Advances in Regenerative Medicine: High-density Platelet-rich Plasma and Stem Cell Prolotherapy For Musculoskeletal Pain (original) (raw)
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From Conventional to Innovative Approaches for Pain Treatment, 2019
Pain is a symptom caused by a disease process and/or tissue injury. With the prolongation of life expectancy in humans, the incidence of degenerative joint diseases and as a result pain has increased. Unfortunately, a method of treatment that stops or reverses progression by affecting the pathogenesis in these diseases has not been developed. Physical therapeutics such as medicine and physical rehabilitation often are prescribed for patients suffering with pain. Recently, in addition to these routine therapies used in pain treatment, many regenerative injection-based therapies, including prolotherapy (PrT) or platelet-rich plasma (PRP) have been widely used. PrT is using for damaged or degenerated connective tissue healing, such as ligaments, tendons, and cartilage. The combination of local inflammatory effect, stimulation of local growth factor release, and down regulation of neuropathic inflammation can be defined as the mechanism. As a result of these, joint instability and ligament laxity reduce and pain decrease. PRP is the cellular component of the plasma. Although PRP is used for the same reasons as PrT, it can be used in acute cases unlike PrT. This chapter is intended to understand the use of regenerative injection therapies (PrT and PRP) better in the treatment of pain.
The most commonly reported chronic pain conditions are corresponding with musculoskeletal dysfunction and degeneration. The most important cause of joint instability is the ligament injury, which leads to symptoms like pain. However, standard therapeutic regimens have failed to be effective in chronic conditions as they do not treat the under lying cause. Hence, this is where prolotherapy comes into picture. Prolotherapy is also known as nonsurgical ligament/tendon reconstruction, or sclerotherapy. The ligaments and tendon become weak over a course of time which leads to inflammation. Prolotherapy by using a sugar based solution is injected into the affected area whereby it causes increase in the blood supply and nutrients which stimulate the tissue repair. Through this review we are trying to highlight that prolotherapy can be regarded as an alternative therapeutic modality that can reduce or eliminate pain by stimulating the natural regenerative processes.
Evidence-Based Regenerative Injection Therapy (Prolotherapy) in Sports Medicine
The Sports Medicine Resource Manual, 2008
The treatment of sports injuries to the point of restoration of full sports performance is an obvious goal in sports medicine. However, healing is the preferred goal because returning connective tissue to normal strength allows for a durable return to full sports performance.. Regenerative injection therapy (prolotherapy) is the injection of growth factors or growth factor production stimulants to promote the regeneration of normal cells and tissue. Inflammation is not required, and scarring is not the result.. Open-label clinical trials have been uniformly positive in outcome, but double-blind clinical trials have been hampered by a needling control that does not appear to be a placebo. Recent studies are making use of a noninjection control.. Making use of consecutive patient data from athletes with career-threatening injuries (i.e., chronic groin strain in soccer or rugby players) that are not responsive to other treatments is a recommended study approach to assess regenerative injection therapy's ability to reverse otherwise permanent conditions. This is an avenue for the critical assessment of regenerative injection therapy's potential.. Serial high-resolution ultrasound images are limited somewhat by uniformity of technique, but they offer a way to follow healing from regenerative injections.
Regenerative Medicine for Spine and Joint Pain, 2020
Current Concepts of Prolotherapy in Orthopedic Surgery
Archives of trauma research, 2016
Context: Prolotherapy is a popular injection-based complementary treatment, which has shown promising results in the treatment of sprained and degenerated ligaments, and damaged dense connective tissues' structures. More research was conducted in this area and many authors declared successful results for different indications. Evidence Acquisition: The purpose of this study was to present a literature review regarding the current concepts of prolotherapy injections and improvements in the orthopedic clinical care practice. The Medline and PubMed databases were searched for the articles related to prolotherapy injections in the field of orthopedic surgery and additionally the reference list of each article was also included to provide a comprehensive evaluation. Results: Numerous studies have been conducted on prolotherapy injections for different indications for orthopedics clinical care practice. Prolotherapy injections have successfully used for major orthopedic procedures in terms of rotator cuff lesions, knee ligamentous lesions, osteoarthritis-cartilage defects, and ligament-tendon injuries. Most of the studies showed that prolotherapy provided faster and better healing of tissues. Conclusions: There is a great interest to prolotherapy in orthopedic clinics, especially to manage musculoskeletal lesions. More research conducted in this area and many authors declared successful results in their studies. In spite of this increasing trend for prolotherapy injections, there were only one or two clinical studies investigated prolotherapy injections for different indications and most of them have limited participants, short-term follow-up or poor quality studies. There is still need for further high-quality studies investigated optimal strategy of the injections of prolotherapy.
Prolotherapy Revisited: a Therapeutic Adjunct For Tmds
2015
The most commonly reported chronic pain conditions are corresponding with musculoskeletal dysfunction and degeneration. The most important cause of joint instability is the ligament injury, which leads to symptoms like pain. However, standard therapeutic regimens have failed to be effective in chronic conditions as they do not treat the under lying cause. Hence, this is where prolotherapy comes into picture. Prolotherapy is also known as nonsurgical ligament/tendon reconstruction, or sclerotherapy. The ligaments and tendon become weak over a course of time which leads to inflammation. Prolotherapy by using a sugar based solution is injected into the affected area whereby it causes increase in the blood supply and nutrients which stimulate the tissue repair. Through this review we are trying to highlight that prolotherapy can be regarded as an alternative therapeutic modality that can reduce or eliminate pain by stimulating the natural regenerative processes.
Regenerative Injection Treatment in the Spine: Review and Case Series with Platelet Rich Plasma
Background: Platelet-Rich Plasma (PRP) has been used for a variety of musculoskeletal disorders including tendinopathies and Osteoarthritis. Few studies exist for PRP in the spine, except for studies involving disc pathology. However, numerous studies exist involving the use of Prolotherapy for spinal disorders. Both Prolotherapy and PRP can be considered within the broad category of Regenerative Injection Treatment (RIT), which are proposed to strengthen or repair injured ligaments, tendons, muscle, cartilage, and bone via injections of proliferative solutions, growth factors, or cells. Provided that double blind randomized controlled trials have shownboth PRP and Prolotherapy to be effective in treating similar regions of the body, it is reasonable to consider that PRP could be comparatively effective as Prolotherapy in treating pain related to the facet joints, capsules and associated spinal ligaments.