neural therapy- huneke a truly wholistic method since 80 years
TRANSCRIPT
Neural Therapy- Huneke
A truly wholistic method since 80 years
Dr. Ferdinand Huneke 1928
• 1925 Ferdinand Huneke’s sister with severe migraine
• Accidental (or was he just desperate ?) injection of Procaine/Novocaine (local anaesthetic) intravenous - sudden improvement of migraine and other symptoms - a “wonder drug” ?
• Ferdinand and Walter Huneke - research
Huneke/Flash Phaenomen
• 1940 Huneke - or “Flash” phaenomen - shoulder injected - flare up and reddening of osteomyelitic leg scar - amputate ? - local injection - shoulder pain immediately gone !
• “Stoerfeld” /Interference zone theory - any scar or traumatised/dysfunctional tissue may cause symptoms, distant from site of pain
Interference zone/Stoerfeld/Spina Irritativa
• ~50 % in ENT region, usually teeth
Stoerfeld/Interference Zone
• Ernesto Adler * 1906 - German expatriate dental technician then dentist in Lloret del Mar/Barcelona ~1926
• “miracoulous” improvements after extractions• relation cervical spine problems and teeth
noted - Vogler pressure points• ~1950ies close cooperation with and many
visits by Ferdinand Huneke
Two minds - same problem
• Two doctors , a dentist and a GP/surgeon, in two countries are working about the same phaenomenon for many years before and after WW II
• Huneke/Flash Phaenomen
• Dr. Adler, a dentist who cooperates with a local GP in Loret del Mar
Definition of Huneke or Flash Phaenomenon
• Suspected Interference Zone (scar, tooth, tonsil..) is injected with local anaesthetic, usually Procaine 1%, short acting - gone after ~20 minutes
• if symptoms improve at least 8 hours after tooth injection, 20 hours elsewhere and repeat injection gives the same response, e.g. tonsils - hip pain, then the underlying cause is identified
Flash phaenomen
• Response sometimes delayed by one or several days
• provocation of secondary Interference zone is possible - ”initial worsening” and emergence of new symptoms
• “Drainage” symptoms may occur, e.g. chronic sinusitis/”stuffy nose” changes to runny nose
Flash phaenomen - responses
• If infected/dead tooth is extracted often allergic symptoms, Urticaria, rheumatoid symptoms, hormonal problems vanish
• from a NT point of view there isn’t any chronic condition that is not due to a Interference zone - Exzema- Arthritis - period problems - unexplained infertility...
Somato-psychic conditions
• The term psycho-somatic or “functional” illness is misleading - mental health often improves after Interference Zone sanitation; severe mental conditions and trauma have somatic effects - Lymphoc. downregulated
• emotional and autonomous responses (weeping, laughing, fainting, sweating) often accompany Flash phaenomaenon
Theories
• Pischinger “Grundsystem” - complex interaction of micro-currents in interstitial space - ends of autonomous nerves
• Autonomous nervous system - Gate control theory- fibres accompany blood vessels and motoric nerves - all connects to all
• Acupuncture meridians ?
Theories
• NT is empiric and individual but experience from >80 years shows where to look first
• see also Head’s zones, e.g. gall bladder-shoulder pain; Simmons and Travell’s work about trigger points and pain projections
• = referred pain; myofascial pain concept
• simple “Where does it hurt” ? approach
Techniques
• Doctor only complex set of injection skills:
• intracutanous blebs around painful areas, e.g. arthritic knees, often followed by intramuscular injection
• segmental approach in Dermatome or Myotome, e.g. bladder symptoms, menorrhagia, delayed delivery - Laimer triangle/bladder meridian
• specific nerve blocks, e.g. Trigeminal ends
Techniques
• Autonomous ganglia e.g. local anaesthetic depot around pterygo-palatine ganglion for trigeminal neuralgia
• Stellate Ganglion block for asthma and CNS conditions
• trigger point intra - muscular injections for musculo-skeletal conditions
Indications for Neural Therapy
• 1.: Prophylactic - e.g. intra - operative infiltration of wound layers helps to limit post-op oedema and pain; fracture cleft anaesthesia limits need for tablets
• 2.: Diagnostic in neurologic and musculo-skeletal medicine - radicular or pseudo-radicular pain ? Trigger point or lumbar disk ? Trigeminal Neuralgia or tooth ?
Indications
• Most effective for head, neck, shoulder, spine conditions, migraine and its differential diagnose; often related to pelvic area/female problems
• “Osteopathy helped, but only for a short time” - “Interference Zone” ? Vascular migraine or migraine cervicale - difference is clearer in text books than in reality, often multi causal
Indications
• Therapeutic Local Anaesthesia - Neuralgias, musculo - skeletal conditions - no limit for repeats, unlike Cortisone injections
• “Depression/Anxiety” - thyroid and I.v. injection of Procaine 1 %
• Difficult wounds: Procaine helps, antiinflammatory effects - Vit C…, nutrition
Indications
• Key indication is search for Interference zone/underlying problem of a condition
• Complimentary to standard therapy and e.g. osteopathy…!?
• Orthomolecular Medicine/Micro-nutrients -constipation ?
• Limited response if immuno-suppressant Rx
Indications
• Neural Therapist/Odontologist should be consulted first and referrals made from there instead of “odyssee” to “-ology” one problem specialists
• Wholistic approach first - good old family GP’s in the UK are replaced by “nurse practitioners !”
Could it be done without needles ?
• Many measuring devices - best is probably Thermography (Rost); Electro-Acupuncture (Voll) - expense and time ?
• I rely on my finger tips/palpation skills and intuition plus clinical findings and history
• sometimes I use Acupuncture/dry needling or Reflexology but NT is more effective
Amalgam-Toxicity ?
• One of the indications for those tests - first avoid different metals in the mouth
• OPG Xray always helpful
• bottom line: a sensitive doctor has very fine natural senses and ultra-fine 0,4mm needles are almost painless !
Needles or not
• A motivated patient with distressing symptoms will accept a needling approach - patient selection !
Contraindications
• Patient unable to consent/cooperate
• active psychotic illness
• advanced Dementia
• Hyperthyroid/uncontrolled thyroid disease
• Bleeding disorders and blood thinning medicines
• Myasthenia Gravis
Contraindications
• Severe cardio-vascular conditions - uncontrolled hypertension, congestive cardiac failure stage III-IV; end stage COPD; any end-stage organ failure - sometimes surprises with e.g. arthrotic hip pain - “Interference zone”
• Cancer other than palliative/pain management
NOT a “Cure all”
• Neural Therapy is not a “cure all miracle therapy” - there are limits in the doctor’s ability , resources and set up as well as within the method
• However:
• Who has experienced a “Flash Phaenomaenon” often will call it a miracle ! Very rewarding for patient and doctor
How long - how often
• Usually some response in first session, but 3 to 8 may be needed, mostly, if no response at all after 3 sessions - re-assess = limited cost and time; top-ups in increasing intervals
• the more acute the condition the easier it is
• beware of “shopping lists” with 25 symptoms and long years history
Key to success
• Careful history by experienced physician, focusing on key physical and mental traumas, injuries, infections; conventional general exam, work up of bloods with inflammatory markers, BM, Urine, Xrays
• Manual exam - lay hands on patient !
• Patient to take responsibility and keep diary of symptoms -pain - sleep - mood...
Ideal setting
• Written consent
• open minded fellow doctors/dentists
• Dentist in clinic to talk to
• psycho-therapist
• nutritionist
Risks
• Allergic reaction - rare - reddening and itch ~1cm is normal with Procaine as vaso-dilating, possibly more pronounced in scars etc., some allergy 1:3000
• severe allergic reaction (shock, asthma) very rare, probably < 1:10 000
• infection - very rare - ultra-thin needles 0,25-0.4mm, Procaine is bacteriostatic
Risks
• Nerve irritation may persist for a few days, permanent nerve damage is very rare as very thin single use needles are used
• Bleed - a few drops from injection site is normal, severe bleed very rare
• injury of organs e.g. lungs, blood vessels
• We train all techniques on fellow doctors !
Professional bodies and training
• Training as of now in German or Spanish only
• 120 hours of lectures and hands-on training with fellow practitioners as “Guinea pigs”- case studies - final exam
• English language Textbooks by Dosch and Barop
• But:
Any doctor can do it
• .. So long as a patient consents and the doctor feels confident about anatomy and injection skills - “Do not underestimate a I.c. bleb” - try it - primum nil nocere !
• vastly popular in Germany, only a minority undergo formal training, so lots of unreported cases since it is part of daily practice, sometimes job description in rehab clinics
Evidence for efficiency
• Randomised double blind not possible as individual approach
• Huneke/Flash phaenomenon must be reproducible; countless case reports since 80 years, growing rapidly - societies in most Spanish speaking all German speaking countries
The Future
• Now Drs. Maik, Hagen, Holger and Juergen Huneke continue, 2 German societies, Austria, CH, ~ 3500 members, vets in Austria, independent societies in Spain, Argentina, Mexico, Columbia...
• Acupuncture most recently was Chinese only, then French and German, English since Nixon’s 1972 visit in China
Beware of I.M. Diclofenac !
• I.M. Diclofenac/Voltarol causes sterile necrosis in injection canal and may cause abscess - try at least I.c. blebs first !
• Oral NSAID’s: gastric erosion/bleed, renal failure, CCF - switch to safer methods ?
• -triptans for migraine may provoke heart attack...
Rainer Kumm
• 079 500 333 61
• communication most welcome, further literature on request
• http://www.ignh.de
• http://www.terapianeural.com - see links