evelyn Mansions, Carlisle Place, Victoria, London SW1P 1NH