The fundamental tenet of regenerative cell therapy turns conventional teaching on its head. Generally, with acute injury or degenerative changes, the clinician treats with anti-inflammatories. This is to mitigate the pain and attempt to augment healing. However, we now know acute inflammation may be beneficial to the injured tissue because it attracts growth and tissue healing factors. It serves much like a beacon on a lost ship at sea. It directs cells and natural healing chemicals to the damaged or injured site to promote proliferation and repair of tissue. Repeated systemic (oral) or local (injectable) administration of anti-inflammatory medication can be detrimental to healing and repair of tissue.
For the last 50 years, clinicians have used a treatment called prolotherapy to treat injured or degenerative tissue. Prolotherapy is the injection of an irritant to the tissue such as a high concentration of sugar or dextrose into the area. To be honest, we were never really sure how or why it worked, but it does work in some conditions. However, now we know through more recent research, the irritation of the injected agent causes the body to dilute the irritant by flooding the area with the body’s serum which contains the natural growth and tissue repair molecules present in our body’s serum. The body is stimulated to enhance a local release of growth factors in increased concentrations. Thus, the inflammation promotes healing over time and with higher levels of natural healing factors present. This promotion of natural and more rapid healing happens faster and more completely than if not stimulated by the irritating injection. Prolotherapy can be effective but is less predictable and can be a bit more painful due to its natural irritating effect. However, it is cost effective and useful for more superficial tissue injury.
Platelet-rich plasma picks up where prolotherapy left us. PRP offers a viable alternative to provide healing to injured or degenerative tissue. It is used most commonly in acute and chronic disorders of the peripheral musculoskeletal system. Professional athletes have spearheaded the use of PRP for sports injuries.
Obtaining platelet-rich plasma is a relatively simple process. The patient’s blood is drawn into a tube, spun in a very fast centrifuge for 15 minutes, and then the red blood cells are removed, leaving a platelet concentrate rich in growth factors. This fluid will hopefully jump start the healing process when injected directly into the affected tissues.
Platelet-rich plasma injections are office procedures. Depending on the age and severity of the injury or degenerative site, most patients require 1-4 sessions of injections. The clinicians at Hill Country Pain use either ultrasound or live radiological guidance for most PRP injections to ensure proper placement of the healing fluid and the best chance at success.
There are times when your pain doctor may decide to use both PRP and another regenerative medicine technique to optimize the opportunity for improvement. Platelet-rich plasma may be used with amniotic fluid or stem cells if the clinician feels it is the best for your condition.
Insurance companies do not cover some of our newest regenerative therapies. However, you can pay for this therapy with cash, credit card, or use your health saving account plan or flexible spending plan (FSA).
Platelet-rich plasma (PRP) is an exciting and modern alternative to steroids and surgery for conditions which have not responded to other more conservative modalities.
If you have a question regarding Platelet-rich plasma (PRP) therapy and whether it might be right for your pain problem, please submit your question below.