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Platelet Rich Plasma for treating chronic
pain
Harry Adelson, N.D.
When I’m interviewing people living with pain, I always start by asking
8 questions in the same order: 1 – how did your pain start, tell me the
entire story from the beginning, 2 – where exactly is the pain, etc.
Then the last question is always: “tell me very specifically how this
pain impacts your quality of life?” At this point, more often than not,
there is a brief pause and a look of surprise (no doctor has asked them
this before), then the tears start to well up, the tissues come out, and
the crying begins. Most commonly, the first words out of a person’s
mouth are “I feel much older than I am”. Also very common are “I’ve lost
all sex drive with my partner and I’ve become mean towards him/her”, or
“I have no motivation to meet anyone, I go to work then I go home”.
When people say their pain makes them feel older it’s because it’s true:
their pain truly does make them physiologically older. When you’re in
pain, you breathe less, you exercise less, you
sleep less, and your
hormones fall out of balance.
A new treatment for pain is becoming popular among
orthopedic and pain
specialists: the injection of
platelet rich plasma (PRP).
Most everyone thinks of blood platelets as being responsible for blood
clotting after injury which is true. What many people do not know is
that blood platelets serve two other important functions. Blood
platelets are responsible for bringing white blood cells to the injured
area to clean up the remains of dead and injured cells. Most importantly
to this discussion, blood platelets release growth factors that are
directly responsible for tissue regeneration. These substances are
called cytokins and include platelet derived growth factor, epithelial
growth factor, and other important growth factors.
PRP has been used for years in surgical centers around the US and abroad
to improve the success of bone grafting (especially in dental surgery)
and also by cosmetic surgeons for speeding healing time and decreasing
the risk of infection after surgery. Only in the last few years have
doctors and surgeons been experimenting with injecting PRP for the
treatment of chronic pain.
Tennis elbow,
Plantar Fasciitis,
Achilles
tendonitis/tendonosis, rotator cuff tears, meniscal tears,
Osteoarthritis and chronic low back and
neck pain are all being treated
with the injection of PRP with the goal of regenerating degenerated
connective tissue with reports of success.
A PRP treatment looks like this: a patient’s blood is drawn and placed
into a special collection kit. Using the person’s own blood eliminates
the risk of transmission of any blood-borne disease. This kit is placed
in a centrifuge for 15 minutes and the platelets and plasma are
separated from the red and white blood cells. Two thirds of the plasma
is removed and discarded and the remaining plasma is mixed with the
platelets. This higher than normal concentration of platelets is what
gives us platelet rich plasma. The PRP is drawn into a syringe. The area
to be treated is injected with a local anesthetic and after waiting five
minutes for the anesthetic to take effect, the PRP is injected.
The injection technique is identical to prolotherapy/regenerative
injection therapy, only the solution injected is different. Same
instrument, different sheet music.
People generally report two days of being sore and then usually pain
relief occurs within the first week and continues to improve over a
period of months. To date, my experience is that one PRP treatment is
the therapeutic equivalent of three or four prolotherapy/regenerative
injection therapy treatments using
dextrose.
One of the attractive aspects of this treatment is the use of a person’s
own blood to eliminate the risk of the transmission of disease. The same
lab that has developed the preparation kit for production of PRP has
also developed a method to collect a person’s own stem cells which
eliminates the need for embryonic, umbilical or placental stem cells.
This procedure is much more invasive as it requires a bone marrow biopsy
and it is quite expensive compared to PRP which is safe, easy and
inexpensive.
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