IV Infusion Therapy and Chiropractic Treatment Protocols

IV Infusion Therapy and Chiropractic Care for Neuropathy

Abstract

Neuropathy can cause burning, tingling, numbness, electric-like pain, weakness, and balance problems. Because nerve pain has many possible causes, treatment should begin by finding the reason for the symptoms. Intravenous immunoglobulin, or IVIG, may help certain immune-mediated neuropathies. Intravenous lidocaine and ketamine may temporarily reduce severe neuropathic pain when standard treatments have not provided enough relief. Vitamins may be appropriate when testing confirms a nutritional deficiency, but routine vitamin infusions should not be presented as a cure for nerve damage. Integrative chiropractic care may support mobility, posture, muscle balance, and rehabilitation when mechanical problems are also present. At Injury Medical Clinic PA in El Paso, Texas, medical oversight, chiropractic care, functional medicine, personal injury care, and rehabilitation can be coordinated within one multidisciplinary plan.

Neuropathy Treatment Starts With the Root Cause

Peripheral neuropathy is not one single disease. It is a broad term for damage or dysfunction involving nerves outside the brain and spinal cord. Symptoms may include:

• Burning, stabbing, or electric-like pain
• Numbness and tingling
• Increased sensitivity to light touch
• Muscle weakness
• Poor balance or coordination
• Pain that becomes worse at night

Possible causes include diabetes, autoimmune disease, vitamin B12 deficiency, medication effects, chemotherapy, physical trauma, nerve compression, infection, and inherited conditions. Some people have small fiber neuropathy, while others have problems involving larger sensory or motor nerves.

This is why a careful evaluation matters. A treatment that helps an immune-related neuropathy may not help neuropathy caused by diabetes, a vitamin deficiency, spinal nerve pressure, or direct trauma. Blood glucose and vitamin B12 testing are among the higher-yield laboratory tests used when evaluating distal symmetric polyneuropathy (England et al., 2009).

The evaluation may also include:

• Muscle strength and reflex testing
• Sensory testing
• Balance and walking assessment
• Medication and supplement review
• Blood testing
• Nerve-conduction studies
• Referral to a neurologist when needed

What Is IV Infusion Therapy?

IV infusion therapy delivers medication, fluid, or nutrients directly into a vein. This route allows a substance to enter the bloodstream without first passing through the digestive system.

However, “IV therapy” is not one single treatment. IVIG, lidocaine, ketamine, fluids, and vitamin preparations have different purposes, risks, and levels of evidence.

Research reviews describe infusion therapy as a possible option for selected cases of difficult or treatment-resistant neuropathic pain. It is usually considered after the diagnosis has been reviewed and more common treatments have not provided enough relief (McMullin et al., 2022).

Infusion therapy should be based on:

• A clear diagnosis
• A review of previous treatments
• Medical and medication screening
• Appropriate laboratory testing
• An individualized discussion of risks and benefits

IVIG for Immune-Mediated Neuropathy

Intravenous immunoglobulin contains antibodies collected and purified from donated plasma. It changes parts of the immune response and may help when the immune system is attacking peripheral nerves.

The European Academy of Neurology and Peripheral Nerve Society strongly recommend IVIG or corticosteroids as initial treatment options for typical chronic inflammatory demyelinating polyradiculoneuropathy, commonly called CIDP, and its recognized variants (Van den Bergh et al., 2021).

IVIG is also used for other selected immune-mediated nerve disorders, such as multifocal motor neuropathy. It is not a general treatment for every case of burning, numbness, or tingling.

A randomized, placebo-controlled trial examined IVIG for painful idiopathic small fiber neuropathy. The researchers found that IVIG did not significantly improve pain, autonomic symptoms, function, disability, or overall well-being compared with placebo (Geerts et al., 2021).

This finding shows why testing for an immune-related cause is important. IVIG is an expensive medical treatment that can also produce headaches, nausea, rash, vomiting, and other adverse effects.

A patient being considered for IVIG may need:

• A complete neurologic examination
• Nerve-conduction or specialized nerve testing
• Laboratory testing for immune or inflammatory disease
• Review of kidney, heart, and blood-clotting risks
• Monitoring for side effects
• Regular measurement of treatment response

IV Lidocaine for Temporary Pain-Signal Control

Lidocaine is best known as a local anesthetic used to numb an area before a procedure. It may also be given through an IV under medical supervision.

Lidocaine blocks sodium channels that nerves use to create and send electrical signals. This may temporarily calm abnormal nerve activity and reduce the transmission of pain signals.

Studies have found that IV lidocaine may reduce neuropathic pain for some patients. However, results vary based on the condition being treated, the dose, the length of the infusion, and the way researchers measure pain. The current evidence is not strong enough to describe lidocaine as a universal or permanent treatment for neuropathy (Gupta et al., 2021; Zhu et al., 2019).

IV lidocaine does not rebuild a damaged nerve or remove the original cause of neuropathy. Its main purpose is temporary symptom control.

A decrease in pain may help a patient:

• Sleep more comfortably
• Walk or exercise with less pain
• Participate in rehabilitation
• Reduce muscle guarding
• Complete daily activities more easily

Because lidocaine can affect the heart and nervous system, the care team must review the patient’s health history, medications, and possible risks. Qualified medical professionals must control the dose and monitor the patient during treatment.

Ketamine Infusions for Difficult Neuropathic Pain

Ketamine affects N-methyl-D-aspartate, or NMDA, receptors involved in pain amplification and central sensitization. Central sensitization happens when the nervous system becomes overly responsive and continues to produce strong pain signals.

A systematic review and meta-analysis examined 18 randomized controlled trials with 706 participants. Adding ketamine to standard treatment was associated with short-term reductions in neuropathic pain. However, the overall certainty of the evidence was low because the studies used different doses, treatment schedules, diagnoses, and routes of administration (Pereira et al., 2022).

Ketamine also increased the risk of psychedelic or dissociative effects. These may include unusual perceptions, confusion, feeling disconnected from the body, or changes in mood.

Ketamine is generally considered only for carefully selected patients with severe or treatment-resistant pain. It is not a routine vitamin infusion. Before treatment, the medical team may need to review:

• Heart and blood pressure risks
• Mental health history
• Current medications
• Liver and kidney health
• History of substance misuse
• Previous pain treatments
• The patient’s response after each infusion

Ketamine may decrease pain signals, but it does not automatically heal the injured nerve or correct the disease that caused the neuropathy.

Vitamins Help When a True Deficiency Exists

Nutritional problems can sometimes cause or worsen nerve symptoms. Vitamin B12 deficiency, for example, may cause numbness, tingling, balance problems, weakness, and other neurologic changes. These nerve-related symptoms can occur even when a person does not have anemia (National Institutes of Health Office of Dietary Supplements, 2025).

Vitamin replacement should match the patient’s actual deficiency. Some people may need injections or medically directed therapy because of poor absorption, pernicious anemia, digestive surgery, or another health condition. Other patients may respond to oral nutrients.

IV delivery is not automatically better for every person. Medical testing should guide the treatment.

More is also not always safer. Large supplemental amounts of vitamin B6 can cause sensory neuropathy. Patients should tell their healthcare team about all vitamins, energy products, injections, and supplements they use.

A responsible functional medicine plan may review:

• Vitamin B12
• Blood glucose and hemoglobin A1C
• Thyroid function
• Folate
• Vitamin B6 use
• Medication-related nutrient problems
• Diet and digestive health
• Alcohol use
• Metabolic and inflammatory risk factors

How Integrative Chiropractic Care Fits In

Chiropractic care and IV infusion therapy work on different parts of the problem. An infusion may target immune activity, pain signaling, hydration, or a documented deficiency. Chiropractic and rehabilitation services focus more on movement, joint function, muscle tension, posture, balance, and mechanical stress.

Integrative chiropractic care does not replace IVIG for CIDP. It does not reverse diabetic nerve damage or rebuild a severely injured nerve. Its role is supportive.

When a patient also has restricted spinal movement, poor posture, muscle guarding, an accident-related injury, or irritation around a nerve pathway, gentle manual care and rehabilitation may help improve movement and reduce added mechanical stress.

A combined care plan may include:

• Gentle chiropractic adjustments when appropriate
• Soft-tissue treatment
• Spinal or extremity mobility exercises
• Balance and gait training
• Corrective exercise
• Strength and flexibility training
• Ergonomic and posture education
• Nutrition and sleep support
• Referral to neurology or pain management

The goal is not to claim that a chiropractic adjustment cures neuropathy. The goal is to improve the patient’s movement environment while medical care addresses the diagnosed disease and pain process.

A Multidisciplinary Model in El Paso, Texas

Clinic materials identify Dr. Maria Guadalupe Cardenas, MD, as Board Certified in Internal Medicine and as the Medical Director and Collaborative Physician at Injury Medical Clinic PA in El Paso, Texas. They list her NPI as #1164426749 and her Texas medical license as #J2933. The practice also describes her as having more than 40 years of internal medicine experience.

Dr. Cardenas works with Dr. Alexander Jimenez, DC, APRN, FNP-BC, CCST, CFMP, IFMCP, ATN. This type of shared-care structure is used in some integrative and injury clinics. It allows medical oversight to be coordinated with chiropractic care, functional medicine, personal injury services, and rehabilitation.

Medical oversight is especially important when a patient has:

• Diabetes or uncontrolled blood sugar
• Autoimmune disease
• Heart or kidney risks
• Medication interactions
• Nutritional deficiencies
• A history of blood clots
• A possible need for prescription infusion therapy
• Symptoms that may require specialist care

Dr. Jimenez’s published clinical observations emphasize looking beyond the painful area. His approach considers joint motion, posture, muscle function, nerve irritation, metabolic health, inflammation, nutrition, and the patient’s ability to return to normal activity. The Injury Medical Clinic PA website describes a model that integrates chiropractic care, medical collaboration, functional medicine, injury care, and rehabilitation.

These observations come from clinical practice and should not be treated as the same level of evidence as a randomized clinical trial. However, they help explain how an integrative team can organize care around the whole patient instead of focusing on only one symptom.

Within this model:

• Dr. Cardenas provides internal medicine direction and medical risk review.
• Dr. Jimenez evaluates neuromusculoskeletal function and directs chiropractic and rehabilitation strategies.
• Functional medicine services examine metabolic, nutritional, and lifestyle factors.
• Personal injury care addresses trauma-related symptoms, documentation, and recovery needs.
• Rehabilitation services work on strength, balance, mobility, coordination, and return to activity.

What a Safe Treatment Journey May Look Like

A safe and logical plan often follows a step-by-step path.

1. Confirm the Neuropathy Pattern

The team documents pain, numbness, weakness, reflexes, balance, walking problems, and limits in daily activities.

2. Search for the Cause

Testing may look for diabetes, vitamin B12 deficiency, autoimmune disease, medication effects, previous chemotherapy, direct trauma, or mechanical nerve irritation.

3. Match Treatment to the Diagnosis

IVIG may be appropriate for a confirmed immune-mediated disease. Lidocaine or ketamine may be considered for selected cases of difficult neuropathic pain. Nutrients are replaced when a deficiency is found.

4. Address Movement Problems

Chiropractic care and rehabilitation may support mobility, strength, posture, balance, and tolerance for normal activity.

5. Measure Progress

The team may track:

• Pain intensity
• Sleep quality
• Walking tolerance
• Muscle strength
• Balance
• Sensation
• Medication use
• Work and daily function

6. Refer When Needed

Progressive weakness, an unclear diagnosis, or a poor response to treatment may require evaluation by neurology, pain management, endocrinology, vascular medicine, or another specialist.

Conclusion

IV infusion therapy may help manage certain forms of neuropathy and nerve pain, but the root cause determines the correct treatment.

IVIG has an important role in confirmed immune-mediated neuropathies such as CIDP. However, it has not shown meaningful benefits for every type of small fiber neuropathy. IV lidocaine and ketamine may temporarily reduce difficult neuropathic pain, but they do not repair the original nerve injury and require careful medical monitoring. Vitamins are most useful when testing confirms a true deficiency.

Integrative chiropractic care can support the treatment plan by addressing mobility, posture, muscle imbalance, mechanical stress, balance, and rehabilitation needs. At Injury Medical Clinic PA in El Paso, the collaboration between Dr. Maria Guadalupe Cardenas and Dr. Alex Jimenez represents a multidisciplinary approach that combines medical oversight, chiropractic care, functional medicine, personal injury care, and rehabilitation.

The strongest plan is not based on one infusion or one adjustment. It is based on a clear diagnosis, realistic goals, patient safety, careful monitoring, and coordinated care.

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References

England, J. D., Gronseth, G. S., Franklin, G., et al. (2009). Practice parameter: Evaluation of distal symmetric polyneuropathy—Role of laboratory and genetic testing. Neurology, 72(2), 185–192.

Geerts, M., de Greef, B. T. A., Sopacua, M., et al. (2021). Intravenous immunoglobulin therapy in patients with painful idiopathic small fiber neuropathy. Neurology, 96(20), e2534–e2545. https://doi.org/10.1212/WNL.0000000000011919

Gupta, H., Patel, A., Eswani, Z., Moore, P., Steib, M., Lee, C., & Kaye, A. D. (2021). Role of intravenous lidocaine infusion in the treatment of peripheral neuropathy. Orthopedic Reviews, 13(2), 25567. https://doi.org/10.52965/001c.25567

Jimenez, A. (n.d.). Dr. Alex Jimenez: El Paso chiropractor and personal injury specialist. Injury Medical Clinic PA.

Jimenez, A. (2026). Dr. Maria Cardenas, MD: Board Certified Internal Medicine specialist. Injury Medical Clinic PA.

Jimenez, A. (n.d.). Dr. Alex Jimenez professional profile. LinkedIn.

McMullin, P. R., Hynes, A. T., Arefin, M. A., Saeed, M., Gandhavadi, S., Arefin, N., & Eckmann, M. S. (2022). Infusion therapy in the treatment of neuropathic pain. Current Pain and Headache Reports, 26(9), 693–699. https://doi.org/10.1007/s11916-022-01071-5

National Institutes of Health Office of Dietary Supplements. (2025). Vitamin B12: Fact sheet for health professionals.

Pereira, J. E. G., Pereira, L. F. G., Pereira, L. M. G., et al. (2022). Efficacy and safety of ketamine in the treatment of neuropathic pain: A systematic review and meta-analysis of randomized controlled trials. Journal of Pain Research, 15, 1011–1037. https://doi.org/10.2147/JPR.S358070

Van den Bergh, P. Y. K., van Doorn, P. A., Hadden, R. D. M., et al. (2021). European Academy of Neurology/Peripheral Nerve Society guideline on diagnosis and treatment of chronic inflammatory demyelinating polyradiculoneuropathy. European Journal of Neurology, 28(11), 3556–3583.

Zhu, B., Zhou, X., Zhou, Q., Wang, H., Wang, S., & Luo, K. (2019). Intra-venous lidocaine to relieve neuropathic pain: A systematic review and meta-analysis. Frontiers in Neurology, 10, 954. https://doi.org/10.3389/fneur.2019.00954