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Empire Medical Training's Perineural Injection Therapy (PIT) Training is a specialized, CME-accredited certification program that teaches healthcare professionals to perform subcutaneous injections of buffered dextrose solution along superficial peripheral nerves to treat neuropathic pain and chronic pain conditions. Perineural injection therapy — also known as neural prolotherapy or Lyftogt perineural injection treatment — targets neurogenic inflammation by delivering low-concentration dextrose to the subcutaneous tissue surrounding cutaneous nerves that have become chronically irritated and inflamed.
This innovative pain management approach addresses a significant clinical gap: the large population of patients with chronic neuropathic pain, treatment-resistant musculoskeletal pain, and post-surgical pain syndromes who have not responded adequately to conventional treatments including oral medications, physical therapy, and traditional corticosteroid injections. Perineural injection therapy offers these patients a safe, minimally invasive treatment option with minimal side effects and growing clinical evidence supporting its efficacy.
Through comprehensive didactic education on the neurogenic inflammation model and supervised hands-on training in subcutaneous nerve palpation and injection techniques, you will learn to identify treatable superficial nerve sites, perform precise perineural injections, and develop multi-session treatment protocols for chronic pain conditions affecting the head, neck, trunk, and extremities. Empire's faculty guide you through the clinical reasoning and technical skills that make PIT an effective addition to your interventional pain management toolkit.
Learn More About Perineural Injection Therapy (PIT) Training CoursePerineural Injection Therapy (PIT) Training Workshops Calendar
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Livestream Virtual Course
Sun, Apr 5, 2026
10:00 AM ET
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Master essential techniques and protocols through our comprehensive, CME-accredited curriculum.
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Our Perineural Injection Therapy Training training in Empire Virtual Training, Online is open to licensed medical professionals looking to expand their clinical expertise.
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Perineural injection therapy (PIT) involves the subcutaneous injection of a low-concentration buffered dextrose solution (typically 5% dextrose) along the course of superficial peripheral nerves that have become chronically irritated and inflamed. The dextrose interacts with TRPV1 receptors on sensory nerve fibers, reducing neurogenic inflammation and restoring normal nerve function. This mechanism addresses the underlying neural dysfunction rather than simply masking pain.
PIT has demonstrated clinical efficacy for chronic neuropathic pain conditions including headaches and migraines, chronic neck and back pain, lateral epicondylitis, Achilles tendinopathy, knee pain, post-surgical pain syndromes, and various other chronic musculoskeletal pain conditions that have a significant neuropathic component. It is particularly valuable for patients who have not responded adequately to conventional pain treatments.
Most patients require a series of four to eight treatment sessions spaced one to two weeks apart, though significant pain reduction is often noticed after the first two to three treatments. Some chronic conditions may require additional maintenance sessions. The course teaches you how to structure multi-session treatment protocols and track clinical outcomes to guide treatment duration.
PIT has an excellent safety profile because the injections are performed subcutaneously (not deep) using a very low-concentration dextrose solution rather than corticosteroids or other medications with systemic side effects. The most common side effect is mild, temporary discomfort at injection sites. The superficial injection depth and benign injectate make PIT one of the safest interventional pain procedures available.
Traditional prolotherapy (regenerative injection therapy) uses higher-concentration dextrose solutions (typically 15-25%) injected into ligament and tendon attachments to stimulate a healing inflammatory response. Perineural injection therapy uses much lower concentrations (5%) injected subcutaneously along superficial nerve pathways to reduce neurogenic inflammation. The targets, mechanisms, and concentrations are distinctly different despite both using dextrose.
Yes, PIT integrates well with other pain management modalities including joint injections, trigger point injections, physical therapy, regenerative medicine treatments, and chiropractic care. Many practitioners use PIT as part of a comprehensive, multi-modal pain management approach that addresses both neuropathic and nociceptive pain components simultaneously.
PIT requires minimal equipment — small gauge needles (typically 27-30 gauge), sterile buffered dextrose solution, syringes, and standard injection supplies. The low equipment cost and absence of expensive imaging or specialized devices make PIT one of the most accessible interventional pain procedures to add to a practice, with virtually no barrier to entry beyond proper training.
Yes, Empire Medical Training's Perineural Injection Therapy Training is fully CME/CE accredited. You receive certification documenting your training in PIT techniques along with earned CME/CE credits applicable to license renewal and professional development requirements for your specific healthcare profession.
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