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Perineural Injections in Vero Beach, FL

Medically reviewed by Dr. Alita Sikora, MD, Board Certified in Physical Medicine and Rehabilitation | Last medically reviewed: September 4, 2026
Home » Services » Regenerative-Medicine » Pain-Management » Perineural-Injections

Targeted Support for Nerve Pain & Chronic Inflammation

Perineural Injection Therapy (PIT) is a gentle, minimally invasive treatment designed to support irritated or dysfunctional peripheral nerves. Developed by Dr. John Lyftogt in New Zealand and introduced to our practice by Dr. Sikora, this technique targets injured or non-healing sensory nerves that may cause muscle tightness, joint pain, or soft-tissue pain.

When nerves near the skin’s surface become inflamed—often due to overuse, injury, movement over bony surfaces, or entanglement with scar tissue—they can contribute to pain, burning, tightness, and restricted movement, particularly in conditions affecting tendons, joints, or nerves.

PIT uses a diluted dextrose solution, delivered just beneath the skin (without steroids or anesthetics), to help calm “sensitized” sensory nerves. This approach may support healthier nerve signaling, reduce neurogenic inflammation, and enhance comfort and mobility without the need for invasive surgery.

Targeted Support for Nerve Pain & Chronic Inflammation
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    Key Benefits of Hormone Pellet Therapy

    Key Benefits of Perineural Injection Therapy

    PIT may offer support for:

    • Calming nerve irritation and hypersensitivity
    • Reducing chronic or stubborn pain patterns
    • Supporting mobility and range of motion
    • Improving tissue comfort and function
    • Reducing inflammation around superficial nerves
    • Complementing other regenerative treatments

    Because PIT works directly on the irritated nerve pathways, many patients notice a change soon after treatment.

    Conditions Supported with Perineural Injections

    PIT may be recommended for:

    Chronic Nerve Pain or Neuralgia

    PIT may help calm irritated superficial nerves, reducing ongoing sensitivity or discomfort.

    Entrapment Neuropathies

    PIT may help ease symptoms from compressed or irritated sensory nerves.

    Post-Injury Nerve Irritation

    PIT may support healing environments for nerves irritated after a sprain, strain, or soft-tissue injury.

    Tendon or Ligament Pain with Nerve Involvement

    By calming nearby irritated nerves, PIT may help reduce pain around stressed tendons or ligaments, including the Achilles and patellar tendons.

    Shoulder, Elbow, Knee, or Ankle Nerve-Path Irritation

    PIT may help calm inflamed or overactive nerves in common joint areas affected by daily movement.

    Radiating or Hypersensitive Nerve Pain

    PIT may help quiet overactive sensory nerves that cause sharp, shooting, burning, “zinging,” or electrically sensitive pain.

    Overuse-Related Nerve Irritation

    PIT may help reduce friction-related nerve irritation from repetitive motion or high-impact activity, including IT band syndrome in runners and cyclists.

    Neck or Low-Back Nerve Irritation

    These injections may help alleviate burning, zinging, or hypersensitive pain patterns associated with surface-level nerve irritation.

    Research support is strongest for entrapment neuropathies such as carpal tunnel syndrome and ulnar neuropathy, where controlled trials have compared dextrose injection to corticosteroids. Other uses are based on clinical experience and emerging evidence. We will assess whether PIT is the proper treatment based on your symptoms and the pattern of nerve tenderness.

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    How Perineural Injections Work

    We offer three customizable microneedling options to suit different goals and skin needs.

    Perineural (superficial sensory) nerves can become inflamed due to injury, compression, repetitive strain, movement over bone surfaces (such as in runners or cyclists), or by becoming entangled in scar tissue in tendons.

    PIT uses:

    • A dilute dextrose solution
    • Shallow injections along the nerve course, just beneath the skin, much like a TB test or pin-prick
    • Targeted treatment of sensitized nerve branches, avoiding steroids or anesthetics

    This helps reduce “over-firing” of irritated nerves and supports healthier nerve function. PIT is often used as part of a comprehensive plan alongside physical therapy, regenerative injections, or lifestyle corrections

    How Perineural Injections Work
    Safety and Considerations

    Safety and Considerations

    PIT is minimally invasive, but understanding what to expect and when to exercise extra caution can help you prepare for treatment.

    • What you may feel afterward: Mild redness, tenderness, or a small welt at the injection sites, usually settling within a day.
    • Dextrose is a sugar solution: The concentration used is low, but tell us if you have diabetes so we can plan accordingly.
    • Anti-inflammatories: Patients are often advised to avoid NSAIDs for a few days after dextrose injections, since they may work against the intended response.
    • A favorable safety profile: Dextrose injections are associated with fewer adverse effects than corticosteroids, which is part of why they are considered for patients who want to avoid steroids.
    • Not appropriate with active infection: Treatment is avoided over an infected area, and candidacy is reviewed if you take blood thinners.
    • Evidence is still developing: AAPM&R describes dextrose injection as an option for carefully selected patients who have not responded to more conventional non-surgical care.

    Your Perineural Injection Treatment

    PIT is a comfortable, quick, and minimally invasive procedure. Here’s what to expect during the process:

    1

    Preparation

    We evaluate your symptoms, map the affected nerve pathways, and identify which nerves require treatment.

    2

    Injection

    A very short, small needle is used to place the diluted dextrose solution beneath the skin along the tender nerve pathways. The procedure often takes 10–20 minutes.

    3

    Recovery

    Most patients resume regular activity immediately. Mild redness or tenderness at injection sites may occur temporarily. Since no anesthetic is used, no special recovery steps are required.

    4

    Treatment Plan

    A series of treatments is typically recommended, often spaced 7-10 days to 2-4 weeks apart, depending on the number of nerves involved, the duration of nerve inflammation, and the extent of nerve involvement.

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    Treatment Results and Timeline

    Treatment Results and Timeline

    Relief can be noticed quickly, especially if nerve irritation is the primary source of symptoms.

    Typical improvement timeline:

    • Immediate or early relief: minutes to hours
    • Sustained improvement: over several sessions
    • Full benefit: often seen after 3-5 treatments (or more if nerves are widespread or longstanding)

    Nerves that have been irritated for long periods or involve multiple branches may require a longer treatment course.

    Other Pain Management Services We Offer

    We also offer a range of non-surgical, evidence-informed treatments.

    Other Pain Management Services We Offer
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    Candidates for Perineural Injection Therapy

    Candidates for Perineural Injection Therapy

    PIT may be considered for adults with nerve-related pain or sensitivity, particularly when conservative care has not provided enough relief.

    Common reasons patients explore PIT include:

    • Nerve-related pain: Burning, zinging, tenderness, or hypersensitivity linked to irritated superficial nerves
    • Overuse or minor nerve entrapment: Symptoms related to repetitive movement, compression, or irritation
    • Persistent tension or discomfort: Pain that continues despite stretching, posture changes, or physical therapy
    • Non-surgical treatment goals: Patients looking to reduce pain, improve movement, and calm irritated nerves without surgery

    We assess your symptoms, exam findings, and goals to determine whether PIT is appropriate for you.

    Why Choose Sikora Integrative Medicine

    We take a precise, patient-centered approach to PIT, combining nerve-focused evaluation, individualized planning, and clear guidance throughout the care process. That approach is supported by:

    PM&R expertise

    Dr. Alita Sikora, MD, is board-certified in Physical Medicine and Rehabilitation and has practiced in Vero Beach since 2007, bringing a strong musculoskeletal and functional perspective to nerve-related pain.

    Experience with PIT

    Dr. Sikora introduced PIT to the practice and provided direct experience with this technique.

    Personalized, safety-focused planning

    Treatment is based on your nerve-pain pattern, functional goals, and clinical findings, including diabetes status, anticoagulant use, and prior response to conservative care.

    Complementary treatment options

    Musculoskeletal ultrasound, PRP, shockwave therapy, and other supportive options are available when appropriate.

    Clear guidance and support

    Our team explains each step of treatment and provides follow-up focused on comfort, clarity, and progress.

    Recognized by patients

    Dr. Sikora is a Patients’ Choice 5-Year Honoree and Castle Connolly Regional Top Doctor 2020.

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    Frequently Asked Questions

    Do perineural injections hurt?

    Most patients feel only a slight sting. Because the injections are very shallow, discomfort is minimal compared with a deeper intramuscular shot.

    Are perineural injections the same as steroid injections?

    No. PIT uses a diluted dextrose solution rather than corticosteroids, and aims to support healthier nerve function rather than suppress inflammation.

    How many perineural treatments will I need?

    Most patients complete three to five treatments. The number may be higher depending on how many nerves are involved and how long the irritation has been present.

    Can PIT be combined with PRP, stem cell therapies, or physical therapy?

    Yes. PIT often pairs well with regenerative therapies and rehabilitative care for more complete support.

    Does insurance cover perineural injections?

    Coverage varies. Many insurers in the US consider the treatment unproven, so it may need to be paid out of pocket. Cost depends on the number of nerves treated and the complexity of the neurogenic inflammation.

    Get Perineural Injection Care at Sikora Integrative Medicine

    Connect with Sikora Integrative Medicine to discuss your nerve-related pain, treatment options, and whether PIT may be appropriate for your needs. Financing through M Lend Financial is available for eligible services.

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    Disclaimer: This information is provided for educational purposes only and is not intended to be medical advice. It should not be used to diagnose, treat, or cure any condition. Always consult your healthcare provider for personalized guidance. Services are available exclusively to Florida residents.

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    772-228-6882

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    Vero Beach, FL 32960

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    © 2026 Sikora Integrative Medicine.
    All Rights Reserved.