PRP Regenerative Medicine

What is regenerative medicine? 

Regenerative medicine is a multidisciplinary specialty and a branch of translational research in tissue engineering and molecular biology which encompasses the process of replacing, engineering, or regenerating human cells, tissues or organs to restore or establish normal function.

Regenerative medicine offers a transformative approach to healthcare, with the promise of endearing damage tissues and organs by stimulating the body's own repair mechanisms to functionally heal previously irreparable tissues or organs. 

The term regenerative medicine is often used synonymously with tissue engineering, even though scientists and Practice nurse involved in reasoning medicine place more emphasis on the use of multiple techniques beginning with Prolotherapy, platelet rich plasma (PRP) and stem cell therapy.

There are two major components of regenerative medicine in managing chronic pain and they include PRP and stem cell therapy. And increasing number of Physicians believe that the injection of PRP or stem cells are in the effective treatment for various spinal and musculoskeletal disorders. even though these treatments have not been well established and the literature continues to emerge, there is enthusiastic support for the evidence based practice of regenerative medicine. 

What is Interventional pain management?

Interventional pain management is defined as the discipline of medicine devoted to the diagnosis and treatment of pain Related Disorders principally with the application of interracial techniques in managing sub acute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment. In addition, interracial techniques are defined as minimally invasive procedures including, percutaneous position needle placement, with placement of drugs in targeted areas or ablation of targeted nerves; and some surgical techniques such as laser or endoscopic diskectomy, intrathecal infusion pumps and spinal cord stimulators, for the diagnosis and management of chronic, persistent or intractable pain.

Regenerative medicine  is an evolving field of Medicine which offers significant potential for Interventional pain Physicians to incorporate into daily practices of chronic pain management. Dr. Roshni Patel is excited to offer Regional medicine along with Interventional pain procedures  two patients seeking pain relief and a better alternative to managing pain. 

Platelet rich plasma (PRP)

PRP is defined as a sample of autologous blood with concentrations of platelets above Baseline values.PRP injections have been shown to be effective in disorders of bone, tendons, muscles, ligaments, joints, and discs. PRP is derived from patients venous blood. Blood is drawn from a patient's body, processed in a centrifuge, and a cellular concentrate, including the Buffy Court, which contains the highest concentration of platelet, is extracted and used as an injectable treatment. many researchers have started to emphasize that not all PRP is created equally currently, there are multiple cellular processing techniques for extracting PRP. 

Interventional pain management Physicians such as Dr. Roshni Patel are excited to offer platelet rich plasma therapy as another line of treatment to treat Chronic Pain. It offers  Doctor Patel an opportunity to not just treat symptoms but potentially heal and increasing number of disorders that cause chronic pain. The platelet, the oldest element in the circulatory system, likely evolved as a first responder that could rapidly be deployed to site of injury. In the future, we hope that PRP and platelet the ride therapies will become as common as antibiotics are today.

In clinical applications, PRP is used for ligaments, fibrocartilage, tendon, joints, cartilage, bone, muscle, intervertebral disc and spine, nerves and neuropathic pain. PRP is not recommended for acute injuries. PRP has become increasingly more utilized in sports, Rehabilitation and pain medicine. 

Studies

There are at least 6 level 1 studies for osteoarthritis of the knee showing Improvement of pain and function following a single or a series off leukocyte poor PRP but not leukocytes Rich PRP injections.

There are at least 8 level 1 studies showing efficacy for leukocytes Ridge PRP and one for leukocyte poor PRP for tendinopathies. One meta-analysis found PRP to be effective for Achilles tendon tears but not tendinopathy, but most clinical trials have not differentiated between outcomes for patients with tears from those with tendinopathy.

PRP is promising for ligament and fibrocartilage injuries, especially in conjunction with precise ultrasound-guided injections and mini Dash open but not arthroscopic surgery. PRP may be helpful for healing chronic injuries, but it's used for acute injuries is not proven and may inhibit naturally occurring healing mechanisms on the basis of a well-done study offense heal injuries in rabbits. Muscles and bones are full of platelets and have not been shown to significantly benefit from PRP. PRP for disco Janet low back pain is promising, with at least one level one study showing good outcomes at 1 year and Beyond. PRP for nerves and neuropathic pain remains investigational.

Who should perform PRP procedures?

PRP procedures should ideally be performed by specialist capable of precisely identifying and guiding injections to sites of injury and pathologic using image guidance.

Interventional Pain Management Physicians are well suited to diagnose and treat pain using interventional and guided injection procedures.

Reference: Essentials of regenerative medicine and Interventional pain management