Meet Dr. Brian McDonagh, a Neuropathy Treatment Specialist who stands out as a seasoned physician with an impressive tenure exceeding 30 years, primarily based in Illinois. His career is a testament to his unwavering commitment to restorative medicine, a field he turned to driven by a personal quest to address his own knee pain. Disenchanted by conventional orthopedic solutions, Dr. McDonagh explored prolotherapy, discovering not only its efficacy in treating degenerative arthritis but also its profound impact on his well-being. This journey of self-healing led him to Neural Prolotherapy, now known as Perineural Injection Therapy (PIT), a groundbreaking approach he deemed highly effective for nerve-triggered disorders.
Driven by his positive experiences and the substantial healing potential of these therapies, Dr. McDonagh became a pioneer in advocating for their broader acceptance. His expertise in PIT now extends to a wide array of neurological conditions, such as migraine, MS, Crohn’s Disease, trigeminal neuralgia, Complex Regional Pain Syndrome (CRPS), tennis elbow, and lower back pain. His innovative use of dextrose injections has shown promising results in enhancing muscular strength among patients with multiple sclerosis (MS) and musculoskeletal disabilities.
Dr. McDonagh’s educational journey began at the prestigious School of Medicine at University College Dublin, Ireland, where he graduated in 1968. After internship and two years of Rehabilitation Medicine at Wayne State, Detroit, Dr. McDonagh was in private practice in suburban Chicago. In a landmark move in 1980, he established Vein Clinics of America. This initiative marked a pivotal shift from traditional vein stripping surgery to minimally invasive, image-guided injection treatments, revolutionizing the management of vein disorders. His pioneering work, documented in the Journal of Phlebology in 2002, has since gained international recognition and adopted now in most countries.
Dr. McDonagh’s career is a narrative of innovation, dedication, and the relentless pursuit of healing. His contributions to medicine, especially in the realms of restorative and neurological therapies, underscore his role as a distinguished physician committed to improving patient care and outcomes.
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What is your background in Peripheral Neuropathy?
There wasn’t a treatment available when I began treating Peripheral Neuropathy in 2010. The buffered D5W solution has no good competitors. I’m the Founder of Vein Clinics of America (in 1980), and I developed the injection protocols that outperformed the surgical treatment (Vein Stripping surgery) for varicose veins and venous leg ulcers. Many patients had leg amputations for venous leg ulcers prior to my treatments. I didn’t invent vein injection which was around for decades, but I figured out why it didn’t work, and I developed a method using ultrasound imaging which made the disease visible for the first time. Now, it’s used around the world instead of vein stripping surgery. I called my procedure the COMPASS protocol, and it was published in the Journal of Phlebology in 2002 (UK).
What makes this Regenerative treatment special?
This treatment stands out as it offers renewed hope for many longstanding conditions that have often been overlooked or deemed untreatable by conventional methods. Specifically, I begin by focusing on Peripheral Neuropathies—a spectrum of disorders that have historically received limited attention from neurologists, primarily due to the absence of a straightforward pharmaceutical solution.
My approach involves meticulous micro-injections, a technique that, while labor-intensive, has proven to be exceptionally effective. This innovative method not only addresses Peripheral Neuropathy but has also inspired the development of advanced treatments for Multiple Sclerosis, Crohn’s Disease, Migraines, among others, further underscoring its significance and potential
Why is this proven treatment not covered by insurance?
Although they are cheaper, safer, and more effective, insurers won’t cover PeriNeural Injection Therapy, (PIT, by injection). Insurers use terms like “Experimental, Unproven or Cosmetic” to justify not covering these methods for apparently political reasons, even though these treatments can replace in-hospital surgery.
Why do patients trust you?
Because they are usually referred by a friend who has been treated here, plus I’ve been around for a long time and people know me. Our work is not covered or reimbursed by the health insurers, as mentioned above, but our work is less expensive than the surgical option, and a co-pay for surgery can be close to our gross fees. Our treatments make more sense, are safer, quick acting and durable.
What does this new type of treatment mean to the patient and to medicine in general?
It’s a new access to treating a whole group of diseases quicker, better, more completely and safer, using current inexpensive medicine & technology. It’s more gratifying to all including the doctor because we’ve not seen anything like it before.
I use Dextrose as a way into controlling and eliminating neuropathic pain and the motor/sensory manifestations of many, if not all, neuropathies, both central or peripheral. One of the challenges is “where to find that access point” that turns off the symptoms and the autoimmune triggering factor. Is it always automatically disengaged? There are many questions to be answered. But these treatments are exciting because of their rapid response and freedom from recurrence.
Q. Why and how does dilute Dextrose help so well as you suggest when so many medical doctors and nurses, etc, say that Dextrose is a placebo and is totally ineffective?
A. I understand the confusion, especially since some of you have a friend who had excellent lasting results from it. You may have heard that it has given much better results than the alternative pills and tablets for so many painful or disabling conditions. I will explain, beginning with the short history of Dextrose Therapy.
The use of Dextrose for Neurological disorders began about 2002 with Dr Lyftogt in NZ. But the treatment of Arthritis with concentrated Dextrose began in the 1930s by George Hackett MD, a Trauma Surgeon in Canton, Ohio, when he saw so many patients going for orthopedic surgery because of Ligament laxity. He thought he could find a safe substance to inject the ligaments that would cause inflammation of that ligament and reverse the laxity. It worked and it saved many patients from unnecessary surgery. That was the beginning of Prolotherapy (where Prolo is the abbreviation of Proliferation, which is the desired action that promotes “regeneration”), but since then it has been used to regenerate the entire joint from ligaments to the articular surfaces. Other medical treatments have been used since then including PRP, Stem cells, even Ozone.
Dr Lyftogt in NZ was trained in Prolotherapy, and it occurred to him to see if it also could regenerate or help painful nerves, and it worked there too but it required significant dilution/modification before it became as effective as it is today. He treated hundreds of athletes in an Olympic style Stadium in NZ, where he had rapid excellent outcomes. I met him when he came to the US in 2010 to give a lecture and a workshop in LA. Since that time he has been travelling the world teaching doctors how to use dilute dextrose most effectively. I attended many of his teaching events, including a week at his Master Class in Christchurch, NZ, in 2013. He has trained over 3000 doctors throughout the world. He just retired in October 2023. Initially, he called his treatment Neural Prolotherapy, but for technical reasons he changed the name to Perineural Injection Therapy (PIT). Some say that PIT doesn’t adequately describe the treatment, but neither does Chemotherapy.
So how does D5W (5% Dextrose in Water) inhibit pain and restore tissue maintenance, renewal and repair following injury? There is a scientific explanation that has to do with Neuro-energetics and ATP, which describes how glucose restores a disorder of Glycolysis in the C-fibers of the nerves. All medical doctors are familiar with ATP (Adenine Triphosphate) and that all living organisms depend on ATP for the energy required in all cellular processes. Glucose has to be transported in the circulation into the cell by the GLUT transporter before its energy can be transformed to ATP. Most living cells on earth have the 10 enzymes required for glycolysis, an ancient primordial intracellular energy production pathway (flux). It produces two “3 carbon molecules” called pyruvate which enter the Krebs cycle for further action producing 36 molecules of ATP in mitochondria. C-fibers have mitochondria but rely on glycolysis for instant response to harm (injury) to the skin and its nerves. This is the essence of nociception (response to pain). C-fibers run quickly out of ATP and depolarize, triggering spike formation, experienced consciously as C-fiber pain associated impaired healing, tissue maintenance and renewal. What we do with D5W is temporarily restoring C-fiber ATP (E) levels until the cell can recover its own ATP production. //
Perhaps the 30-60 second response of the Crohn’s disease patient to Dextrose within 30-60 seconds is the most impressive I’ve seen in a medical procedure. But there are many other impressive responses. Switching off pain and dysfunction within a few seconds is normal with neurogenic inflammation. Migraine pain is usually gone in a minute with Dextrose but it can take many hours in the ER where the use of strong analgesics is common. The difference is that the ER is attempting to overcome the pain, but dextrose stops the pain by restoring the C-fiber ATP level. It also relieves Trigeminal neuralgia quickly. Same with Rotator Cuff pain and Frozen Shoulder. The only negative is that C-fiber response is blocked by Opioids which then fails to respond to glucose.
I began treating Peripheral Neuropathy (PN) about 2013, using D5W on the degenerating peripheral nerves, mostly in the legs, but they can occur almost anywhere, e.g., the lacrimal nerves which cause Dry Eye or Wet Eye.
And commonly the Superior Cluneal nerves referring pain to the hip and thigh descending down to the foot; often accompanied by balance problems. It’s all treatable and responsive. You don’t need surgery which can’t help anyway.
A lot of Peripheral Neuropathy is caused by Chemotherapy and Radiation. This is more serious because it can totally destroy your peripheral nerves, so you should begin treatment early, as soon as you notice the symptoms of tingling and numbness. The treatment can’t oppose the Chemo/Radiation; it can only protect/regenerate the nerves if treatment begins ASAP. Urinary bladder frequency or incontinence, male and female, is another PN, but it can be normalized if caught in time with injections high on the thigh.
Muscular Dystrophy is a recent surprise: A 21 yr old male presented in a wheelchair. His main complaint was pain in his hip and knee joints and in the diminished thigh muscles between those joints. I treated one leg, leaving the other leg as a control, with dextrose to those painful nerves and he had remarkable relief with ability to move his joints with those diminished muscles. His dad drove him about 7 hours each way, and I contacted the patient several times for his progress. His pain relief lasted over a week, and I suggested that he contact the nearest branch of the Muscular Dystrophy Association for their assistance in getting financial assistance for what appears to be a breakthrough in the treatment of his disease. They were not cooperative, and his family had no health insurance. I told him that I would like him to stay nearby my office for further treatment, Phys Therapy and Orthopedic consultation, etc., as needed, but I think he’s given up. I still have other ideas. I think this kid has a chance of escaping his walker if we can continue.
I began treating Multiple Sclerosis about 2007when I examined an old friend who I saw walking with 2 canes. His examination revealed a pattern similar to that of the many Peripheral Neuropathy patients I had previously treated. I treated him as a PN patient, and the numbness he had on both legs for 20 years was gone in about 35 minutes. I asked about his diagnosis, and he had been to a special clinic for MS. He had not been improving clinically at his home clinic but he recovered rapidly in the short time with me. He felt his legs getting stronger. His home clinic uses the standard treatment with DMTs, etc, which I disagree with. It’s based on the false assumption that MS is a CNS (Central Nerve System) disease, meaning that it originates in the brain and spinal cord. Their treatment is very disappointing. I see most evidence peripherally and I treat it as a Peripheral Neuropathy and my MS patients respond much better. They don’t show the dreaded progression. I’m willing to share my knowledge with the status quo if asked.
Brian McDonagh, MD