PRP Injections

Platelet Rich plasma injections seem to be all the rage these days. Well, they don’t seem as popular as surgery, but they do seem to be recommended by more doctors. And many of those doctors have not tried prolotherapy with a simple dextrose solution.

Let me be clear, this is my prolotherapy diary, and while I imagine that someday there may be guest posts from others who have experienced prolotherapy as a patient, so far there are none. And I personally have not yet experienced Platelet Rich Plasma injections. So if you want to read about the experience frist hand, I can’t offer you that yet. What I can offer is a perspective from my own experience, my own cynical view of medicine, and two cents thrown in from my doctor who does not do PRP injections, as well.

My doctor told me he does not do PRP injections because he said the research has not yet shown that the results are dramatically better than prolotherapy with the basic “medicine,” as he calls the 15% dextrose solution he usually uses. PRP is a multistep process in that you supply the Platelet Rich Plasma. That means the doctor must draw blood, process it to extract the platelets, mix or create a solution which is then injected into your joint or area needing prolotherapy.

Additional steps mean it takes longer, turning a simple prolotherapy treatment into a several step and often a several day process which includes more than a single doctor visit. This cynic thinks that seems like a great way to charge more, and indeed I have heard that PRP injections can cost close to $1000 (and indeed brief research shows a range of $500-$2000) where most basic prolotherapy treatments are closer to $150-$500 depending on the doctor, the location, and the treatment.

Please don’t misunderstand me, I am all for anything that works and I can even see myself getting PRP injections at some point if basic prolotherapy does not work to heal an injury. However, as Occam’s Razor teaches us, in most things including medicine, the simplest answer is often the best. And so I do not see a reason to spend the additional money and time on PRP unless and until basic prolotherapy has been tried and found wanting. After all, all forms of prolotherapy are meant to stimulate the body to heal itself.

In conclusion, unless you are pressed for time and need to be healed in order to pitch in the playoffs, or you happen to have more time and money than you really need, my personal non-medical recommendation is to try prolotherapy first and if it does not heal your injuries, then try PRP injections. I have no doubt that they are effective as well, and they might even be more so. I just don’t have the time or money to burn, nor did we make the playoffs this year.

Prolotherapy for Neck Pain Follow Up

I was surprised. All the other times I have had prolotherapy, I have had a considerable amount of stiffness in the are on the following day. The day after shots in my neck, I felt no such stiffness. In fact, other than where the needles went in, I felt very little pain or stiffness in the area.

What was apparent though is that the neck is indeed connected to all the other areas. I found that my middle back had much more movement of vertebrae than I had previously experienced while stretching. By movement I mean those little cracks or adjustments that you can feel as you stretch or twist.

n short, I was surprised at how much the neck affected the rest of the back and the shoulders. It has now been almost a week and I have definitely noticed a difference, an improvement in my back and shoulders as a result of the prolotherapy shots on my neck.


Prolotherapy for Neck Pain

I haven’t posted for several weeks, but that does not mean I haven’t been getting injections. I feel like the bionic man in some ways, with the goal of rebuilding myself to be better than before. I have now had prolotherapy several times each in my lower back, both shoulders, upper back, and now the area that ties it all together, the neck.

Today was my first treatment on the neck, and it will be my last. It is not that it is more painful than the others, but the idea and execution of large needles going into that area is not just not pleasant, it strikes fear into me, and there are few things I fear. But recently I have come to way risks and benefits much more closely than I have in the past, and I am just not in enough pain to justify having that area treated again. The odds of a mistake are very low, but the consequences when poking around the neck just seem too high to justify even the tiny risk. That said, I did do it.

It has beenĀ  less than an hour and I have not experienced any dizziness or vertigo which the doctor told me I might. This is good. The novacain is starting to wear off and I can feel where the needles went in. I’m sitting on the couch, not lying down, and am not uncomfortable.

The prolotherapy shots themselves where no different than in other areas. Some of them I felt the needle go in and others I felt the fluid being injected. Probably a dozen or fifteen shots in total to stabilize the area, and while the doctor always tells me to leave the dressing on for 2 days, I will take it off as I shower tomorrow.

One thing that I have found, especially from the shots in the lower back, is that the prolotherapy definitely stabilizes and tightens up an area. By tightens up, I don’t mean making it harder to stretch. Before prolo I would lie on my back,lift one leg and move it across my body touching my toe to the floor. That would often “crack” my back and I would feel better as the vertebraeĀ  moved back into alignment. Now that rarely happens as the vertebrae don’t move out of alignment and the area feels much better. I expect a similar effect with the prolotherapy on my neck.

Stay tuned. We shall see.

Shoulder Pain Treatment

This morning I was scheduled for the second treatment on both my left shoulder and left upper back, basically the top four ribs. Although some doctors say the average treatment is between 3 and 6 prolotherapy treatments a month apart, my doctor says he has never had to do more than 3 on any one area. Perhaps, he says, that other doctors have patients with more complicated injuries or perhaps he does more injections each time. He does not know, but I liked hearing it.

Today instead of the standard prolotherapy in which the injections are given into the ligament, right at the bone, we tried a new technique. This form of prolotherapy injects a weaker glucose solution into the nerves in the area. Nerves not only convey pain impulses, but also feed the muscles and ligaments. You can read more about the idea and philosophy behind treating the nerves in this article on Subcutaneous Prolotherapy.

So compared to standard prolotherapy the treatment was vastly less painful. Traditional prolotherapy uses large needles to inject the irritant into the ligament right at the bone. Even with the lidacain to numb the area, the injections themselves can be fairly painful. Definitely worth the pain, but painful nevertheless.

The subcutaneous prolotherapy uses short small needles to inject the nerves which are just under the skin. Also the idea is to take away the pain immediately. By injecting the nerves, he doctor is both numbing and curing the damaged areas. In fact the doctor would not let me leave until we identified any areas of pain and he ahd a chance to treat those areas again. when I left, I was without pain in the shoulder and upper left back, and I ahd about 30-40 tiny bandaids over the needle spots.



Prolotherapy on Lower Back FU

Had prolotherapy on my lower back on Monday, and a follow up visit to the doctor yesterday, Thursday. The doctor took a quick look and was pleased that three days after the treatment, in which I had about 40 shots into the lumbar and sacral areas of my back, that the needle holes had healed and could not even see them. Interesting. As he tells me whenever I ask a question about what I can expect from a particular prolotherapy treatment, “everyone responds differently.”

I have experienced a fascinating sensation this week while working out. One of the exercises I do is to roll on a foam roller. This often leads to a realignment of the spine and sometimes I get the sensation that some people refer to as a cracking of the back. Also I lift one leg and cross it across the body, which also leads to a simiar “cracking” or realignment of the vertabrae in the lower back. when they are misaligned and this adjustment takes place, it usually feels very good.

This week I have noticed the inflammation in the lower back, the area treated on Monday, to the point where it is difficult to put all my weight on the foam roller when it gets down to that area. I had a similar sensation and sensitivity when I had the prolotherapy for my upper back pain a few weeks ago.

Now I have noticed in both areas that there is very little realignment going on as I stretch, roll on the foam, or turn my hips trying to get a crack. In fact, I almost feel as though I can feel how the ligaments have tightened things up so that the misalignments are not happening as much. I’m no doctor, so I can’t say that is what is happening, but it feels that way.

I also feel like I can feel the difference between my muscles and the ligaments. Perhaps I can and perhaps I can’t. Part of this comes with my new knowledge of what each of them does, and part comes with the prolotherapy treatments specifically designed to help the body strengthen and repair the ligaments. I definitely feel the difference in my shoulders and am now starting to differentiate the feelings in my upper and lower back as well.