Prolotherapy & Platelet Rich Plasma Therapy
A Solution for Chronic Pain and Joint Laxity
“Not many physicians are aware of Prolotherapy… but I was also a patient who benefited from Prolotherapy. My intractable pain was not intractable and I was remarkably improved… I saw so many patients cured that I could not help but become a ‘believer’ in Prolotherapy. The nice thing about Prolotherapy, if properly done, is that it cannot do any harm.”
– C. Everett Koop, M.D., former U.S. Surgeon General
Prolotherapy is a simple and safe technique that stimulates the body’s healing mechanisms to repair damaged ligaments and tendons. Damaged ligaments and tendons are usually the source of chronic pain when they become damaged, weakened, stretched or hyper mobile. With this minimally invasive technique, the injured areas are injected with a steroid-free solution that causes a nominal amount of irritation. In response to this irritation, the body begins to repair itself, strengthening the weakened areas by stimulating new growth of tissue. This process leads to elimination of pain.
How does Prolotherapy work?
When you injure a ligament or tendon there is an increased amount of laxity that occurs at the joint. Your body responds by creating inflammation which causes an increased blood flow to the area. This process results in the formation of new collagen and strengthening of the joint. But due to ligaments and tendons having poor blood supply, sometimes that process is unable to complete itself. The result can be pain, numbness, joint instability/laxity, and muscle spasms. Prolotherapy injections specifically target these weakened areas by causing localized, controlled inflammation. This response attracts blood flow and forces a healing reaction. This healing reaction regenerates the injured tissue and subsequently tightens the lax joint. As the ligaments and tendons tighten, the pain is eliminated. Studies show that Prolotherapy can generate tissue that is stronger than even the original tissue.
The use of non-steroidal anti-inflammatory medications (NSAIDS’s), such as aspirin and ibuprofen can suppress inflammation, and hinder the healing process. In fact, research is increasingly finding that the use of NSAID’s causes even repaired ligaments and tendons to become weak, and may even directly cause ligament laxity and tendinopathy.
How many treatments are given?
There are many factors that are involved in a person’s ability to heal after Prolotherapy. Age, obesity, hormones, diet, sleep, physical activity, and medications are some of those factors. Proper immune function is needed for a person to adequately heal soft tissue injuries and respond well to Prolotherapy. Most patients require between 2-5 treatments, spaced 3-4 weeks apart. The number of treatments also depends on severity of injury.
When will I see pain relief?
This is dependent on each patient. The amount of collagen growth required to provide joint stabilization is highly variable. Most patients will not start to see improvement until after the 2nd treatment so don’t be discouraged if you don’t have immediate pain relief. It is recommended to receive the full-recommended course of Prolotherapy for complete healing.
Do I need to do anything before or after the procedure?
Since anti-inflammatory medications (ibuprofen, Motrin, Aleve, etc.) are known to hinder the healing process, they should be stopped at least 24 hours prior to the Prolotherapy treatment. The use of these medications should be discontinued between treatments. Also, the usage of ice only decreases blood supply to the injured areas, further increasing the time needed to repair.
If it’s such a great procedure, why don’t more doctors use it?
Although it has taken quite a long time for modern medicine to acknowledge the success of alternative treatments, the medical field is finally recognizing many of these as legitimate healing methods. Until recently, many effective therapies have been overlooked by conventional medicine—and Prolotherapy is one of those. It isn’t currently being taught in traditional medical schools, but increasingly more physicians are becoming aware of its existence and training in its use. Also, since the therapy is absent of pharmaceutical drugs there is no financial incentive to study Prolotherapy.
What are some conditions that can be treated with Prolotherapy?
Arthritis pain, sports injuries, loose/weakened joints, TMJ, tendonitis, sciatica, cartilage degeneration, degenerative joint disease, herniated disks, golfer’s elbow, tennis elbow, plantar fasciitis, or generalized neck, wrist, back, shoulder, hand, knee, foot, hip, leg or ankle pain.
Platelet Rich Plasma Therapy
Platelet Rich Plasma (PRP) therapy is a form of prolotherapy. This innovative, cutting edge technique involves injecting plasma harvested from a patient’s own blood (autologous) directly into an injured area (damaged tendon, ligament, or joint). This plasma, which is rich in platelets and growth factors, stimulates the body’s natural healing system to enhance repair of both acute and chronic injuries. PRP therapy utilizes your body’s ability to heal itself naturally from its own elements, making it very safe, minimally invasive and requiring only minor recovery.
Why use Platelets to heal?
During the normal healing process your body sends many types of cells to heal the injured area. One of the most important types of these cells are platelets. Platelets are sticky, irregular-shaped, colorless bodies present in blood. They are formed in the bone marrow. Platelets are full of growth factors that stimulate cell and tissue regeneration. Yoshiteru Kajikawa, a professor at the Kyoto Prefecture University of Medicine, dyed bone marrow cells with a green fluorescent protein to follow their movements, and found that PRP injections attract bone marrow cells to a damaged area, focusing the body’s healing power. This phenomenon alone has sparked the interest of scientists to research additional benefits of PRP therapy.
What are growth factors?
Growth factors are natural proteins involved in growth and creation of cells and are the body’s primary source of bioactive tissue. Growth factors accelerate your bodies own healing capacity in the injured areas by stimulating transforming growth factor beta (TGF-b), platelet-derived growth factor (PDGF), insulin-like growth factor (IGF), vascular endothelial growth factors (VEGF), epidermal growth factor (EGF), and fibroblast growth factor (FGF-2) which creates collagen.
How does the process work?
- 30 ml of blood is withdrawn from the patient and is placed in a blood separation tube
- Tube is placed in a high speed centrifuge for 10 minutes which separates the blood into 3 layers (platelet poor plasma, platelet rich plasma, red blood cells)
- The Platelet Rich Plasma (now 5x more concentrated than regular blood) is removed and the platelet poor plasma and red blood cells are discarded
- The site to be injected is anesthetized locally with Lidocaine
- The PRP is then precisely injected into the injured area overloading the site with the healing cells needed to encourage the natural repair process
Is PRP therapy expensive?
No. Just because the media buzz concerning the professional athletes: Golf’s Tiger Woods, Hines Ward and Troy Polamalu of the Pittsburgh Steelers, Takashi Saito of the Los Angeles Dodgers and Carlos Beltran of the New York Mets of having success with PRP doesn’t mean the treatment is reserved only for the elite athletes or is expensive. Due to technological advances in reducing the cost of treatment, ordinary people can enjoy the same success as these elite athletes.
Is PRP therapy safe?
Since PRP involves the use of the patient’s own blood safety is unparalleled. Autologous (patient derived) PRP has been used for over 30 years as an aid in recovery following certain surgical, orthopedic and dental procedures. There are thousands of research articles published on the safety of PRP.
How many treatments are required?
Most cases are resolved in 1-2 treatments spaced 6-8 weeks apart.
Tennis Elbow, Golfer’s Elbow, Chronic Tendonitis, Plantar Fasciitis, Achilles Tendonitis, hamstring injury, sacroiliac joint dysfunction, cartilage degeneration, meniscus injury, and labrum tear.