Features and Clinical Effectiveness of the Regenerative Injection Treatments: Prolotherapy and Platelet-Rich Plasma for Musculoskeletal Pain Management

Abstract

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.

Treatment of Osteoarthritis Secondary to Developmental Dysplasia of the Hip with Prolotherapy Injection versus a Supervised Progressive Exercise Control

“…Various injection types and methods are available in the literature for different hip pathologies [7,8]. Prolotherapy (PrT) is an injection method successfully used in the degenerated and damaged joint structures including tendons, cartilage, and other connective tissues [9][10][11][12][13][14][15]. Previous studies have shown that dextrose has a neurogenic effect on pain at 5% concentrations [16,17], creates non-inflammatory ligament growth at 10% concentration [18] and, at more than 10% concentration, initiates a brief inflammatory cascade which promotes fibroblast growth and subsequent collagen production [19], and appears to be chondrogenic [20], thereby providing healing and tissue renewal.…”

The Effectivity of Prolotherapy Treatment in Shin Splint: A Randomized Controlled Study

“…The formation of SS formation is the damage of the tibia where the adhesion site of the posterior lower leg muscles as a result of overuse. In the treatment of prolotherapy, injection is applied to the enthesis where the muscle adheres to the bone 9 . Although the diagnosis of enthesopathy is unclear, prolotherapy has focused on enthesis as a source of chronic low back pain 22 .…”

“…But, there is no published randomized controlled trial with these various injection techniques for SS in the literature 5 . Prolotherapy has proven to be a safe and effective procedure because of its healing or regeneration ability for soft tissues when used in chronic musculoskeletal conditions such as low back pain, tendinopathy, osteoarthritis 8,9 . After an injury if an inadequate repair occurs, pain and disability can emerge from degenerated ligaments, tendons, cartilage, and enthesis.…”

“…After an injury if an inadequate repair occurs, pain and disability can emerge from degenerated ligaments, tendons, cartilage, and enthesis. These structures can be treated by using the Prolotherapy injection method 9 . Hypertonic dextrose is one of the most solution using in prolotherapy 9,10 .…”

“…These structures can be treated by using the Prolotherapy injection method 9 . Hypertonic dextrose is one of the most solution using in prolotherapy 9,10 . Despite a variety of treatment methods mentioned before on the treatment of SS, and there is no evidence about prolotherapy in the treatment of this condition.…”