Rejuvenation
What is a Prolotherapy?
Prolotherapy (aka regenerative injection therapy -RIT) is a non-cortisone type of injection that can treat many orthopedic conditions. “Prolo” is short for proliferation, because the treatments cause the proliferation (growth, or formation) and remodeling of new ligament or tendon tissue in areas where it has become weak. Ligaments are bands of tissue that hold bones together. Ligaments can become weak or injured and may not heal back to their original strength or endurance. The blood supply to ligaments is limited and therefore limits healing in these areas. The ligaments have many nerve endings; therefore patients will feel pain at the areas where ligaments are damaged or loose. Tendons help to connect muscle to bone and also lack blood supply which lead to poor healing. Prolotherapy uses dextrose (sugar water) solution mixed with a numbing agent such as lidocaine and injects this into the tendon or ligament at the attachment to the bone. This causes localized inflammation in these weak areas which then increases the blood supply and flow of nutrients and growth factors and can stimulate the tissue to repair itself.
Prolotherapy is helpful for what conditions?
The treatment is useful for many different types of disorders, including neck and back pain, sports injuries, partially damaged tendons or ligaments, arthritis, and fibromyalgia.
How many treatments are necessary?
The response to treatment varies from individual to individual, and depends upon one’s healing ability. Some people may only need a few treatments while others may need 10 or more. The average number of treatments in 4-6, and there is not the concern of repeated injections as with cortisone. Once you begin treatment, your doctor can tell better how you are responding and make appropriate recommendations.
What are the risks and side-effects?
This procedure is safe when performed with sterile ultrasound and proper sterile injection techniques. The most common side effect is discomfort which is temporary. The other risks involve infection, bleeding, and worsening of pain. Ice is not allowed post injection for prolotherapy as it is used post biopuncture or steroid injection therapy. Ice directly inhibits inflammation, which is what we are trying to induce and is the purpose of the prolotherapy. This may be the reason for increased pain post injection in comparison with other injection therapies.
Platelet Rich Plasma Therapy, or PRP, is a 100% natural treatment for pain and injury.
PRP is an exciting, natural, non-surgical treatment that involves the injection of patient’s own blood after extracting the platelets and reinjecting them with the areas of injury and degeneration. It has been shown to be safe and effective in treating a variety of sports injuries, from chronic conditions to acute trauma. The growth factors contained within platelets provide a powerful stimulus for tissue healing and regeneration. This treatment can often completely repair tissue and eliminate the need for surgery. PRP treatment is a safe, injection technique.
How do we use platelets?
Platelets are best known for their ability to stick to one another and stop bleeding in the body via the clotting cascade, but they have many other functions. They also release numerous growth factors which stimulate the proliferation of collagen connective tissue, tissue regeneration and healing. The platelets are often responsible for initiating a healing cascade in soft tissue injuries such as abrasions and lacerations.
The rationale for the utilization of platelets is the myriad of growth factors derived from platelets that alter the healing response and tissue regeneration. These growth factors can enhance healing, grafting, and connective tissue repair include: TGF-β, Platelet derived growth factor(PDGF), Insulin-like growth factor (IGF), Vascular endothelial growth factors(VEGF), Epidermal growth factor (EGF), Fibroblastic growth factor-2 (FGF-2).What is PRP used for?
The use of platelet rich plasma injection for the purpose of treatment of areas which are resistant to healing due to lack of blood flow to the area, repetitive stress and erosion of tissue. Treatment of chronic tendinopathy, cartilage erosion, and muscle injury has become common in the world of sports medicine.
What conditions are helped by PRP?
It can be used any site of injury in the body. In musculoskeletal medicine, it is used to repair: ● Arm & Shoulder pain● Rotator Cuff tendonitis or tears● Acromio-clavicular joint pain● Bicipital tendonitis● Medial epicondylitis (golfers elbow)● Lateral epicondylitis (tennis elbow)● Ulnar collateral ligament injury● Hip pain● Pyriformis syndrome● Trochanteric Bursitis● Ischial bursitis● Pubic symphysis pain● Sacroiliac joint pain● Leg & Foot pain gluteus medius tendonitis● Hamstring tendonitis or tears● Patellar tendonitis/tendinosis● Quadriceps muscle/ ligament injuries● Plantar fasciitis● Peroneal tendonitis● Achilles tendonitis or partial tears
How is PRP done?
A patient’s blood is drawn similar to a normal blood draw and placed into a centrifuge where the platelets are concentrated. Harvest labs is able to concentrate the platelets 16% over baseline and is considered one of the best technologies for platelet extraction. The highly concentrated platelets mixed with a bit of lidocaine is then injected into the area of injury via ultrasound guidance. The entire procedure can be completed in less than one hour.
What are the side-effects/contraindications?
Because platelets are autologous, from one's own body, there is no chance of developing an allergic or autoimmune reaction post injection. The side effects are limited to a little soreness at the injection site. If the patient suffers from an anti-phospholipid antibody syndrome or any platelet disorder, the procedure should not be performed as the quality of the platelets may be compromised.
Therapy duration
Two to three weeks after the first PRP treatment, the doctor will evaluate the progress and determine whether more therapy is needed. Depending on the severity and duration of the injury or disorder, most patients require between 1 and 4 treatments.
As PRP therapy now gains popularity in the U.S., it is getting recognized by doctors and patients alike for having a terrific rate of success. Many believe PRP has the potential to revolutionize sports medicine, orthopedics and beyond, with new applications being discovered daily.