Millions of patients are affected by pain. This can be neck or back pain but also knee, shoulder, ankle, hip and elbow pain, as well as plantar fasciitis, can be a chronic, debilitating problem. Patients have tried cortisone shots, physical therapy, chiropractic and acupuncture therapy but still their pain persists. Many have even had surgery, frequently with no benefit or with worsening of their pain. Now a new, innovative FDA approved therapy is available to provide many of these patients with chronic pain, a hope for pain relief. This therapy is known as PRP therapy or Platelet Rich Plasma therapy.
Blood is a natural healing fluid but all of the blood components are not responsible for healing. Actually only about 10% of the components of blood perform actual tissue healing. Through a special process, we can take a small amount of your own blood, extract and concentrate the healing components by up to 500%. We can then take this concentrated “healing fluid” – PRP and inject it directly into the area that needs to be healed.
The contents of PRP include the platelets, which are immature, not fully developed cells made in the bone marrow. They have receptors on them known as cytokines. These receptors, when activated, cause the platelets to clump together to form a clot or graft. The platelets then release other cytokines that is the signal to trigger the healing mechanism. Other components of the blood concentrate in the area of the graft. Fibrinocytes come in and lay down fibrin, the structural matrix or “skeleton” that collagen fibers can attach to and start to rebuild the injured tissue.
Initially there may be a small amount of swelling or inflammation. This is part of the normal healing process and may take about one week to clear. Then collagen fibers are laid into the matrix structure to heal the tissue. This process can go on for up to four weeks.
Remodeling then occurs to allow the new collagen to adapt to the area that it was laid down in. For example, if the graft was put in a joint, the collagen would remodel to the cartilage surface to allow the joint to work better. If the graft was put into a muscle tendon or bone ligament, it would remodel to function the best as a tendon or ligament. Tendons attach muscles to bone and ligaments attach bones to bones.
Common areas of tendon injury are in the shoulders, elbows and ankles. Ligament injuries occur in the knees, ankles and acromioclavicular joints. Plantar fasciitis is inflammation of a ligament in the bottom of the foot. When the plantar fascia becomes inflamed it is very painful. A condition known as plantar fasciitis results.
Various knee injuries such as partial meniscus tears, ACL tears, arthritis or inflammatory conditions of the knee cap can occur. This causes problems with persistent knee pain and trouble walking. Many patients have had steroid shots or even surgery to treat these conditions. Unfortunately many are left with pain, despite adequate rehabilitation and taking anti-inflammatory agents. These are the very patients that are ideal candidates for PRP therapy.
PRP can be injected into the knee joint (with anesthesia, to minimize the discomfort.) The PRP graft then works over the next few weeks to heal the injury. For the first six weeks after PRP therapy, you should not take any anti-inflammatory medications (such as aspirin, ibuprofen or naproxen.) Only Tylenol products should be taken. If there is swelling ice packs may be used sparingly for the first two days after being given a PRP treatment. Within a week, patients may start to feel better. It is advisable to rest the injected area for a few days and then gradually resume activities over the next three to six weeks. Neurologists frequently see patients with knee and leg pain. Contact Sarasota Neurology for a consultation appointment to see if platelet rich plasma would help you.