By Nickolas Rhoades, APRN, Shelle Schumacher, PA-C, and Dr. Ji Li, Applied Pain Institute
If you are looking for alternative solutions for chronic pain or reading about the therapies celebrities or athletes are using, you might run across the terms PRP (platelet rich plasma), stem cell therapy, and regenerative medicine. But what is exactly meant by these terms? PRP and stem cell therapy are two therapies within a subspecialty of medical practice called regenerative medicine. Regenerative medicine is a growing field with a focus on therapies that can help restore normal tissue function. In pain management, PRP and stem cell therapy have been used in the treatment of osteoarthritis, tendinopathies, and other conditions where there is damage of the cartilage and tendons, with some significant and growing evidence of success over the past 50 years. These treatments work by harnessing and concentrating the natural growth factors found in our blood, which results in a reduction of inflammation and repairing of damaged tissue. The location and severity of the condition will determine which treatment is selected, as there are some differences in treatment processes, costs, and outcomes.
PRP therapy is a relatively simple office-based procedure that usually takes an hour from start to finish. Blood is collected from the patient and then processed in a centrifuge. The concentrated sample of platelets and plasma is then drawn-up and injected back into the patient at the target location. Many studies have demonstrated the effectiveness and safety of PRP for the treatment of multiple conditions, including:
- Knee osteoarthritis
- Lateral epicondylitis (tennis elbow)
- Patellar tendinopathy (jumper’s knee)
- Plantar fasciitis.
- Rotator cuff tears
On the other hand, stem cell therapy involves the collection of bone marrow with a needle at a place on the pelvic bone called the iliac crest. This is completed in the office under local anesthetic. After processing the bone marrow sample, the stem cells from the bone marrow are then injected into the targeted area. It takes approximately 1-2 hours to complete the treatment process. Multiple studies have reviewed the effectiveness of stem cell therapy for several conditions, including:
- Knee and shoulder osteoarthritis
- Rotator cuff tears
- Lateral epicondylitis (tennis elbow)
- Patellar tendinopathy (jumper’s knee)
- Achilles tendinopathy
- Plantar fasciitis
- Ligament tears in the knee
Between both PRP and stem cell therapy, knee osteoarthritis has the highest level of evidence for efficacy. For example, research has shown PRP treatment of mild to moderate knee osteoarthritis can provide approximately a 50% decrease in pain for a year with a reduced rate of joint degeneration. Stem cell therapy can also provide a 50% decrease in pain with a decrease in joint degeneration, but it can last up to several years and can also be used for the treatment of severe knee osteoarthritis. In contrast, a typical steroid injection for mild to moderate knee osteoarthritis is expected to provide up to 50% relief for three months. In addition, both PRP and stem cell therapy have been shown to reduce the risk of repeated tendon tears in the treatment of tendinopathies with and without current tendon tears. Possible risks of these treatments can include increased pain, swelling, and decreased range of motion for 1-4 days after the injection. Other possible risks include a small risk of localized bleeding and infection.
PRP and stem cell therapy are both natural therapies, but still are considered experimental by the FDA. This means PRP and stem cell therapy are not covered by insurance plans or Medicare. When dealing with chronic pain, the cost may be worth considering if more long-term relief is possible. If you are suffering from chronic pain, a pain management specialist will help you understand the cause of your pain, provide a comprehensive assessment of all treatment options, and determine if you are a good candidate for PRP or stem cell therapy treatment.
To learn more about pain management procedures, contact Applied Pain Institute at 309-662-0088 to set up a consultation. Dr Li and his medical team have many years of successful experience managing all pain syndromes.