Patients are increasingly seeking non-surgical treatment options for orthopedic and sports injuries. Regenerative medicine, which enhances the body’s natural healing process to repair damaged tissues, is one of the fastest growing fields in medicine. If you have sustained a tendon or ligament injury, or suffer from chronic back or neck pain, you may be a good candidate for Prolotherapy, Platelet Rich Plasma (PRP), or Stem Cell Injections, depending on your unique medical condition.
Prolotherapy, which is short for “proliferative therapy,” is an injection technique where natural solutions (from a simple dextrose solution to more complex stem cells) are delivered to the injury site to restart and maximize the body’s own healing process This healing technique is applied to unstable and injured joints, ligaments, and tendons to encourage the restoration of normal, healthy tissue. As such, prolotherapy can help people avoid surgery.
Where and how does prolotherapy work?
The amount of clinical research on prolotherapy has increased substantially over the last several years. Multiple studies have demonstrated its effectiveness in treating neck pain and instability; low back pain; sacroiliac dysfunction; chronic groin pain; osteoarthritis of the knee and hand; tennis elbow (lateral epicondylosis); knee tendon, ligament and meniscus injuries; and Achilles tendon injury. In everyday clinical practice, prolotherapy is used to treat painful conditions in virtually every major area of the body with excellent results. The healing response itself is triggered when the prolotherapy solution causes the injured tissue to release specific growth factors that attract tissue-healing cells to the injury site.
Who can benefit from prolotherapy?
Good candidates for prolotherapy include people who have joint or muscle pain. Prolotherapy works synergistically with treatments such as physical therapy, manual adjustments, massage therapy, and other treatments. The root causes of the pain can be wide-ranging, including osteoarthritis, sports injuries, post-surgical complications, ligament laxity from hypermobility, and direct trauma caused by an event such as a fall or car accident.
What is a prolotherapy treatment like?
After answering any questions, the doctor will examine the area to be treated via ultrasound or fluoroscopy (x-ray) and may note a few anatomical “landmarks” on the skin surface with a pen. The treatment area is then thoroughly cleansed and sterilized, so treatment can begin. Although prolotherapy involves injections, sometimes to multiple areas, it is generally very well tolerated. Because the areas of the body that are being treated are already injured and sensitive, the injections typically cause some temporary pain and discomfort. Our highly trained doctors take several measures to minimize this discomfort, such as using the smallest and thinnest needles possible, prescribing medications to reduce pain, and sometimes recommending anesthetic creams which numb the skin before the procedure. Since the body’s natural healing response can be a slow process, it may take two to four weeks before patients notice significant improvement. The results, however, are often long-lasting and may even be permanent in some cases.
What is the bottom line?
As with any other medical treatment, prolotherapy does not work in all cases. But it can provide long-term pain relief in situations where multiple other therapies have been unsuccessful. When performed as part of a comprehensive treatment strategy that maximizes your healing potential by improving your overall health, prolotherapy can be the catalyst that helps to bring you out of pain and back into the game of life.
Platelet Rich Plasma (PRP)
Platelet Rich Plasma Therapy is an exciting treatment that uses one’s own blood platelets to activate tissue regeneration and accelerate tissue repair following an injury, surgery, or degeneration.
How does PRP work?
Treatments are a multi-step process that is completed in one doctor’s visit, PRP involves:
- drawing a patient’s blood;
- placing it in a centrifuge to separate the plasma from the red blood cells; and
- injecting the plasma solution back into the patient’s body at the site(s) of the injury.
The high concentration of platelets in the plasma solution creates a localized inflammatory reaction that stimulates the growth of new ligament and tendon fibers, cartilage, and bone. The PRP process replicates the body’s natural healing response where blood swells around an injured area of the body to protect it and facilitate healing.
This technique can help shorten the rehabilitation time following an injury or surgery and can often help patients to avoid surgery or the need for cortisone injections. Compared to surgery, PRP carries a substantially lower chance of infection, leaves no scar tissue or irreversible destruction of cartilage. Visits, which include preparation and injection of the plasma solution, take approximately 50 minutes. In addition, the recovery period post-PRP is considerably shorter than post-surgery, and PRP is considerably less expensive than surgery.
In addition to orthopedic injuries, PRP can be used to improve painful intercourse (dyspareunia), vaginal dryness and even enhance orgasm. For more information on the O-Shot®, click here.
Depending upon your particular circumstances, your Kaplan physician will utilize ultrasound or fluoroscopic guidance during the PRP procedure.
Stem Cell Therapy
As people are living longer and engaging in activity well into their golden years, the prevalence of musculoskeletal degeneration and orthopedic injuries have also increased. Stem cell therapy is another type of regenerative medicine treatment that is revolutionizing the way injuries and degeneration of muscles, tendons, and ligaments are treated.
Mesenchymal stem cells (MSCs) are a type of adult stem cell that can be found and collected from bone marrow. Stem cells have the distinct ability to turn into various specialized cells that repair degenerated or damaged tissue. Because of their ability to develop into other tissue types, stem cells accelerate the healing process, alleviating pain symptoms and providing a faster recovery from injury or illness.
Sources of Adult Stem Cells
At the Kaplan Center, we use stem cells obtained from either bone marrow or umbilical cord tissue, primarily the latter. While adult stem cells can also be derived from adipose (fat) tissue, we do not utilize this method.
- Umbilical cord-derived stem cells: Women who are undergoing a cesarean section birth can choose to donate placental tissue and umbilical cord to a laboratory which harvests the Wharton’s jelly, connective tissue from the umbilical cord. This tissue from healthy births would otherwise be medical waste. Wharton’s jelly is very rich in young mesenchymal stem cells, cytokines, and growth factors. Mesenchymal stem cells are different and should not be confused with embryonic stem cells.
- Bone marrow-derived stem cells: The process of collecting bone marrow stem cells is surprisingly quick and simple. Like other regenerative injection treatments, this is a same-day procedure that takes approximately 90 minutes. After collecting bone marrow from the patient utilizing ultrasound or fluoroscopic guidance, the different compounds are spun in a centrifuge and separated. The stem cells, proteins & growth factors are then extracted and injected into the site (Depending on the site, dynamic ultrasound and x-ray fluoroscopic guidance are used to selectively target the injured structures as painlessly as possible.)