Prolotherapy / PRP / Stemcells / BMPs / others


Prolotherapy

It involves injections of an irritant solution like dextrose into weakend/damaged tendons and ligaments, where they connect to bone, for the purpose of strengthening connective tissue and relieve pain.

The mechanism is unclear by now but first clinical trials showed that most likely it works through local inflammation and the immigration of tissue building cells. It is supposed to regenerate the tissue and not, how it was thought earlier, to build scar tissue.

Prolotherapy is supposed to be a regenerative and healing therapy.

The most commonly used substances are Dextrose (sugar), Lidocaine or Procaine (local anesthetic) and natural substances which aid with healing.

It is very important that the therapist is experienced with prolotherapy on the cervical spine because also prolo can cause damages.

All kinds of ligament laxity, damages or capsular damages which lead to pain or instability can be treated with prolotherapy. But keep in mind that prolotherapy has borders as well. Especially the cervical spine has some ligaments and tendons which cannot be injected due to their anatomical location. There is only one therapist (of which I know) who injects into the Ligamenta alaria.

Prolotherapy is still an alternative method which is described as experimental and there are very few clinical studies about the success. On the other hand, by now prolotherapy is the only form of non-invasive therapy which can lead to a permanent cure.

Everyone needs to be aware of the fact that prolotherapy has side effects like ligament ruptures and that the cervical spine is one of the most complicated regions for any therapy.

You can find my prolo experience here.

And here there are experiences written by others.

 

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PRP – platelet rich plasma

Platelet rich plasma (PRP) is generated from your own blood plasma and centrifuged to concentrate the platelets. The platelets release growth factors and other cytokines that stimulate healing of bone and soft tissue.

 

MSC – Mesenchymal stem cells

MSCs are cells which can grow to whatever cells they want to be. We use this mechanism in science to grow different tissues. There are clincial trials where doctors use MSCs to heal bone fractures. And now there is also a prolotherapy with stem cells. The principle is almost like the PRP. The MSC binds to another cell and secretes cytokines and growth factors which stimulates, again, the healing.

MSCs can be isolated from almost all tissues but most commonly we use bone marrow (hip) or adipose tissue, which is easier to get.

Stemcell therapy is also an experimental therapy but gets more and more attention from researchers all around the world. There are not many therapists who use this kind of therapy for cervical spine injuries.

 

BMPs – bone morphogenic proteins

BMPs belong to the group of growth factors (cytokines). In new studies it was found out that BMPs can induce bone and cartilage formation. Some doctors use it after a spinal fusion for better healing. (Also like PRP or stemcells)

 

Others

hyaluronic acid, orthokin, prolozone (ozone prolo) etc.

 

At the moment there is a huge increase of methods and therapies which are highly similar to prolo but with a few changes to the ingredients. The therapists develop therapies which are supposed to be more innovative and better. It makes it really hard to differentiate what therapy works best for what injuries.

In my opinion, it is very important to be careful with those kind of therapies and to chose your therapist with caution. All those therapies can potentially cause damage to your spine and this is why you should be informed as much as you can, contact the doctor and ask about studies or experiences from other patients.

Prolotherapy

C1-C2 Injection under fluoroskopy

 

Helpful information about prolo with dextrose, stem cells and PRP you can find here:

http://www.prolotherapy.org
Here is an overview of the US therapists and some good information about prolo:

http://www.getprolo.com

 

Therapists which use the Hackett Hemwall technique:

http://www.hacketthemwall.org
Other US therapists:

http://www.caringmedical.com
http://www.centenoschultz.com

 

The following pictures that explain the mechanism of prolotherapy are used with permission of  Caring Medical Regenerative Medicine Clinics, Fort Myers Florida and Oak Park Illinois.

www.caringmedical.com

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A Video Dr. Hauser made for us: