Regenerative medicine is a new medical buzz term and is a very useful and exciting option in pain management therapy. Two of the most common regenerative treatments are Platelet Rich Plasma (PRP) injections and Stem Cell (SC) injections. Essentially, these injections harness the body’s ability to heal itself, in a very condensed form, by directing the blood’s healing factors towards injured and arthritic tissues. The procedures involve drawing a patient’s blood (or bone marrow) and then using a centrifuge machine to isolate and concentrate the healing elements (PRP and SC) that can be then reinjected into the target areas of the body that are painful.
Regenerative medicine therapy is extremely successful for many types of pain including muscle tears and strains, partial ligament and tendon tears (shoulder rotator cuff injuries especially), osteoarthritis of the knees and hips and sacroiliac and spinal facet arthritis, as well as most other joints. Oftentimes, chronic pain is the result of reduced blood flow to the area of injury such that the crucial elements in the blood for healing are not able to access the area to repair the injury.
The Platelet Rich Plasma or Stem cell product that is re-injected has both an anti-inflammatory effect and a healing and tissue renewal effect. Whole blood, or blood with all of its components, contains plasma (55%), red blood cells (45%) and white blood cells and platelets (1%). Plasma contains clotting factors, antibodies, protein, glucose and vitamins and minerals and is the main fluid that the other components are suspended in. Red blood cells carry oxygen and carbon dioxide to and from the tissues and organs. White blood cells destroy bacteria and produce antibodies against viruses and bacteria. Platelets are responsible for blood clotting by sticking together along with the clotting factors in the plasma to form a “patch” along the blood vessel. When injury and bleeding occur, platelets also release growth factors into the injured areas to help facilitate the repair process and tissue regeneration.
There are over 40 kinds of growth factors that are released by the platelets and are activated depending on what type of tissue needs to be healed. Growth factors can stimulate injured tissues in the body to grow and repair themselves including bone, cartilage, connective tissue, muscle and blood vessels.
Stem cells themselves can grow and mature into any type of tissue that the body might need to repair an injury. When platelets release their growth factors, the stem cells are “called” in from the bone marrow like a rescue brigade to start regenerating and replacing the damaged bone, muscle, cartilage, etc. Stem cells are located in the bone marrow and are readily accessible and can be harvested from large bones such as the iliac crest (hip bone) with a minimal discomfort. When concentrated stem cells are injected into an area of damage, the effect is similar to having a transplant because they grow into new tissue altogether.
The effects of both PRP and SC injections on pain relief and tissue regeneration take about three to four weeks to complete. Generally, people see a gradual improvement in pain and function starting at one week that progresses over a month. The injections can be repeated for maximum effect at 4 or 5 week intervals for persistent pain. A maximum of three injections is used as the endpoint of therapy after which further improvement is not likely.
Prior to the having the injections, all medications that block platelet activity need to be discontinued for one to two weeks. These include aspirin and aspirin containing products, anti-inflammatories such as prednisone, ibuprofen, naproxen and the like. There are other medications that can be substituted for those if needed for pain relief in the interim that will not interfere with the platelet activity. Platelets and stem cells will remain viable and active for up to 4 weeks after injected so it is important not to take medication that will block their activity during the healing phase as well.
Regenerative medicine is quickly gaining acceptance as a valuable and highly effective treatment in Pain Management. I have been performing PRP and SC injections in my office for the past 2 years and the success rates have been exceptional. The risk of the treatment itself is minimal and because PRP and SC are autologous products (from your own body) they are completely safe and free from potential drug reaction side effects unlike other kinds of injections.
In my opinion, this YouTube video does a nice job of explaining the process.
Call my office to make an appointment and discuss whether this could be a great treatment choice for you!