Prolotherapy and Stem Cell Therapy are methods of repairing damage to your joints or bones without surgery.
These treatments consist of stimulating local stem cells through a treatment called “prolotherapy” where needles are used to inject concentrated dextrose and vitamins with anesthetics. A modification of this original prolotherapy is when the effect of it is amplified by growth factors from platelet rich plasma (PRP), also administered by injections. The ultimate healing signal occurs when you mix in stem cells with the PRP into the injured tissues, using stem cells taken from bone marrow or fat tissue.
The use of prolotherapy with concentrated dextrose or platelet rich plasma (PRP) with or without the addition of stem cells are used in the treatment of various musculoskeletal injuries.
When Prolotherapy is done by itself, 17.0 % Dextrose is used to inject into the area of injury. The reason it works is that local stem cells in the injured area are getting activated where the Dextrose is injected and these activated stem cells will do the healing. This result can be improved by injecting a small amount of PRP very specifically to an area of ligament sprain or rupture. PRP is obtained by centrifuging blood from the patient’s vein. The red blood cells are discarded, but the platelet fraction and some of the plasma is use as the PRP preparation. To amplify the effect of the PRP, stem cells from bone marrow and from fatty tissue may be given. Bone marrow is aspirated from the pelvic bone and in the same patient, a liposuction is also done to obtain adipose tissue. Both tissue samples are put through a cell separator to obtain bone marrow derived stem cells and adipose derived mesenchymal stem cells. Both fractions are combined as they make a superior stem cell mix and are activated by using platelet rich plasma too. This mix is used for bone fractures that were slow to heal, for ruptured tendons, ligaments, Achilles tendons and rotator cuff tearsand all sorts of sprains and strains. Stem cells are the specialists of healing such defects and injuries because they change into whatever cell type is required and they fill in the defects. This explains the perfect function after the injury is healed following stem cell and PRP injection. It also explains why many athletes who had this done went on to winning more medals after the repair. You do not hear about success stories that often after conventional surgery, because the range of motion and strength suffer from scarring following conventional surgical repairs.
Patients with knee injuries that were treated with prolotherapy state that their procedures only involved needles in the injured area, that they experienced almost complete pain relief on the day of the procedure and that they could rehabilitate right away from such specific knee ligament injuries, as those involving the medial collateral ligament (MCL), the posterior cruciate ligament (PCL) and the anterior cruciate ligament (ACL). These are very important support ligaments within the knee.
Conventional medicine for lower back injuries with ruptured discs would have offered a discectomy, but at GLRM, these patients were treated with prolotherapy or Regenerative Injection Treatments (RIT). They experience a stabilization of the weak areas, spontaneous resorption of the prolapsed disc and stabilization and strengthening of the weak spine. MRI scans of the spinal injury before treatment and several months after the treatment were shown with a complete normalization of the spine.
Spinal injuries in the neck have been treated and again there was minimal pain, immediate rehabilitation and a full range of motion several weeks after the injury had been treated with RIT, or PRP and/or stem cells.
What is treated with Prolotherapy?
Basically all of the major joints can be treated with Prolotherapy: the shoulder, knee, back, the neck, ankle, elbow and hip. The types of injuries that are treated are sports injuries, fibromyalgia, sciatica, muscle tears, tendonitis, arthritis, bursitis and temporomandibular joint problems (TMJ).
It should be noted that platelet rich plasma needs to be used to activate stem cells. They go together.
Patellar tendinitis and Achilles tendinitis respond very well to prolotherapy and PRP plus stem cell therapy. This provides complete healing of these otherwise very difficult clinical entities.
The late C. Everett Koop, MD, the former Surgeon General of the Untied States had this to say about prolotherapy: ““I have been a patient who has benefited from prolotherapy. Having been so remarkably relieved of my chronic disabling pain, I began to use it on some of my patients.” This may yet be the strongest argument to at least consider prolotherapy in otherwise hopeless cases.
PRP stands for platelet rich plasma, which is a “soup” of various growth factors and exosomes which are cell-to-cell mediators). Apart from the white blood cells (WBC) and platelets, an important component of PRP are very small embryonic like stem cells (VSELs). They can be seen with the microscope. The missing link has been the observation that white blood cells produce inflammatory substances, which have been detrimental when stem cell injections with PRP were done in the past (poor survival rate of stem cells). Now it has been detected that photo-activation of the PRP before injection leads to anti-inflammatory behavior of the WBC in PRP. This is called “light activated PRP”, which leads to the best results with stem cell/PRP injections. Soft laser stimulation with red, green and blue soft lasers have been shown to improve tissue healing significantly when stem cells and light activated PRP are used. The main sources for good stem cells are the fat tissue (from the “love handles”) and the bone marrow (obtained from pelvic bone). Nitric oxide and electrical stimulation also help to improve stem cell survival and reduce inflammation. All of these methods are revolutionizing orthopedics where injured tissues can be mended with the help of injecting stem cells, light activated PRP and using laser treatments. When you use PRP with bone and adipose tissue derived stem cells and inject it into the knees of a person with degenerative arthritis, you get the ideal remedy to calm down the degenerative process with instant pain relief and the stem cells are transforming into cartilage cells (chondrocytes) building up hyaline cartilage. The end result is a new knee surface where the old and the new repaired knee surfaces are knitted into one seamless unit.
PRP by itself can be used successfully for repairing bursitis of the shoulder and rotator cuff tears, muscle tears and sprains, meniscus tears of the knee, mild to moderate osteoarthritis of various joints and spine disorders, particularly facet joint problems.
Prolotherapy Stem Cell Therapy
- Stem Cells are undifferentiated and they are capable of self-renewal by replication
- Stem Cells can undergo differentiation into specific cell lineages.
“The FDA states it is ok to use these cells as long as they are put back into the same patient and they are minimally manipulated.”
There are a host of other factors beside platelet rich plasma that supports stem cells, increases their survival on transplantation and stimulates them to differentiate and heal the defect at the recipient site as quickly as possible. Photoactivation of platelet rich plasma with low level lasers (soft lasers) will release exosomes, which are tiny particles, released by platelets and white blood cells. They contain proteins and genetic material required for wound healing and stimulation of stem cells.
Prolotherapy and stem cell therapy are the newest treatment modalities for ruptured tendons, ligamentous injuries, and disc herniations in the neck and in the lower back. You will not get this from your primary care physician or from your regular orthopedic surgeon at the present time, because they profit from the conventional procedures. But you owe it to your health to try these alternatives first as they are much less invasive and they involve your own cells that will heal the defects with a very high probability. You still have the option to seek surgery, should these alternative procedures fail (which is unlikely). Unfortunately most insurance carriers will not pay for this service at this time.