Rotator Cuff Injuries
The Role of Platelet Rich Plasma (PRP) & Prolotherapy in Healing Rotator Cuff Injuries
The rotator cuff is a group of four muscles, with their associated tendons, that connect the arm to the shoulder. The shoulder joint is unique in that it is one of the most mobile joints in the body.
It is also one of the joints that is most susceptible to injury from overuse. Rotator cuff injuries are most common in people who engage in activities (jobs or hobbies) that involve repetitive motions. They are also more common as we age.
The pain of rotator cuff injuries usually starts as a sharp stabbing pain when performing certain motions with the arm. It can progress to a constant dull ache that can interrupt sleep, interfere with work, or stop you from taking part in your hobbies.
Chronic inflammation in the tendons of the rotator cuff can increase your chances of developing a tear in a tendon of the rotator cuff.
Prolotherapy and Platelet Rich Plasama (PRP) are effective treatments for rotator cuff injuries from the early stages of inflammation and pain to severe tears.
During a Prolotherapy treatment, the affected tendons are injected with a dextrose solution that directly stimulates the growth of strong, healthy tissue. The dextrose creates a short duration of inflammation which stimulates a healing cascade bringing in growth factors to the area. These growth factors interact with fibroblasts that are also attracted to the area to synthesize precursors to mature collagen (important components of tendons).
In a 2016 double blind, placebo controlled study published in the Archives of Physical Medicine and Rehabilitation, a group (n=73) of people with chronic shoulder pain, signs of rotator cuff injury and evidence of a tear as seen on ultrasound, were placed in two groups. Group 1 received prolotherapy and group 2 received placebo(injections of saline). Both groups received physical therapy. The group that received the prolotherapy treatments reported superior long-term pain improvements and patient satisfaction compared with saline injections.
Most people feel sore after their Prolotherapy or PRP treatment. This soreness can last for just a couple of hours to a couple days. However for most people the soreness is gone by the next day. As the tendonitis improves after subsequent treatments, the post-treatment discomfort is less and less.
Some people need only 2-3 prolotherapy treatments while others with long term injuries may need 15 or more treatments. The average number of prolotherapy treatments is 5-7. Most people need less PRP treatment because PRP induces a bigger healing response in the body. Some people achieve complete healing with one PRP treatment while others need 2-3.
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