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IRR: Infraspinatus Respiratory Reflex Injection

Asthma/irritable airway/bronchospasm is an extreme version of allergy which can be life-threatening.   Emergency treatment is best done in an Emergency Room, where the full range of respiratory support is available.  Office treatment is best directed toward milder attacks, and towards long term resolution of the problem.


Short term symptom relief can be had very gratifyingly with the Infraspinatus Respiratory Reflex (IRR) technique.  This is an approach first described thirty years ago in the American Journal of Family Practice.   The nerve plexus in the infraspinatus muscle (which lies on the surface of the shoulder blade) is anesthetized with local anesthetic, causing measureable relaxation of the nerves controlling bronchospasm.   People with moderately severe asthma attacks can enjoy a 30% improvement in pulmonary function (PFTs) within half an hour. 


IRR can be done every two weeks, and in the published trial about 80% became symptom free after 6 or 8 biweekly treatments.   I have had several patients with similar success, one of whom comes back every 3 or 4 years for a “top up,” but in between is symptom free on no medications.



Longer term, I really like Lose Dose Antigen therapy (LDA) as a general immune regulator.   LDA is less stringent from a lab testing standpoint than sublingual immunotherapy in that it is not necessary to nail precisely everything that is causing symptoms.  LDA covers almost everything, safely, with 80+% success for allergies to pollens, molds, foods, various chemicals.  It is not an immune suppressant, just a regulator which brings immunity back into balance.  Some documentation of allergy or a very good history of allergy will suffice to start treatment.


LDA has been in use in the UK for forty years, with no reported deaths or serious complications.


Longer term, detoxification of various chemicals and metals via the usual interventions can be quite helpful in bringing Th1/Th2 immunity back into balance.

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