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Musculoskeletal injuries affect the muscles, nerves, blood vessels, ligaments, and tendons. These injuries have a huge impact on the physical and emotional health and work life of the person as well as the healthcare system of the country.
Musculoskeletal injuries are the 2nd greatest cause of disability and have the 4th greatest impact on the overall health of the world population. Musculoskeletal injuries also cause an economic burden. Work-related musculoskeletal injuries are the most frequently reported causes of lost or restricted work time.
According to the Bureau of Labour Statistics (BLS) in 2013, musculoskeletal injuries accounted for 33% of all the work-related injuries and illnesses. Treatment cost for musculoskeletal injuries is more than $213 billion per year. Musculoskeletal injuries also lead to early retirements and work loss.
On the individual level, musculoskeletal injuries can have following impacts on the body:
Conventional and alternative treatment methods are available for treating musculoskeletal injuries. Conventional methods include pain medication, anti-inflammatory drugs, steroidal injections, and surgery. Alternative methods include homeopathy, physical therapy, rest, ice and heat, and massage.
Recovery time is one of the most important factors of any treatment method in the modern days. Faster recovery time helps the patients to recover faster and resume the daily activities and work. It becomes even more important in sports medicine where recovery time is the most crucial thing for an athlete.
Painkiller drugs and anti-inflammatory drugs are considered to be a quick fix. They mask the pain caused by the injury, but do not heal the injury. This can lead to more musculoskeletal damage due to lack of proper repair; thus it is not a suitable option in the long-term.
Surgery is another widely used treatment option. It is a very effective method that repairs the musculoskeletal damage. But recovery from surgery is very slow and it can take months for a person to be fully functional.
Alternative treatment methods are used along with the conventional treatments to accelerate the healing process. Physical therapy is the most widely used method to treat the musculoskeletal pain and it takes several months and sometimes years to relieve the pain.
Platelet-rich plasma Prolotherapy is getting popular these days in athletes for faster recovery. Athletes like Tiger Woods, Kobe Bryant, Hines Ward, and Cliff Lee have undergone platelet-rich plasma Prolotherapy for musculoskeletal injuries. It is an alternative treatment method which is also used in the fields of orthopedics, neurosurgery, ENT, wound healing and cardiothoracic surgeries. It is a minimally invasive method that uses the healing properties of the blood to accelerate the healing process. PRP contains growth factors and bioactive proteins that influence the healing of tendons, ligaments, muscles, and bones.
Platelet-rich plasma Prolotherapy is a type of Prolotherapy in which the blood is used to treat the musculoskeletal injury. Our blood consists of 4 major components: Red blood cells, White blood cells, Platelets, and Plasma. These components have different functions. Platelets have a major role in blood clotting, but they also contain growth factors that help in tissue repair and regeneration. Due to this, platelets are manipulated in PRP Prolotherapy.
In PRP Prolotherapy, blood is drawn under sterile conditions in PRP Prolotherapy clinics. This blood is then centrifuged to separate the different components of the blood. After centrifugation, the platelet-rich plasma is separated and the rest of the components are discarded. This platelet-rich plasma is then injected back at the site of injury under ultrasound monitoring.
When the platelet-rich plasma is injected at the site of injury, the platelets get activated and release alpha granules. Alpha granules contain growth factors. Growth factors are the proteins that promote cell repair and growth. These growth factors stimulate the epithelial growth factors (EGF) which induce the cell migration and replication at the site of damage, causing the damaged tissues to heal quickly. The platelet-rich plasma injection is followed by three stages of healing:
Platelet-rich plasma Prolotherapy is considered a very safe method. As the patient's own blood is used, the chances of blood-borne disease transfer, immune reaction, and allergic reaction are eliminated. There is no evidence of tumor growth and cancer caused by PRP Prolotherapy. Since it is an invasive method, there are chances of nerve injury, tissue injury, needle breakage, pain, and infection.
Platelet-rich plasma Prolotherapy is said to increase the recovery from a musculoskeletal injury as compared to conventional treatment options. In 2006, a research study was published in The American Journal of Sports Medicine. In this study, 20 patients who were considering surgery for a musculoskeletal injury were divided into two groups: one group received RRP Prolotherapy while the other went through surgery. After 2 months, the patients receiving PRP therapy showed a 60% improvement in pain measurements as compared with 16% for the control group.
A group of researchers evaluated the effectiveness of PRP Prolotherapy on Achilles' tendon ruptures and found that the recovery time was reduced in the patients who received PRP injections as compared to the control group.
PRP Prolotherapy has made a faster recovery in the parts of the body that have less blood supply and normally do not show fast growth such as bones, tendons, and ligaments. An early clinical study of PRP Prolotherapy used during maxillofacial reconstructive surgery showed consolidation of the bones at 4 weeks as compared to 8 weeks in the control group.
In a study, 15 patients with chronic elbow tendinosis who received PRP injection showed an 81% improvement in pain score at 6 months and up to 93% at 25 months as compared with the baseline status. A recent, larger double-blinded randomized controlled study compared recovery with PRP Prolotherapy and corticosteroid injection. The results showed that the PRP group progressively improved at 1 year compared with the steroid group which declined after the initial short-term improvement.
In a research conducted on 18 athletes who had Achilles' tendon injuries, 12 athletes were treated with PRP injection and 6 were given a placebo. The group of athletes treated with PRP injections showed faster recovery and improvement in functional recovery after 7 weeks as compared to the control group that showed recovery after 11 weeks. Athletes treated with PRP injection were able to perform gentle exercises after 11 weeks while the control group was able to do that after 18 weeks. Athletes treated with PRP were fully recovered after 14 weeks and were able to train fully while the control group took 21 weeks to recover fully.
These evidences show that PRP Prolotherapy helps to recover faster as compared with surgery and it is more effective than quick fix methods like taking pain killers or corticosteroid injections as it heals the cause of pain and discomfort rather than masking the pain which can lead to more damage.
The recovery also depends on the part being treated. According to the research, some parts show faster recovery than the others. It also depends on the extent of the musculoskeletal injury. Some injuries take longer to recover such as a bone fracture as compared to others such as a minor muscle tear.
PRP Prolotherapy can also be combined with other treatment methods to make a faster recovery from injury. Platelet-rich plasma Prolotherapy holds promise for sports medicine and can help athletes to recover faster.
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Middleton , K. K., Barro , V., Muller , B., Terada , S., & Fu , F. H. (2012). Evaluation of the effects of platelet-rich plasma (PRP) therapy involved in the healing of sports-related soft tissue injuries. Iowa Orthop J, 150-63.
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