What is Regenerative Injection Therapy?
Regenerative injection therapy (RIT) is also called Prolotherapy (short for proliferative therapy). RIT involves the injection of therapeutic substances directly at the site of strain in damaged connective tissue. The result is a mild, controlled inflammation that stimulates the body’s innate healing process of laying down new collagen fibers on the weakened area. The wound healing cascade starts with increased circulation and the release of growth factors that cause proliferation of fibroblasts resulting in the formation and deposition of new collagen. New collagen shrinks and tightens as it matures replacing damaged connective tissue, making it stronger.
The success of RIT is based on the premise that much of chronic musculoskeletal pain is caused by degeneration of connective tissue: essentially connective tissue wearing out faster than it can be replaced due to either major injuries or small, repetitive injuries. Tennis elbow, plantar fasciitis, Achilles tendonitis/tendonosis, rotator cuff tears, meniscal tears, osteoarthritis and chronic low back and neck pain are all being treated by RIT with the goal of regenerating degenerated connective tissue. RIT takes an hour or less in the office and the results are long-lasting to permanent. If you have tried and failed physical therapy, cortisone injections, or medication, then RIT may be just the right option for you.
What is dextrose based Prolotherapy?
utilizes dextrose as the therapeutic solution. Dextrose is a mild stimulant of fibroblast proliferation and collagen deposition.
Studies have been performed showing microscopic views of ligaments before and after prolo, and show prolo does in fact normalize tissue. Prolo is extremely safe, relatively inexpensive and effective for many chronic joint, tendon and ligament conditions.
What is platelet rich plasma therapy?
You may only think of platelets as being responsible for blood clotting, which is true. What you may not know is that platelets serve two other important functions. First, platelets are responsible for bringing white blood cells to the injured area to clean up the remains of dead and injured cells. Secondly, platelets release growth factors that are directly responsible for tissue regeneration including platelet derived growth factor, epithelial growth factor, and other important growth factors.
Platelet Rich Plasma (PRP) is a concentrate of your own platelets from your body. Therapy with PRP is an emerging biologic treatment that has been shown to improve healing of wounds, tendons, ligaments and joints. PRP harnesses the body’s own natural healing power as PRP is rich in your own connective tissue growth factors including fibroblast growth factor. PRP therapy is simply the injection concentrated platelets from your own blood into the damaged portion of a tendon or ligament under ultrasound guidance.
For many years PRP has been used to improve the success of bone grafting (especially in dental surgery), speed healing time and decreasing the risk of infection after surgery. In the last few years PRP has been researched and used for the treatment of chronic pain.
How is PRP Done?
In the office, blood is drawn from the patient and placed in a special centrifuge, where the blood is spun down. The platelets are separated from the red blood cells and are
concentrated. The red blood cells are discarded, and the resulting platelet concentrate is used for treatment. While the blood is spinning in the centrifuge, the painful area is injected with lidocaine to numb it. The entire treatment, from blood draw, to solution preparation, to injection, takes 46 to 60 minutes.
What Conditions Benefit From RIT?
RIT works best for chronic ligament sprains and laxity, tendon strains, tendinosis, tenosynovitis that have failed other conservative treatment, including:
* Shoulder: rotator cuff injuries, shoulder pain and instability, capsulitis
* Elbow: tennis & golfer’s elbow
* Wrist and Hands: arthritis, finger pain,
* Hamstring and hip strains, hip capsulitis
* Knee: collateral ligaments sprains and instability, patellofemoral syndrome, patellar
tendinosis, meniscus injuries, Baker’s cysts
* Ankle and foot: sprains, Achilles tendinosis, plantar fasciitis
* Spine: back pain, neck pain
RIT may also benefit headaches, myofascial pain and fibromyalgia.
What is the Success Rate of RIT?
Studies suggest an improvement of 80-85%. Some patients experience complete relief of their pain. The results are generally permanent!
How Often are Injections Given?
After the initial treatment, a follow up visit is scheduled 6-8 weeks later. Some patients respond very well to just one treatment. However, typically 1-4 treatments are necessary with PRP and usually 4 to 10 treatments are needed with prolotherapy. If no signs of improvement are seen after 3 treatments, treatment is usually discontinued. If there is marked improvement after only 1-2 treatments, then no further treatments may be necessary.
To get maximum benefit from the treatment, and to help prevent re-injury, you may be prescribed physical therapy for a specially-designed home-based rehabilitation and exercise program as part of your treatment. This helps the newly developing connective tissue mature into healthy and strong tendon or ligament fibers. The effectiveness of RIT may be enhanced by improving nutrition for connective tissue through supplementation and dietary guidance.