Neural therapy

from Wikipedia, the free encyclopedia
Skin wheals in segmental neural therapy
Injection of local anesthetics for pain and regulation therapy

The neural is a historically used scientifically not sufficiently accepted procedure in the field of complementary medicine . The use of a local anesthetic is intended to influence the autonomic nervous system and, in contrast to scientifically recognized local anesthetic methods, develop "remote effects". Neural therapy is based on two branches of therapy: segment therapy at the location of the pain or the area of ​​complaints and interference field therapy, in which neural therapists use so-called interference fields such as B. Treat scars that are inconspicuous themselves and cause no discomfort, but cause pain in completely different parts of the body. In both cases, wheal- forming intradermal injections of a local anesthetic are given.

history

The neural therapy was largely developed by the doctors Ferdinand and Walter Huneke. In 1925, Ferdinand Huneke inadvertently injected his sister, who suffered from chronic migraine , with a preparation containing procaine instead of the procaine- free variant. The intravenous application of procaine was unusual at the time because of the fear of fatal cerebral palsy. However, Huneke stated that in this case he had observed a sudden and lasting healing effect, so that he and his brother Walter continued to research the therapeutic use of procaine. Initially, this resulted in what is known as segment therapy as part of neural therapy.

In 1940 Huneke treated a woman suffering from migraines and joint problems in the shoulder in the area of ​​a leg wound ( osteomyelitis ) after he had previously performed the segment therapy several times without success. After the treatment on the leg, there should be a significant improvement in the shoulder area within seconds. He postulated the existence of so-called "interference fields"; These are said to be chronic inflammatory conditions that "energetically" weaken the entire organism and cause complaints in other areas of the body. Their existence has never been proven. Huneke believed that what he called the second phenomenon healing was a healing of the foci of illness that had caused a “distant disorder”. He indignantly rejected any objections that could be suggestions. From this he developed what is known as interference field therapy , which his students continue to use to this day.

The “International Medical Society for Neural Therapy according to Huneke e. V. “(IGNH) was founded in 1958 with the aim of promoting and disseminating neural therapy. In 1981 the German Academy for Neural Therapy and Acupuncture split from this association . V. , which has since understood neural therapy as an additional therapy in the sense of diagnostic-therapeutic local anesthesia. In 1971, the "German Society for Acupuncture and Neural Therapy" (DGfAN eV) was founded for the GDR region - initially as a reflex medicine working group in the Society for Internal Medicine. In Zotero an extensive Bibliography of neural therapy (more than 2,000 bibliographic entries) is available.

Forms of treatment

Segment therapy

In segment therapy , a local anesthetic, usually procaine , but also lidocaine , mepivacaine or prilocaine , is injected in the form of skin wheals in the corresponding Head's zones of the internal organs or on vegetative ganglia . The aim is to convey the effect via the vegetative nervous system in the affected segment.

Interference field therapy

According to Huneke, “interference fields” are chronic inflammatory conditions that “energetically” weaken the entire organism and can cause complaints in other areas of the body. The most common interference fields are said to be in the tonsils , paranasal sinuses, the tooth and jaw region, thyroid gland and in scars.

Huneke was based on the following three principles:

  1. Every chronic illness can be caused by interference fields.
  2. Any part of the body can become an interference field.
  3. Every disturbance field disease can only be cured by switching off the disturbance field.

Targeted questioning and examination are used to try to find the interference field and to interrupt the interference effect by injecting a local anesthetic. The elimination of electromagnetic signals, which can trigger diseases in any part of the body via the autonomic nervous system, should play a role. The "second phenomenon" should be proof of finding the interference field: If the symptoms are improved within seconds for at least 20 hours after the local anesthetic has been injected, and this phenomenon is reproducible, the source of the interference field has been found. Neither the effectiveness and mechanism of action of neural therapy nor the existence of the interference fields it postulates have been scientifically proven. The existence of the “seconds phenomenon” has also not been scientifically proven.

Mechanism of action according to neural therapists

According to Peter Dosch, Huneke's secondary school student - to be read in his textbook for neural therapy - neural therapy works as follows: The local anesthetic brought into the interference field (= diseased tissue) has a high "inherent potential". It repolarizes and stabilizes the irritated "cell boundary membrane potential". Dosch claims that repeated injections restored the normal potential at around 90 mV and "sealed" the cells. The terms “interference field” and “self-potential” have no scientific acceptance in this context. In fact, local anesthetics block the sodium channels in the cell membrane and thus the depolarization of nerve cells . In this way you prevent the transmission of pain and sensory stimuli.

Other forms of treatment

In therapeutic local anesthesia (TLA), irritated nerve roots , for example in the lumbar spine , are infiltrated with a local anesthetic. Sometimes sacral anesthesia or epidural anesthesia are only used for therapeutic purposes. Another method is the Reischauer blockade , which is used for severe sciatica irritation. The sympathetic blockade is used in algodystrophies to treat disorders of the local blood flow.

Another variant of neural therapy is functional neural therapy (FNT). In FNT, subcutaneous points are defined on the front of the body that are “functionally” connected to individual internal organs. In the case of diseases of these organs, the respectively assigned points should also be clearly tender and palpable as knots. Injecting a local anesthetic into these points should not only interrupt the transmission of pain signals from the functionally assigned points, but also from the diseased internal organs. The healing process should be initiated through repeated use.

In mesotherapy - a combination of elements from acupuncture, neural therapy, reflex zones and homeopathy - various diluted active ingredients are injected.

Education and legal status

Neural therapy is offered by trained doctors who, after 120–150 hours of training and a final examination, carry out this form of treatment. There is no uniform further training regulation; the individual existing certificates are awarded by the medical societies under different conditions. The teaching of the basics of neural therapy is part of the training for the additional designation "Naturopathic Treatment" and is therefore recognized in Germany by the respective state medical associations.

Until April 1, 2006, neural therapy was also carried out by alternative practitioners after special training. Since April 1, 2006, the local anesthetics used for the application, mainly procaine and lidocaine, have been made subject to prescription and thus neural therapy has been curtailed for the naturopathic profession. The only exception is the use of lidocaine and procaine up to two percent and intracutaneous injection (i. C. - the so-called wheal) into healthy skin, but wheal treatment is also one of the neural therapeutic injections.

Neural therapy has been evaluated in Switzerland over several years with regard to the criteria of effectiveness, appropriateness and cost-effectiveness. Since these criteria are met, the Federal Department of Home Affairs decided in January 2011 that there is a permanent obligation to provide benefits at the expense of the compulsory health insurance for segmental and local neural therapy. In Germany, segment therapy is paid for by various health insurance companies , provided it is carried out by a contract doctor.

Side effects and complications

As with any other invasive procedure, performing Huneke's neural therapy can injure the patient. Possible complications and cases, some of which were described by Huneke himself and some by others, are:

  • Injury after stellatum injection
  • Cerebral haemorrhage after injection into the vertebral artery
  • Injury to the pancreas
  • Perforation of the eyeball
  • Allergic reactions or hypersensitivity to procaine

Stöhr and Mayer (1976) and other authors reported on five patients who had suffered nerve root lesions after paravertebral injection of neural therapeutic agents. In one case, there was a life-threatening cerebral hemorrhage after neural therapy.

The local anesthetic procaine traditionally plays a prominent role in neural therapy . In clinical anesthesia , however, this substance has lost its importance because it has some unfavorable properties. On the one hand, it spreads poorly in the tissue compared to other local anesthetics, and on the other hand it belongs to the group of amino esters , whose breakdown by the ubiquitous pseudocholinesterase produces paraaminobenzoic acid . Some patients have an allergic reaction to this breakdown product. For this reason, a trial dose of procaine is recommended before therapy. In addition, when using procaine (as with any other local anesthetic), the typical side effects of this group of substances such as cardiac arrhythmias and CNS symptoms up to generalized seizures can occur.

literature

  • G. Badtke, I. Mudra: Neural therapy. Textbook and atlas. 2nd edition, Munich 1998, ISBN 3-86126-104-9 .
  • P. Barbagli, R. Bollettin: Therapy of articular and periarticular pain with local anesthetics (neural therapy of Huneke). Long and short term results. Minerva Anestesiol 1998; 64 (1-2): pp. 35-43.
  • P. Barbagli, F. Ceccherelli: Possible etiopathogenic role of scars in chronic non malignant pain. Cases and case records. Minerva Medica 2005; 96 (suppl. 2 n. 3): pp. 15-24.
  • H. Barop: textbook and atlas neural therapy according to Huneke. Hippokrates-Verlag, Stuttgart 1996.
  • P. Dosch: Textbook of neural therapy according to Huneke. 14th edition, Karl F. Haug, Heidelberg 1995, ISBN 3-8304-0632-0 .
  • E. Ernst: Neural Therapy, Complementary Therapies for Pain Management / An Evidence-based Approach. Elsevier, 2007, ISBN 0-7234-3400-X , p. 149.
  • L. Fischer: Neural therapy according to Huneke. Neurophysiology, injection technology and therapy proposals. Haug, 4th edition, Stuttgart 2014. ISBN 978-3-8304-7493-7
  • JD Hahn-Godeffroy: Neural therapy according to Huneke - interference field therapy - a regulatory medical procedure using procaine. 2nd edition, Uelzen 2004. ISBN 3-88136-223-1 .
  • JD Hahn-Godeffroy: Effects and side effects of procaine: what is certain? In: Complementary and Integrative Medicine. 02/2007, ISSN  1863-8678 , pp. 32-34.
  • S. Weinschenk: Handbook of Neural Therapy: Diagnostics and Therapy with Local Anesthetics. Urban & Fischer, Munich 2011.

Web links

Commons : Neural Therapy  - collection of images, videos and audio files
Wiktionary: Neural therapy  - explanations of meanings, word origins, synonyms, translations

Individual evidence

  1. ↑ a b degam.de/AG - Complementary Medicine (PDF)
  2. ↑ AG Complementary Medicine. German Society for General Practice and Family Medicine (DEGAM) , accessed on April 19, 2019 .
  3. ^ E. Ernst: Neural Therapy, Complementary Therapies for Pain Management / An Evidence-based Approach. Elsevier, 2007, ISBN 0-7234-3400-X , p. 149.
  4. ↑ a b Irmgard Oepen : Neural therapy “magic injection” or diagnostic-therapeutic local anesthesia? In: Outsider Methods in Medicine. Origins, dangers, consequences. Scientific Book Society, Darmstadt 1986, ISBN 3-534-01736-6 .
  5. ↑ Neural therapy is a valuable addition to acupuncture
  6. ↑ https://www.zotero.org/groups/2407404/neural_therapy/items/
  7. ↑ a b onmeda.de
  8. ↑ Süddeutsche Zeitung : White bread against cancer , from February 16, 2015
  9. ↑ Onmeda : Neural Therapy , accessed on February 16, 2015
  10. ↑ a b Colin Goldner: Neural therapy - stinging against disorders. In: sueddeutsche.de . June 8, 2010, accessed July 24, 2016 .
  11. ^ HA Fozzard, MF Sheets, DA Hanck: The sodium channel as a target for local anesthetic drugs. In: Frontiers in pharmacology. Volume 2, 2011, p. 68, doi: 10.3389 / fphar.2011.00068 , PMID 22053156 , PMC 3205381 (free full text).
  12. ↑ Further education regulations of the LÄK Thuringia ( Memento of the original from July 6, 2016 in the Internet Archive ) Info: The archive link has been inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. @1@ 2Template: Webachiv / IABot / www.laek-thueringen.de
  13. ↑ SR 832.112.31 Ordinance of the Federal Department of Home Affairs of September 29, 1995 on benefits in compulsory health care insurance (Health Care Service Ordinance, KLV). Accessed January 31, 2019 .
  14. ↑ Federal Office of Public Health BAG: Explanations of the changes to the EDI ordinance of September 29, 1995 on benefits in the compulsory health insurance (health care insurance, KLV) (PDF) Retrieved January 31, 2019 .
  15. ↑ Katrin von Bechtolsheim: Neural therapy: Needle with great effect? Techniker Krankenkasse , October 9, 2017, accessed on September 6, 2019 .
  16. ↑ onmeda.de
  17. ↑ M. Stöhr, K. Mayer: Nerve-root damage from local injections. In: Dtsch Med Wochenschr. 101, No. 33, Aug 13, 1976, pp. 1218-1220.
  18. ^ W. Mattig, W. Buchholz, H. Schulz: Severe iatrogenic lesions caused by Huneke's neural therapy. In: Z Total Inn Med. 34, No. 5, March 1, 1979, pp. 143-147.
  19. ↑ U. Heyll, DJ Ziegenhagen: Subarachnoid hemorrhage as life-threatening complication of neural therapy. Case report. In: Insurance Medicine. 52, No. 1, March 1, 2000, pp. 33-36.
  20. ^ Larsen: Anesthesia. 7th edition.