Regenerative Medicine for Musculoskeletal & Peripheral Vascular Disorders
Regenerative Medicine: A Holistic Approach for Musculoskeletal and Peripheral Vascular Disorders implies that regenerative medicine techniques for musculoskeletal and peripheral vascular disorders are both available and effective. That is true. Adding a holistic approach is another step in the process that helps your body move forward on a healing path.
Numerous forms of regenerative medicine exist. From a musculoskeletal and peripheral vascular perspective the first step should embrace the importance of nutrition. While several procedures are available to enhance cell regeneration none of them will be as effective if the body is nutritionally deficient. While numerous supplements are available, we recommend Juice Plus. This is a whole food fruits and vegetable extract with several medical school studies that demonstrate Juice Plus absorption and cell integration of the underlying nutrients.
Before regenerative medicine techniques are initiated it is best to have a medical doctor evaluate the root cause of the problem. Often underlying conditions are present that affect healing. For example a patient with diabetes or early peripheral arterial disease will not heal as quickly as someone without those conditions. Medical management to obtain optimal control of co morbid disease can only enhance a regenerative medicine approach.
Likewise a torn rotator cuff in the shoulder or an osteoarthritic knee may be associated with a strained ligament in the neck or a nerve irritation in the low back. Quite often treating the spinal component will improve the results of treating the injured limb. That means the whole body should be evaluated, not just the area of most obvious interest. If muscles are inhibited, tight or weak a functional restoration program to re educate, stretch and then strengthen should occur.
Diagnostic Musculoskeletal Ultrasound, Segmental Plethysmography, and Arterial Duplex studies are three non invasive and non ionizing tests that can both image and detect the presence of injury or disease. Depending upon the severity of findings results can be used to formulate a focused treatment plan. A very powerful tool to re-grow, or proliferate torn or stretched muscle, tendon and ligament is Prolotherapy.
Prolotherapy is a technique where medications are injected into an injured musculoskeletal body part with the intent of regenerating tissue. Various compounds are used, but we prefer a combination of Xylocaine and Sodium Morrhuate. Morruate is 80% arachandonic acid. When injected into the injured body part it stimulates local prostaglandin production, which in turn initiates the wound healing cascade.
Essentially Prolotherapy is a natural way of telling your body’s natural wound healing response to come to an area and to it. Injections are often done an average of three times over a several weeks. Biopsies have been done and confirm the creation of organized tissue (not scar formation). After the third injection a 40% thickening can be expected.
For more severe cases, or in instances where a faster response is needed, PRP can be done. In this instance Platelet Rich Plasma (concentrated growth factors from your own blood) are injected into the injured tissue. Unlike prolotherapy that tells your body’s natural wound healing response to come to an area, PRP concentrates those cells involved in wound healing and puts them into the area. Usually only one or two injections are needed. While there can be more pain right after the injection it is usually short lived and followed by rapid improvement.
Even more advanced techniques include obtaining “stem cells” from bone marrow or fatty tissue. Stem cell therapy of this type is similar to PRP but makes use of a higher concentration of undifferentiated cells (cells that have not yet decided what they want to be). Because they come from your bone marrow or from your fat cells the technology needed to obtain these cells, and then to concentrate them, is more involved. This means that the cost is higher, and more pain can be experienced when the tissue is taken.
The FDA now allows adipose derived mesenchymal cells take from your own body to be used for tissue support, volume enhancement, cushioning, and medicinal cell signaling. That is because adipose tissue typically performs these functions. As a results of its endocrine abilities adipose derived cells and facilitate your body’s cells to reduce pain and enhance function through its own tissue engineering response. Plus, with the newer technologies used at Piedmont Physical Medicine and Rehabilitation, PA for fat harvesting, cell viability is greatly enhanced.
It is readily accepted that PRP and Cell therapies can facilitate ligament, muscle & tendon healing. Cartilage restoration is a bit more controversial. In addition, there is still debate regarding reports of cell therapies that reverse congestive heart failure or that revascularize limbs where toe amputation was pending. We have had some success in the reversal of peripheral vascular disease when nutritional support (Juice Plus) is combined with medications such as Plavix and Pletal. PRP or cell therapy injection is a natural extension of this approach.
Reducing total load means doing what ever is necessary to put the body back onto a healing path. That means some patients will also benefit from treatment with hormone replacement therapy, infectious and immunological approaches, or addressing mind body spirit challenges. Whether you suffer from strained or partially torn muscle, tendon or ligament, or have peripheral vascular disease, regenerative medicine offers new treatment options for restoring quality of life.