Category: Platelet Rich Plasma

High Dose PRP for Low Back Pain

Posted on by Will Bozeman

More often than not, when a patient is suffering from some sort of pain, it can be directly tied to some irritation in the back. Whether the pain is high or low, it is likely that many can claim to have experienced it at one point or another. Low back pain is extremely common and manifests mostly in people who are obese or have suffered injury throughout their lifetime. However, low back pain can be a result of many different conditions besides injury and these conditions can require years of therapy and management. While most pain experienced is mild and manageable, many patients experience pain that is debilitating and precludes them from completing any normal, day-to-day activities. Although there are several different causes for low back pain, patients should understand that the pain is manageable through various treatment options.

When patients know and understand the conditions and causes of their low back pain, they are more likely to find a treatment that works and makes sense to them. While the most common treatment methods are sought out at home, some may consider drastic surgical options. For patients who seek a nonsurgical treatment and a treatment without addictive or risky medications, Orthagenex offers the treatment of high dose platelet rich plasma, High Dose PRP. However, before we cover the ins and outs related to high dose platelet rich plasma, we will review some of the aspects of low back pain so that patients could more easily pinpoint their condition.

When faced with the effects of lower back pain, patients will often resort to massaging the lower back without realizing that their pain is likely the result of nerves firing and not muscles being overworked. People often assume the pain is a result of muscle fatigue because the affected area is often the same area, they would feel pain in after heavy-lifting. While heavy lifting over an extended period of time could result in back pain, the pain is often a symptom of a deeper problem. Without confirmation of a condition, it would come to no surprise that patients experience frustration after massaging the affected area to no relief. The first thing that patients with lower back pain need to understand is that most lower back pain is a result of the nerves in their lower back being agitated. The first step in seeking effective treatment is learning what is wrong with our bodies. Once we know and understand what our bodies are communicating to us, we can assess the situation, seek effective treatment, and overcome our bodies’ obstacles with confidence.

Some of the most common causes for lower back pain might not be readily apparent to patients and may take a proper diagnosis from a medical professional before starting the recommended treatment. As mentioned previously, most people will experience lower back pain in their lives, and it will likely become an issue for which most would seek medical attention. At the same time, some patients who seek medical attention might have experienced an acute injury that spurred them into action. However, the types of patients who seek medical attention for lower back pain will often be divided into subsets before doctors recommend them for a particular treatment. So, like medical professionals, when considering the causes of lower back pain, we must also consider these various subsets of patients who are categorized by the conditions they face that would be considered risk factors.

The first, most prominent qualifier for the cause of lower back pain is age. Lower back pain is most common with patients who are over the age of thirty and the likelihood increases from then on. This is not to say that patients under thirty cannot or will not experience back pain, but it is more likely that a patient who is experiencing back pain will be over the age of thirty. Unfortunately, age is a risk factor for most conditions including lower back pain and this is due to the wearing down of disks that sit along the vertebrae of the human spine. Over time, these soft and flexible disks that can absorb the impact and stretching required from physical activity, become more brittle and unable to support the weight placed upon the vertebrae of the spine. In addition to the wearing down of these discs, it is often the case that low back pain is a result of a herniated disc– a condition wherein the disc ruptures.

The issue of accomplishing physical tasks is further exacerbated by the weight of an individual. The extra and unnecessary weight of an individual will strongly contribute to the pain experienced in the lower back. Because we ask our spine to handle hundreds of tasks which can often be strenuous every day, adding extra weight to the spine would further increase the pain experienced by patients with lower back pain. Dr. Lee and his associates in the International Journal of Environmental Research and Public Health explain that “[f]irst, as weight increases, a load is placed on the joint carrying the weight, and compression of the intervertebral disc may be induced due to axial loading on the lumbar spine, one of the major joints carrying the weight, and this may lead to injury. Second, weight gain can cause spinal malalignment, especially lumbar lordosis, leading to LBP [low back pain]. Third, the increase in adipose tissue as the body weight increases secretes cytokines such as tumor necrosis alpha and interleukin 6, which contribute to the development of pain via the alteration of neurophysiological properties of peripheral nociceptors and central neurons” (2021). With these complications related to weight in mind, patients will likely consider the lifestyle choices they have made and will make to manage their low back pain.

Weight is often a result of an individual’s occupation or lifestyle. Unfortunately, those who live or work in an environment that is more sedentary and requires the patient to sit for several hours at a time have a much higher chance of being overweight and experiencing greater low back pain. Patients who live or work in such environments may be surprised to learn that their environment can cause lower back pain because it is not requiring them to do any strenuous exercise or activities. Contributing factors for low back pain, while surprising, are no less serious and vary from the aforementioned qualifiers to osteoarthritis and even depression or anxiety.

With these conditions and qualifiers in mind as causes for low back pain, we must also consider a condition that is directly tied to the nerves along the lower back; sciatica. Sciatica, being a condition that results from the pinching of the sciatic nerve, may also be directly tied to the disks along the vertebrae that compress the nerve. So, if the nerve is compressed by the disks, the disks along the spine are also wearing out over time, and a patient suffers from any of the former qualifiers, one can begin to understand that low back pain is a condition that is complex and multifaceted. At the outset in search of treatment, patients should understand that their low back pain is likely a result of more than one contributing factor. Because of the enumeration of conditions that contribute to low back pain, patients will often feel discouraged and assume that there is no one-size-fits-all solution to their back pain. While most patients may know of and utilize temporary pain-relievers, all would rather have effective, safe, and lasting treatment without risking surgery.

For a more safe and effective form of low back pain treatment, patients and doctors are more frequently turning to platelet rich plasma (PRP) Dr. Akeda and her associates in the Journal of Pain Research who research the efficacy of PRP for low back pain first explain that, “[p]latelet-rich plasma (PRP) is an autologous blood concentrate that contains a natural concentration of autologous growth factors and cytokines and is currently widely used in the clinical setting for tissue regeneration and repair. PRP has great potential to stimulate cell proliferation and metabolic activity of IVD [in vitro diagnosis] cells in vitro” (2019). The more physicians research and apply PRP for treatment purposes, the more they find promising results.

The study continues to claim that, “[s]everal animal studies have shown that the injection of PRP into degenerated IVDs is effective in restoring structural changes (IVD height) and improving the matrix integrity of degenerated IVDs as evaluated by magnetic resonance imaging (MRI) and histology. The results of this basic research have shown the great possibility that PRP has significant biological effects for tissue repair to counteract IVD degeneration”. These several studies, while showing promising results in animals can also be applied to use in human research when it comes to low back pain treatment.

The research article concludes that, “[c]linical studies for evaluating the effects of the injection of PRP into degenerated IVDs for patients with discogenic LBP have been reviewed. Although there was only one double-blind randomized controlled trial, all the studies reported that PRP was safe and effective in reducing back pain. While the clinical evidence of tissue repair of IVDs by PRP treatment is currently lacking, there is a great possibility that the application of PRP has the potential to lead to a feasible intradiscal therapy for the treatment of degenerative disc diseases. Further large-scale studies may be required to confirm the clinical evidence of PRP for the treatment of discogenic LBP” While these results are certainly promising, patients might wonder if PRP is the best treatment when compared to other similar types of treatment.

Dr. Xuan and his associates in the Journal of Neurological Surgery, first explain that, “PRP is an autologous blood derivative containing high concentrations of activated growth factors and cytokines (e.g., platelet-derived growth factor, transforming growth factor, fibroblast growth factor, insulinlike growth factor 1, and epidermal growth factor). These elements serve as important humoral mediators to induce an anti-inflammatory effect and natural healing cascade by promoting cell proliferation, migration and differentiation, protein transcription, extracellular matrix regeneration, angiogenesis, and collagen synthesis” (2020). All of these elements mentioned by Dr. Xuan and his associates not only prove to make PRP an effective treatment, but a safe treatment when compared to its competitors.

The doctors continued their study and found that, “Our meta-analysis concluded that PRP injection resulted in significantly improved pain relief (as evidenced by the meta-analysis of pain scores within 8 weeks and > 50% pain relief at 3 months) and patient satisfaction for patients with low back pain. In addition, one included RCT revealed that PRP injection was able to result in sustained and more reduction in pain visual analog scores and lumbar functional improvements at the end of 6 months than local anesthetic using a corticosteroid. These results indicated autologous PRP served as the superior treatment option for longer duration efficacy for low back pain compared with corticosteroids”. Not only do patients have the added benefit of longer duration away from pain, but they will also avoided unwanted complications from corticosteroid injections. In conclusion, Dr. Xuan found that, “PRP injection showed an important ability to provide pain relief and patient satisfaction for those with low back pain”.

Regardless of a patient’s history with low back pain, whether it is a result of an acute injury, or whether they have tried every treatment in the book, Orthagenex High Dose PRP, platelet rich plasma, proves to be the standard for treatment. When patients are treated with high dose PRP, they will experience a higher quantity and quality of these growth factors that promote cellular regeneration and tissue regrowth. When high dose PRP is administered to patients, there is a high likelihood that they will see results immediately because Orthagenex High Dose PRP facilitates the body’s ability to treat itself in a concentrated form. With this treatment, patients don’t need to worry about where the relief will be or whether they will return to a higher quality of life and activity. The treatment is here with Orthagenex High Dose PRP, the most advanced platelet rich plasma treatment available today.

High Dose PRP, Platelet Rich Plasma, as a Treatment for Epicondylitis

Posted on by Will Bozeman

Differing locations and levels of pain throughout the body can be perplexing to the average person who is experiencing or learning about their pain. One minute, a patient might be experiencing pain in one location of their body and the next their pain has vanished or relocated. Typically, Orthagenex works to help patients treat chronic conditions by non-invasive means. However, there are some conditions that can be both chronic long-term issues that present routinely as short-term repeat episodes of inflammation and pain. Epicondylitis, both lateral and medial, is one such condition that perplexes patients who suffer from it. However, regardless of a patient’s history or constancy with the condition, Orthagenex understands that effective pain relief can be difficult to find– especially when the condition needing treatment is not easily understood. So, what is lateral/medial epicondylitis and how can Orthagenex help?

In 2013, Dr. Ahmad and his associates in The Bone & Joint Journal conducted an extensive study on the nature of epicondylitis and first determined that, “[l]ateral epicondylitis, or ’tennis elbow’, is a common condition that usually affects patients between 35 and 55 years of age. It is generally self-limiting, but in some patients, it may continue to cause persistent symptoms, which can be refractory [stubborn] to treatment” (Ahmad, 2013). Because of the condition’s sporadic influence on a patient and symptoms that prevent regular treatment, patients are often left frustrated and confused. However, learning more about the condition and its vagaries can help.

Dr Ahmad continued to pursue the elusive condition and its effects on patients and determined that epicondylitis, “ . . . affects between 1% and 3% of the population, mainly those aged from 35 to 55 years, with an equal gender distribution. It is generally self-limiting, and most cases require no more than treatment with simple analgesia . . . Although popularly associated with tennis, lateral epicondylitis may develop from a variety of activities that involve excessive and repetitive use of the forearm extensors,18 such as typing, playing the piano and various types of manual work. When affected, any movement that puts force on the extended wrist may be painful, as it increases the load on the diseased common extensor tendon”. When understanding that epicondylitis can result from activities as innocuous as playing the piano, patients can begin to understand why the condition is so sporadic in nature; they may not realize the various activities they perform every day could trigger and inflame the condition.

However, as Ahmad previously mentioned, epicondylitis is commonly referred to as “tennis elbow” and this is for a very good reason. Dr. Ahmad, in a summary of the relation between tennis and epicondylitis concluded that, “racquet sports may cause the condition due to a combination of factors: 1) incorrect technique (snapping the wrist in a backhand play, incorrect positioning of the feet, and hitting the ball late or with a bent elbow all result in power generation from the forearm extensors rather than core muscles or the rotator cuff); 2) extended duration of play; 3) frequency of play; 4) size of the racquet handle (affecting the lever arm of the force applied through the forearm); and 5) racquet weight”. While it is likely and obvious that many patients who suffer from “tennis elbow” are involved in some form of racquet sport, there are of course other contributing factors.

Dr. Ahmad in studying the origin of epicondylitis also concludes that, “[w]ork-related lateral epicondylitis may be linked to handling tools heavier than 1 kg, loads heavier than 20 kg more than ten times per day, and repetitive movements for more than two hours”. In general, it may be assumed that anyone who does repetitive motion with their arms and/or lifts heavy loads regularly may experience some level of pain from epicondylitis. With this being the case, it is no surprise that many who suffer from the condition will ask what they can to decrease the pain and increase mobility in their arms.

While many seek treatment for epicondylitis, others maintain that the condition– in its ephemeral nature– will eventually dissipate. In 2019, Dr. Lenoir and his associates in the journal of Orthopaedics & Traumatology: Surgery & Research determined that, “LE usually resolves spontaneously without treatment within 1–2 years. Very few studies have compared outcomes with and without treatment. As a result, whether a favourable outcome should be ascribed to the treatments used or to the natural history of the disorder is unclear . . . Overall, the available data suggest that LE often resolves spontaneously. Therefore, considerable circumspection is in order before embarking on a course of treatment, regardless of the modality chosen. Studies comparing specific types of treatment versus placebo are needed”. However, while patients often experience the pain of epicondylitis spontaneously resolve without treatment, many will experience the pain for extended periods of time and won’t necessarily appreciate being told to wait until the pain subsides. For patients who want to be proactive in treating their epicondylitis, there is a recommended treatment offered by Orthagenex.

In Dr. Ahmad’s same study mentioned previously in The Bone & Joint Journal, he and his associates found that, “[p]latelet-rich plasma (PRP) is a concentrate of platelets derived from the patient’s own blood and is known to contain a high content of growth factors that have the potential to enhance the healing process of the tendon [related to epicondylitis]. A blood sample is taken and centrifuged to extract the plasma content, and the blood is then re-injected around the lateral epicondyle. A number of RCTs have shown that PRP is superior to autologous blood and bupivacaine injections” (2013). With an understanding of the procedure and hope that it could be an effective treatment for epicondylitis, patients may wonder how Orthagenex uses high dose PRP treatments and what studies prove that it is an effective treatment.

In separate trials focusing on the efficacy of platelet rich plasma versus other methods in treating epicondylitis, Dr. Ahmad explains that, “[t]wo cohort studies showed that PRP improved clinical satisfaction scores. One case-control study showed that PRP yielded a significantly greater improvement in symptoms compared with bupivacaine [a local anesthetic]. Two randomized controlled trials compared the effect of injections of PRP and blood. Only 1 of the studies noted a significant difference at the 6-week time point. Three randomized controlled trials compared corticosteroids with PRP. Two of the smaller trials, which had follow-up periods of 6 weeks and 3 months, showed no significant difference between treatment groups. The largest randomized controlled trial found that PRP had significant benefit compared with corticosteroids with regard to pain and Disabilities of the Arm, Shoulder and Hand scores at 1- and 2-year time points” (2013). As we can clearly see, patients undergoing high dose PRP treatments with Orthagenex have a high likelihood of treating the pain symptoms of epicondylitis. Dr. Ahmad concludes that these clinical trials are “. . . limited but evolving evidence for the use of PRP in lateral epicondylitis”.

As the use of High Dose PRP treatment has increased, the trials and understanding of the treatment has only provided further advocacy for its recommendation in treating epicondylitis. In a more recent 2019 study, Dr. Boden determined that, “ME and LE [Medial and Lateral Epicondylitis] are common conditions that affect between 1% and 3% of the population, mainly in persons aged 35 to 55 years . . . Although a multitude of treatment options are available, there is currently no clear gold-standard treatment for patients with chronic pain. With the aging population, successful, less invasive treatment modalities are essential” With the necessity for less invasive treatment options, Dr. Boden determined that, “PRP . . . procedures are effective, minimally invasive, nonsurgical options for treating recalcitrant [again, stubborn] ME or LE. “. . . showed a clinically and statistically significant improvement in pain and function”. As our understanding of this condition continues to evolve, Orthagenex offers the premier solution for patients with epicondylitis through high dose PRP treatment.

Patients who undergo these high dose PRP treatments for their epicondylitis pain will not only experience a safe and effective way to mitigate the pain but become further educated in the nature of their condition. The more a patient understands the nature of their pain condition, even a condition as unpredictable as epicondylitis, the more they will come to understand how Orthagenex High Dose PRP treatments may work for them. Improving one’s understanding of painful conditions not only educates patients to help them seek effective treatments like high dose PRP but gives them the confidence they need to make informed and productive decisions. Throughout this process, Orthagenex is here to help– all with the aim of improving a patient’s quality of life and reducing irritating pain.

High Dose PRP, Platelet Rich Plasma, as a Treatment for Degenerative Disc Disease

Posted on by Will Bozeman

Typically, as most patients age, they will begin to feel the wearing down of their joints and muscles. This pain is not only likely, but it is probable that some (if not all) of that pain will come from the back. Besides acute back injuries that are a result of incidental injury and typically heal within a matter of weeks, aging patients will likely deal with the degeneration and deterioration of their joints. This deterioration can appear in a number of forms and conditions such as osteoarthritis. However, one of the most common conditions patients will face with age is degenerative disc disease.

Degenerative Disc Disease (DDD) refers specifically to the loss of cushion between the vertebrae in the back and (as mentioned previously) is typically experienced by elderly patients and not a result of an acute injury. In many cases, patients with DDD may not even be aware they have the condition because there will be no symptoms to pinpoint. The fact is our joints wear down throughout our lives– necessitating the intervention for joint health. In other cases, patients with degenerative disc disease will experience reduced flexibility and painful bone spurs that push against the nerves in the back.

Patients who have experienced DDD or are beginning to learn about the condition may see some similarities between it and the condition of osteoarthritis–another chronic pain condition that affects the joints in the vertebrae as well as other joints around the body. Osteoarthritis also increases with age and facilitates the decrease in cushioning between the vertebrae. However, the two conditions, while falling under a similar category of “degenerative skeletal disorders”, should be diagnosed and treated differently. Without the foresight to diagnose these conditions separately, a misdiagnosis could not only result in lackluster treatment but potential harm.

Dr. Shiro Ikegawa from the Laboratory of Bone and Joint Diseases at the Center for Genomic Medicine in Tokyo determined that, “[d]egenerative skeletal disorders are common and serious problems worldwide, especially in aging populations. They are polygenic diseases influenced by both genetic and environmental factors, and hence the identification of susceptibility genes may provide clues to their etiology and pathogenesis, although this is still in its early stages” (2013). Dr. Ikegawa continues to explain that his, “ . . . review focuses on genetic studies of two representative degenerative skeletal disorders: osteoarthritis and degenerative disc disease. Genetic studies of these two diseases share common features and face similar problems, although their current statuses are very different”. As was previously stated, one of the most important reasons we much differentiate between the two diseases is so that the proper treatment is administered.

Dr. Ikegawa agrees with this statement and concludes that, “[t]he future success of genetic studies of these diseases will depend on accurate and reliable diagnostics, large-scale interpopulation association studies and replications, and consideration of environmental effects and related diseases with similar phenotypes”. So, while these diseases may have a similar pathogenesis, symptoms, and even overlapping patients who suffer from both, each is different and should be treated differently.

Dr. Michele Battié of the University of Western Toronto shares a similar concern in the identification and clarification of DDD by stating that, “[d]espite longstanding use and important consequences, degenerative disc disease represents an underdeveloped concept, with greatly varying, disparate definitions documented. Such inconsistencies challenge clear, accurate communication in medicine and science, create confusion and misconceptions among clinicians, patients and others, and hinder the advancement of related knowledge” (2019). With even the term “degenerative disc disease” being given multiple meanings, patients might consider any accurate diagnosis or treatment precluded.

Dr. Fadi Taher and his associates accentuate the importance of having a knowledge of DDD and states that, “[u]nderstanding the pathophysiological basis of disc degeneration is essential for the development of treatment strategies that target the underlying mechanisms of disc degeneration rather than the downstream symptom of pain” (2012). Understanding the underlying conditions and of DDD and how those conditions can be ameliorated with high dose platelet rich plasma treatments would go a long way in helping patients get the hope they need to pursue a rich and fulfilling life without DDD. So first, what exactly is DDD and how can patients recognize it?

In order to understand DDD, we should first look at the anatomy of the back and the composition of the vertebrae. Dr. Taher continues to explain that “[t]he intervertebral disc (IVD) is composed of the nucleus pulposus (NP) centrally, the annulus fibrosus (AF) peripherally, and the cartilaginous endplates cranially and caudally at the junction to the vertebral bodies. Within the NP, an abundance of proteoglycans allows for absorption of water. This property of the NP is essential for the IVD’s handling of axial loads. In the healthy disc, the most common type of collagen within the NP is type II collagen. The AF surrounds the NP and consists primarily of type I collagen”. Later on, Dr. Taher explains how this complex composition can break down through degenerative disc disease by concluding that, “With increasing age, the water content of the IVD decreases and fissures in the NP, potentially extending into the AF, can occur, and the start of this process, termed chondrosis intervertebralis, can mark the beginning of degenerative destruction of the IVD, the endplates, and the vertebral bodies. DDD is a complex degenerative process due to age-related changes in molecular composition of the disc. This cascade has biomechanical and often times clinical sequelae that can result in substantial impairment in the afflicted individual”. Dr. Taher continues and explains the most common type of DDD diagnosis by stating that, “Magnetic Resonance Imaging (MRI) is a more sensitive imaging study for the evaluation of degenerative disc disease. Findings on MRI scan include disc space narrowing, loss of T2 signal within the nucleus pulposus, endplate changes, and signs of internal disc derangement or tears”. Luckily, with this technology and the knowledge of what to look for on the imaging, doctors can accurately diagnose degenerative disc disease. Once diagnosis is determined, patients can look forward to an effective and lasting treatment with high dose platelet rich plasma.

Injecting high dose platelet rich plasma into the regions of the back that are affected by degenerative disc disease is completely safe for a number of reasons. The first reason the procedure is safe is because it is an injection of our own plasma’s healing platelets. When these healing platelets interact with the DDD damaged nerves in the back, they not only reduce the pain experienced by a patient but regenerate the nerves damaged from years of suffering from DDD. Perhaps one of the biggest perks for high dose platelet rich plasma injection is that the process is simple: blood from our own body (autologous blood) is extracted, spun in a centrifuge to separate the platelet rich plasma from the rest of our blood, and the high dose platelet rich plasma is then taken and applied to affected internal areas of the spine.

According to a 2017 study evaluating the high dose platelet rich plasma healing process, doctors concluded that the six pieces of evidence that support nerve regeneration include: “1) neuroprotection and prevention of neuronal apoptosis, 2) stimulation of vascular regeneration, 3) promotion of axonal regeneration, 4) regulation of inflammatory response in the microenvironment, 5) alleviation of nerve collateral muscle atrophy, and 6) improvement of human nervous system parameters” (2017). With the benefits of this natural application of healing platelets in mind, patients struggling with degenerative disc disease are more likely to seek this type of treatment over risky and addictive medications or surgeries.

Orthagenex offers an alternative to medical surgeries and risk-related medications– an alternative that is safe, simple to apply and easily understood by all patients who are seeking relief from degenerative disc disease. Orthagenex High Dose PRP, the most advanced platelet rich plasma treatments in use today, are often the first choice of patients suffering from DDD and patients continue to seek out this treatment after experiencing its pain-relieving effects. As patients continue to educate themselves on the nature of their degenerative disc disease, they will come to learn how high dose platelet rich plasma is a remedy that is right for them. In addition to furthering the education on their condition of back pain, patients can expect fully cooperative consulting with our highly trained professionals at Orthagenex and treatments that work for DDD– including the treatment of High Dose PRP, the most advanced platelet rich plasma treatment available today.

High Dose PRP, Platelet Rich Plasma, as a Treatment for Bulging Discs in the Spine

Posted on by Will Bozeman

It might be unsurprising, but low back pain is just par-for-the-course for most adults. Defining the region affected and the exact cause of the pain is a different story. Generally, both low back health and low back pain is related to the spine which contains a system of nerves. Any pain we experience in our back will be communicated along the spinal nerves and our central nervous system. However, most of the time, chronic low back pain (back pain that is not a result of recent acute injury) signals a malfunction in the spine.

In the American Journal of Neuroradiology American Journal of Neuroradiology, Dr. Brinjikji gives a brief overview of low back pain by stating that, “[l]ow back pain affects up to two-thirds of adults at some point in their lives. Back pain–related disability has significant economic consequences due to consumption of health care resources and loss of economic productivity. Increased use of MR imaging and CT in the evaluation of patients with back pain consumes a large amount of health care resources. Imaging findings such as disc bulge and disc protrusion/extrusion are often interpreted as causes of back pain, triggering both medical and surgical interventions” (2015). With the prevalence of low back pain being so high in most adults (roughly two-thirds, as stated by Dr. Brinjikji) it would seem that our attention should focus on the health of the spine– namely the health of its discs.

Determining the health of the discs and the various conditions they could be in would only be the first step– however, it is a crucial step. Dr. Brinjikji continues to not only emphasize determining disc health but recognizes that disc bulges may be the highest contributing factor for low back pain: “Disc findings, including disc bulge, disc degeneration, and disc extrusion and protrusions, had significant associations with low back pain . . . One surprising finding from our study was that disc bulge had a strong association with low back pain. Because of the high prevalence in the asymptomatic population, disc bulges are often considered incidental findings and not associated with low back pain. The prevalence of disc bulges in asymptomatic populations ranges from 20% in young adults to >75% in patients older than 70 years of age”. Because some patients with disc bulges are asymptomatic to back pain and disc bulges are overlooked, many go untreated or are unable to find the care they need to treat the pain. Many are left unaware and uneducated on the relation between disc bulges and low back pain.

Dr. Oktay, in a study examining the regression of the spine and pathogenesis of disc bulges determined that, “. . . the exact mechanisms of regression still remain unclear. There are three hypotheses proposed in the literature: dehydration of herniated disc, retraction of herniated disc, and inflammation‑related resorption theories” (2019). Initially, herniated discs are a result of age and degradation, and most people cannot pinpoint a specific instant to attribute to the condition.

In addition to the herniated disc, there are three regressive mechanisms to which Dr. Oktay goes into further detail and explains that,“[t]he first theory includes the gradual dehydration and shrinkage of the herniated nucleus pulposus. The second theory proposes that the herniated disc may retract back into the intervertebral disc space, but this theoretically only occurs if the herniated disc has protruded through the annulus fibrosis without separating from it. The third theory states that the herniated nucleus pulposus, once extruded into the epidural vascular space of the spine, is recognized as a foreign body by the autoimmune system and induces an inflammatory reaction. This inflammatory reaction would lead the bulging disc to neovascularization, enzymatic degradation, and macrophage phagocytosis. In our opinion, the third theory may play a key role in the process of spontaneous regression . . .”. It is, of course, difficult to determine the condition of our back, its spine, or its discs. So, finding treatment solutions after learning how complex the spine can be can feel like an insurmountable task. Patients may feel that their low back pain will never end but they can have hope that Orthagenex has a solution through high dose platelet rich plasma.

Before patients risk surgery to alleviate low back pain, another treatment to consider is High Dose PRP, high dose platelet-rich plasma with Orthagenex. High dose platelet rich plasma treatment for bulging disc pain, while increasing in patient use, is still considered to be an unconventional treatment but quickly becoming mainstream as the processes become standardized and the data of treatment outcomes is more refined. High Dose PRP works to target and heal nerve/tissue damage in the spine, not only caused by disc bulges but other causes of nerve damage as well, but what exactly is high dose platelet-rich plasma and how can it treat bulging disc pain?

In a study of high dose platelet rich plasma conducted by the China-Japan Union Hospital of Jilin University, physicians found that, “[p]latelet-rich plasma (PRP) is a platelet concentrate extracted from autologous blood by centrifugation, which is a kind of bioactive substance” (Wang 2022). But, what does all this mean? In our own (autologous) blood, we are able to take platelets in a concentrated form. When blood is taken from us and put in a centrifuge, it is spun around quickly to separate red blood cells from white blood cells as well as concentrate the number of platelets together. These concentrated platelets, once extracted and applied, act as a treatment that can be used to target nerve-damaged areas. These damaged areas include nerves damaged through bulging discs in the spine– regardless of their current pathogenesis. High dose platelet rich plasma even has the potential to heal and regrow damaged tissue around the back joints and is even favored among those patients who have suffered acute injuries. We’ve all witnessed the human body’s incredible capability to heal injuries. A scraped back will bleed, scab, and scar in a number of days and a broken bone will reset itself in a matter of weeks. These healing processes work through the cells in our body activating and targeting the affected areas. With nerve damage, the process of treatment is more complicated. However, the healing capability of our body works in much the same way.

Our body contains the capability to heal nerve damage through the application of high dose platelet rich plasma. Orthagenex now has the ability to apply that in concentration to nerves affected by bulging discs and the application is safe. Wang continues with his evaluation of high dose platelet rich plasma by stating that, “[t]he application of PRP comes from the body, there is no immune rejection reaction . . . it is, therefore, widely used in various clinical fields”. With Orthagenex’s high dose platelet rich plasma, patients don’t need to worry about a foreign or unidentified substance entering or affecting their body with adverse and uncontrollable side-effects. By targeting problematic bulging discs with this concentration, the application of high dose platelet rich plasma to affected areas is an assistance to the body’s natural healing process. According to a 2017 study evaluating the high dose platelet rich plasma treatment process, doctors Sanchez and his associates concluded that the six pieces of evidence that support nerve regeneration include: “1) neuroprotection and prevention of neuronal apoptosis, 2) stimulation of vascular regeneration, 3) promotion of axonal regeneration, 4) regulation of inflammatory response in the microenvironment, 5) alleviation of nerve collateral muscle atrophy, and 6) improvement of human nervous system parameters” (2017). With the benefits of this natural application of healing platelets in mind, patients struggling with disc bulge pain are more and more likely to seek this type of treatment every day they have to live with the condition

High Dose PRP – Platelet Rich Plasma – as a Treatment for Bursitis

Posted on by Will Bozeman

Conditions that chronically affect the joints like osteoarthritis, and acute incidents that damage the joints like injuries are both common and expected by most people at some point in their lifetime. If there is one thing that patients with these experiences don’t need, it’s a painful byproduct of their joint pain. Unfortunately, for many, joint pain and stiffness may not only be a result of acute or chronic conditions, but a condition known as bursitis. In general, bursitis is a condition that manifests in the inflammation of the pads that protect our joints (bursae). While all of our joints contain bursae, it is more common for the bursae to become inflamed when the joint is repeatedly used– most commonly, the knee and elbow joints.

For decades, physicians have known the causes of bursitis and generally its direction for treatment. In 2001, doctors Arromdee and Matteson determined in The Journal of Musculoskeletal Medicine that, “[t]he most common causes of bursitis are repetitive microtrauma or macrotrauma . . .”. Microtrauma and Macrotrauma refers to inside and outside injury respectively. Doctors Arromdee and Matteson continue to list the micro/macro traumas to include, “. . . extension of inflammation from the surrounding structures, including adjacent tendons, muscle fascia, skin, and joint synovium; crystalline deposition diseases; and infection” (2001). To elaborate further, the extension of inflammation refers to other sections of the joints becoming inflamed and causing inflammation of the bursae. Crystalline deposition diseases that can contribute to bursitis include gout and other forms of arthritis. However, while some of these contributing factors to bursitis may appear serious, others are seemingly innocuous and even incidental.

Oddly enough, a study conducted in in 2020 by physicians Elizabeth Hesse and Ronald Navarro found that, “[s]ubdeltoid bursitis has been reported as an adverse event after intramuscular vaccination in the deltoid muscle . . . The cohort included 2 943 493 vaccinated persons. Sixteen cases of symptom onset in the risk interval and 51 cases of symptom onset in the control interval were identified. The median age of persons in the risk interval was 57.5 years (range, 24 to 98 years), and 69% were women. The incidence rate ratio was 3.24 (95% CI, 1.85 to 5.68). The attributable risk was 7.78 (CI, 2.19 to 13.38) additional cases of bursitis per 1 million persons vaccinated . . . Although an increased risk for bursitis after vaccination was present, the absolute risk was small” (2020). While the risk for bursitis after vaccination into the deltoid is small, patients can begin to see just how sensitive the bursae is to both micro and macro traumas and even though bursitis can be common, that does not make it less serious or negate the necessity for treatment.

“Bursitis is a common reason for seeking medical help, notably via emergency room visits. The olecranon and prepatellar [elbow and knee joints, respectively] bursae are the most often involved sites, as their superficial location exposes them to injury. About one-third of cases of olecranon and prepatellar bursitis are septic [or infected]. The annual incidence of olecranon and prepatellar bursitis has been estimated at 0.1/1000 population. Septic olecranon and prepatellar bursitis has been reported to account for 0.01% to 0.1% of all hospital admissions. These numbers may underestimate the true incidence of septic bursitis, as only the most severe forms require admission” (2018). As we discussed earlier, bursitis can be relatively common for a number of reasons. With up to 33% of bursitis cases requiring hospitalization, one can begin to see why treatment is not only desired to reduce pain and stiffness but stave off any further micro/macro traumas that could worsen to the incidence of septic bursitis.

Luckily, treatment for bursitis not only exists in the form of High Dose PRP, but this specialized treatment is offered by Orthagenex. A 2019 study in the Journal of Orthopaedics and Sports Medicine, doctors Madhan Jeyaraman and his associates evaluated the efficacy of high dose platelet rich plasma (PRP) as a treatment for bursitis. The physicians explain that their study was, “. . . conducted to review a series of patients prospectively with symptomatic retrocalcaneal [Achilles tendon] bursitis and its associations to determine if PRP injections (1) provide symptomatic relief, (2) improved VAS and AOFAS scores and (3) alleviation of need of surgery” (2019).

Once the three objectives were clear, the physicians continued and made their methods for study clear by explaining that, “[a]fter screening of cases, 128 cases entered into the study and have been treated with an autologous platelet rich plasma injection with due pre and post procedural care. The cases are followed up on day 0, at the end of 1st week, 1st and 6th month for pain and range of movements. The patients are followed up for complications and the data were analyzed statistically”. With a sample size of 128 cases entering the study, Dr. Jeyaraman and his associates were able to gain more accurate statistics and determine whether high dose platelet rich plasma injection had any bearing on Achilles pain levels and mobility.

At the end of this study, the physicians had their results and determined that, “[o]ut of 128 cases, 76 patients (59.37%) improved with 1st dose and a further 38 patients (29.68%) with a 2nd dose of autologous PRP injection with an interval of 3 weeks from the first dose. A total of 89.05% of patients, who got treated with autologous PRP injection, had a good clinical and functional outcome even at the end of 1 year of injections and presented with statistically significant results with a p value <0.001. No adverse reactions and serious complications are noted in the study participants . . . [t]he autologous PRP injection is considered superior in treatment of retrocalcaneal bursitis, which minimise the pain and improve the functional quality of life”. With nearly 90% of patients in this study finding both joint mobility and pain reduction with the use of high dose platelet rich plasma, one can begin to understand how it has become increasingly popular for treating painful conditions like bursitis. But, what exactly is high dose platelet rich plasma and how can Orthagenex help?

Dr. Jeyaraman referred to high dose platelet rich plasma as “autologous” which specifically means the plasma is from the patient’s own body. From a patient’s autologous blood, we are able to take platelets in a concentrated form. When blood is taken from these patients and put in a centrifuge, it is spun around quickly to separate red blood cells from white blood cells as well as concentrate the number of platelets together. These concentrated platelets, once extracted and applied, act as a treatment that can be used to target nerve-damaged areas. These damaged areas include nerves damaged through bursitis– regardless of their current pathogenesis.

High Dose PRP even has the potential to heal and regrow damaged tissue around the bursae and is often favored among those patients who have suffered acute injuries. We’ve all witnessed the human body’s incredible capability to heal injuries. A scraped back will bleed, scab, and scar in a number of days and a broken bone will reset itself in a matter of weeks. These healing processes work through the cells in our body activating and targeting the affected areas. With nerve damage, the process of treatment is more complicated. However, the healing capability of our body works in much the same way. The application of high dose platelet rich plasma to bursitis-affected areas is an assistance to the body’s natural healing process. According to a 2017 study evaluating the high dose platelet rich plasma treatment process, doctors Sanchez and his associates concluded that the six pieces of evidence that support nerve regeneration include: “1) neuroprotection and prevention of neuronal apoptosis, 2) stimulation of vascular regeneration, 3) promotion of axonal regeneration, 4) regulation of inflammatory response in the microenvironment, 5) alleviation of nerve collateral muscle atrophy, and 6) improvement of human nervous system parameters” (2017). With the benefits of this natural application of healing platelets in mind, patients struggling with bursitis are more and more likely to seek this type of treatment every day they have to live with the condition. Orthagenex not only offers patients high dose platelet rich plasma as a treatment for their bursitis, but consultation and educational tools to help them maintain and manage their bursitis with confidence. Sessions with Orthagenex see patients not only going through the treatment process to reduce pain and increase flexibility but ensure patients have the tools they need to manage their conditions on a daily basis.

Knee Osteoarthritis and Platelet-Rich Plasma: A Study of Convenience and Efficacy with High Dose PRP®

Posted on by Will Bozeman

Whether a patient has experienced knee pain from an isolated injury or endured decades of chronic pain, the underlying concern for all patients is whether or not they can find an effective treatment. Once a patient believes they have found a treatment that works for them, the next concern would likely be whether there is any risk involved and whether that risk pays off. Barring medical expenses and recovery time, which both vary wildly for myriad reasons, a patient’s primary concern when it comes to treating knee pain is whether the treatment works and that it works for them.

One difference between patients with chronic and isolated knee pain is that patients with chronic knee pain have likely had years of trial-and-error options in the search for a right treatment. It is equally likely that patients with chronic knee pain have experienced the pathogenesis of their condition, a progression to a level that has deteriorated the function of their knee joints. However, many who suffer from chronic knee pain will likely be unaware of the condition that causes increased pain over time; they will simply chalk up the pain as pain and do whatever they must to get rid of it. For the purpose of this article, let’s focus on the primary cause of chronic knee pain: osteoarthritis (OA).

When patients understand osteoarthritis as a contributing factor to knee pain, they can begin to understand how other risk factors can contribute and combine to aggravate knee pain. But first, what is osteoarthritis? When patients understand the condition they suffer from, and recognize what has worsened the pathogenesis of their osteoarthritis, they might begin to determine what they can do on a personal level to treat the pain. Taking personal steps to mitigate the pain greatly increases a patient’s ability to feel relief and confidence. When patients feel confident in their understanding of their osteoarthritis, treatment is that much easier to understand, and its importance leaves an impact that cannot be shaken by complacency or frustration with the condition itself. Dr. Dragan Primorac highlights the importance of paying attention to osteoarthritis (OA) by stating that, “[i]t is estimated that the prevalence of knee osteoarthritis (OA) among adults 60 years of age or older is approximately 10% in men and 13% in women, making knee OA one of the leading causes of disability in elderly population. Today, we know that osteoarthritis is not a disease characterized by loss of cartilage due to mechanical loading only, but a condition that affects all of the tissues in the joint, causing detectable changes in tissue architecture, its metabolism and function” (2020). Along with Dr. Primorac’s assessment that OA is a general loss of cartilage in the knee, we should also qualify that the reduction of this cartilage is not only the cause of pain but the effects of that lost cartilage are what will lead to increasing pain, depending largely on the risk factors.

Other than time and its accompanying decay of the human body, there are several risk factors that often exacerbate the condition of osteoarthritis so it is only appropriate that patients be made aware that other risk factors might be complicating the condition. Over time the internal and external anatomical structure of our body’s breakdown and the risk for osteoarthritis increases as the body ages. Osteoarthritis occurs when the protective pads of cartilage are worn down and the bones grind against each other and cause this pain. Unfortunately, everyone is at risk for osteoarthritis. However, patients who have experienced injuries to their knees or other joints are more likely to experience arthritis at an older age and OA is further exacerbated by other risk factors, especially in cases of patients who are obese.

While keeping these risk factors in mind, many patients will recognize that there are some risk factors that can be addressed (variables) and others that cannot (constants). When patients take on the information presented about their condition, it can often be overwhelming and patients hearing they have one or more risk factors will often feel hopeless. What is crucial in the process of treatment is the management of expectations– meaning the acceptance of the constants and confrontation of the variables.

While patients assess which OA risk factors might be constant and/or variable, they should take comfort in knowing that obesity is a largely variable risk factor that they can impact on their own. Dr. Lianzhi Chen and her associates found that, “[o]besity-related osteoarthritis (OA) is a complex, multifactorial condition that can cause significant impact on patients’ quality of life . . . Moderate dynamic mechanical loading is one of the most important mechanical factors for maintaining joint homeostasis. The integrity of articular cartilage is maintained under moderate loading conditions during routine daily activities. However, when receiving abnormal excessive mechanical loading, disruption of cartilage homeostasis and deformation of normal joint morphology occurs, further inducing and accelerating the progression of OA”. While it may seem to be common sense to many that knee pain would increase with the increase of a patient’s weight, many do not consider, as Dr. Chen states, that obesity can accelerate the pathogenesis of osteoarthritis. Not only does excess weight increase knee pain but it can literally deform the knee joint itself, further complicating the pain and necessitating more drastic treatment intervention.

Necessary knowledge of osteoarthritis and its variable, albeit critical, risk factors necessitate a patient’s intervention. If patients struggle with obesity, it is essential that they take action to mitigate their osteoarthritis, the pain, and the eventual deformation of the knee joint. Avoidance and of intervention in the day-to-day choices could contribute to the furthered pathogenesis of osteoarthritis. However, patients should not assume they will be alone in the treatment of their condition. In fact, while several options for knee pain treatment exist, there are only a few that can promise efficacy, safety, and convenience, and these treatments can all be found with multiple treatment solutions offered by Orthagenex.

One of the most effective and safe treatments offered by Orthagenex is the injection of High Dose PRP®, or platelet rich plasma (PRP). High Dose PRP® treatment for knee joint pain, while increasing in use and acclaim, is still considered to be unconventional and unheard of among those who have sought treatment for osteoarthritis in the past. High dose platelet rich plasma works to target and heal nerve/tissue damage, not only caused by osteoarthritis, but other causes of nerve damage as well. However, many patients might feel that a relatively nascent treatment for knee osteoarthritis like High Dose PRP® injections would be less than reputable or tested to a comfortable extent. To alleviate any concerns patients might have in their limited understanding of High Dose PRP®, let’s review what it is and how it helps osteoarthritis knee pain. In an evaluation of High Dose PRP® injections conducted by the China-Japan Union Hospital of Jilin University, researchers explain that “[p]latelet-rich plasma (PRP) is a platelet concentrate extracted from autologous blood by centrifugation, which is a kind of bioactive substance” (Wang 2022). From a patient’s own blood (autologous), Orthagenex is capable of injecting high dose platelet rich plasma in a concentrated form. When blood is taken from a patient and put in a centrifuge, it is spun rapidly to separate plasma and platelets from the rest of the blood elements that are not required for effective PRP treatments. These concentrated platelets, once extracted and applied, act as a powerful regenerative growth factor solution that can be used to target repair and restoration of damaged tissues, such as areas damaged by osteoarthritis in the knee. High Dose PRP® has the potential to heal and regrow damaged tissue around the knee joints and is favored among those patients who have suffered injuries or dealt with chronic pain over an extended period of time– even years. The treatment process of High Dose PRP® works through the cells in our damages tissue areas being stimulated by the high levels of growth factors and other beneficial components of PRP, activating and targeting the affected areas. The healing capability of our body works in much the same way but lacks the concentrations of growth factors and other elements to create rapid healing and regeneration, which is what makes PRP so effective at high doses. In fact many studies show that PRP only becomes effective at tissue regeneration over certain concentrations. Our body contains the capability to heal through the injection of High Dose PRP®. Orthagenex has the ability to apply platelet rich plasma in high concentrations required to create effective healing and recovery, and most importantly, the application is safe.

Wang continues with his evaluation of High Dose PRP® injections by clarifying that, “[t]he application of PRP comes from the body, there is no immune rejection reaction . . . it is, therefore, widely used in various clinical fields”. With High Dose PRP®, patients don’t need to worry about a foreign or unidentified substance entering or affecting their body with adverse and uncontrollable side-effects. As long as High Dose PRP® is prepared under proper conditions it is a safe and effective treatment. By contrast, many offices that offer a basic entry level PRP treatment are most likely using an unknown concentration using a regular blood spinning centrifuge that can’t differentiate with precision and can’t concentrate PRP to levels required to see effective regeneration. By targeting knee joints with osteoarthritis using the application of High Dose PRP®, it is an amplification of the body’s natural healing process.

According to a 2017 study evaluating high dose platelet rich plasma healing process in regards to the damaged tissues associated with reporting pain, doctors concluded that the six pieces of evidence that support damaged tissue regeneration include: “1) neuroprotection and prevention of neuronal apoptosis, 2) stimulation of vascular regeneration, 3) promotion of axonal regeneration, 4) regulation of inflammatory response in the microenvironment, 5) alleviation of nerve collateral muscle atrophy, and 6) improvement of human nervous system parameters” (Sanchez 2017). With the benefits of this natural application of healing platelets in mind, patients struggling with chronic knee pain are more likely to seek this type of treatment. As patients continue to learn about their condition, especially in the case of knee osteoarthritis, it can be daunting to consider the countless options for treatment, their efficacy and side effects. With Orthagenex and its state-of-the-art treatment options, the possibility for effective treatment that takes the patient’s comfort level into account is greater than ever. High Dose PRP® injection is just one of the many treatments that patients can count on to treat knee osteoarthritis and make a difference in their daily lives.

High-Dose PRP For Carpal Tunnel Syndrome: A Breakthrough Treatment

Posted on by Will Bozeman

One of the most frustrating and common conditions of hand pain is carpal tunnel syndrome. When patients have a lifestyle, hobby, or occupation that requires them to use their hands, there is a higher likelihood they will experience carpal tunnel syndrome, which can complicate the accomplishment of what would be routine tasks. 

Despite carpal tunnel syndrome being common, most patients do not understand the condition and dismiss it as a cramp. But when the pain is persistent and precludes the use of one’s hands, it is likely to be carpal tunnel syndrome, and it is certainly more serious than a muscle cramp or spasm.

Understanding the true nature of carpal tunnel syndrome is essential for patients to seek proper diagnosis, treatment, and management strategies. In the following sections, we will explore the anatomy and development of carpal tunnel syndrome, its symptoms, risk factors, and conventional treatment approaches.

Additionally, we will discuss a breakthrough treatment option involving high-dose platelet-rich plasma (PRP) therapy and its potential benefits in managing carpal tunnel syndrome.

In this article, we will explore the innovative therapy option of PRP for carpal tunnel, which may provide the relief you have been seeking. We aim to equip you with valuable insights and knowledge to identify and alleviate the painful symptoms of this painful condition.

To begin, let’s delve into the definition of carpal tunnel syndrome and discuss the process of how it can develop.

Defining Carpal Tunnel Syndrome

Carpal tunnel syndrome (CTS) develops gradually over a long period of time. For example, imagine someone who spends hours each day typing on a keyboard with improper wrist positioning. The repetitive hand and wrist movements, combined with sustained poor hand posture, can cause strain and irritation on the tendons in the wrist.

Over time, this repetitive strain leads to swelling and inflammation within the carpal tunnel, which in turn increases pressure on the median nerve. As the pressure on the nerve persists, it can result in the characteristic uncomfortable symptoms of CTS, including pain, numbness, and tingling.

It is essential to emphasize that carpal tunnel syndrome is a nerve condition rather than a muscular complication. While muscle strain can contribute to the development of CTS, the primary cause lies in the compression and irritation of the median nerve as it travels through the carpal tunnel. 

For example, during their comprehensive literature review, Dr. Genova and Dix conducted an in-depth analysis of the nature and pathogenesis of CTS and determined that “[c]arpal tunnel syndrome (CTS) is a common medical condition that remains one of the most frequently reported forms of median nerve compression. 

CTS occurs when the median nerve is squeezed or compressed as it travels through the wrist. The syndrome is characterized by pain in the hand, numbness, and tingling in the distribution of the median nerve” (2020). 

The distinction is vital as some individuals mistakenly categorize CTS as a problem related to muscles. Clarifying this point helps patients grasp the true nature of the condition and its impact on the median nerve. By recognizing CTS as a nerve-related syndrome, patients can gain a better understanding of the appropriate treatment approaches and management strategies required to effectively address the underlying nerve compression and alleviate the associated symptoms.

Having established a comprehensive understanding of the development and pathophysiology of CTS, we will now explore the distinctive indicators and symptoms that characterize this condition in the following section.

Symptoms Of Carpal Tunnel Syndrome

CTS presents a range of symptoms that can significantly impact an individual’s daily life and activities. The most common signs of CTS include pain, numbness, tingling, and a “pins and needles” sensation in the hand and fingers, particularly in the thumb, index, middle, and ring fingers. 

These symptoms may start gradually and primarily affect the hand’s palm side, but they can progress over time.

As CTS progresses, individuals may experience weakness in the affected hand, making it challenging to perform routine tasks that require fine motor skills, such as buttoning clothes, gripping objects, or holding utensils. 

The loss of grip strength and dexterity can hinder the ability to perform work-related duties or engage in hobbies and recreational activities, causing frustration and limitations in daily functioning.

Moreover, the symptoms of CTS often worsen at night, leading to sleep disturbances and disrupted rest. Many individuals report awakening with a feeling of numbness or pain in their hands or having the need to shake or move their hands to relieve discomfort. The constant disruption of sleep can lead to fatigue, daytime drowsiness, and decreased productivity.

The impact of CTS symptoms extends beyond physical limitations. Chronic pain and discomfort may result in emotional distress, anxiety, and depression. The inability to participate fully in activities that were once enjoyable can contribute to feelings of isolation and reduced quality of life.

It is essential to recognize and address the symptoms of CTS promptly to minimize their impact on daily life. Seeking medical attention, receiving an accurate diagnosis, and exploring appropriate treatment options can help alleviate symptoms, restore hand functionality, and improve overall well-being.

Risk Factors And Causes Of Carpal Tunnel Syndrome

CTS is influenced by various risk factors that increase the likelihood of the condition developing. Along with understanding CTS as a nerve condition and not a muscular condition, patients should also have a thorough understanding of the risk factors for CTS that could apply to them.

Dr. Genova and Dix continue to review the condition of CTS and explain that the “[r]isk factors for CTS include obesity, monotonous wrist activity, pregnancy, genetic heredity, and rheumatoid inflammation.”

Certain individual factors, including age, sex, hormonal changes, and diabetes mellitus, which can lead to peripheral neuropathy, are associated with increased susceptibility to CTS. Women, in particular, are more prone to developing this condition.

Therefore, individuals who possess these risk factors should be especially vigilant in implementing preventive measures and seeking early intervention to manage and reduce the impact of CTS.

This can include practicing proper ergonomics, maintaining good posture, taking regular breaks, using ergonomic equipment, implementing stretching exercises, and seeking medical advice for early intervention and management. 

Furthermore, obesity is recognized as a significant factor in nerve-damaging conditions, such as diabetic peripheral neuropathy. To reduce the risks of developing CTS and other related disorders, individuals can take steps to control their weight.

Extensive research has focused on understanding these risk factors and the specific causes associated with CTS, particularly in relation to repetitive hand movements and work-related activities. Let’s go on to explore these in greater detail.

Work-Related Carpal Tunnel Syndrome

Patients who experience CTS may have developed the condition from work/hobby repetition–including something as innocuous as typing on a keyboard. Work-related carpal tunnel syndrome has significant implications for occupational health and carries an associated economic burden.

Dr. Genova and Dix’s literature review has clearly categorized CTS as a work-related musculoskeletal disorder, highlighting its relevance in today’s world by explaining that “[m]ost western nations indicate a rise in the number of work-related musculoskeletal disorders (WMSDs). 

This is associated with increased strain and repetitive movements by individuals. Europe, in 1998, for instance, reported more than 60% of upper limb musculoskeletal disorders recognized as work-related . . . CTS incidences. 

The prevalence levels may also vary across the different occupations and industries, with industries such as the fish processing industries reporting the occurrence of CTS in their workers estimated at 73%. These views on the occurrence rates of CTS illustrate the weight of the challenge, making it a significant area of concern, which would require effective strategies for management”. It may not surprise patients to learn that CTS is more prevalent in those who engage in activities requiring prolonged and forceful use of the hand and wrist, as well as exposure to hand-arm vibration, such as assembly line work and manual labor. Still, these monotonous and repetitive motions can irritate the hand’s median nerve and pose a significant risk for developing CTS over time.

Relationship Between Carpal Tunnel Syndrome And Repetitive Hand Movement

If the hand’s median nerve is continually irritated due to repetitive activities, the pain associated with CTS can intensify over time. 

This prolonged irritation can lead to swelling, inflammation, and increased pressure, which ultimately worsens nerve compression and escalates the severity of pain associated with CTS.

Dr. Tonga and Bahadir explain why increased pain could lead to drastic decisions made by patients in regard to their treatment and go on to specify the importance of first addressing weight management and B12 deficiency before considering surgery. 

The doctors found that throughout their experiences, “CTS severity not only increases patient’s discomfort but also makes them lean toward surgery. Controlling CTS severity may help keep symptoms manageable with conservative means. 

In this regard, as BMI and vitamin B12 deficiency increase the CTS grade, patients with CTS should keep their weights under control and carefully choose their diets to prevent vitamin B12 deficiency” (2022).

Like most doctors, Tonga and Bahadir seek to mitigate the conditions of their patients and intend to keep surgical intervention as a last resort. But, when weight maintenance and B12 supplementation are not enough, patients may be looking for an alternative that works and is safe.

Recognizing the impact of CTS severity on patients’ decision-making, along with the potential influence of factors such as weight and B12 deficiency, as well as the weighty decision surrounding surgical intervention, highlights the importance of exploring accurate diagnostic methods for CTS. Let’s go on to discuss how CTS is diagnosed in the next section.

Diagnosing Carpal Tunnel Syndrome

To ensure accurate diagnosis and appropriate treatment of CTS, healthcare professionals may utilize a number of diagnostic approaches. The evaluation typically consists of the following:

  • Medical history: The doctor reviews the patient’s symptoms, risk factors, and relevant medical conditions to understand the context and potential causes of CTS.
  • Physical examination: The doctor examines the hands, wrists, and arms, looking for signs of swelling, tenderness, or weakness. They may also check for abnormalities in the range of motion and assess muscle strength.
  • Nerve conduction study: This test measures the speed at which electrical signals travel through the median nerve. Electrodes are placed on specific points along the nerve pathway, and small electrical impulses are applied to evaluate how well the nerve conducts these signals.
  • Electromyogram (EMG): This test assesses the electrical activity of muscles and helps determine if there is nerve damage. Thin, needle-like electrodes are inserted into specific muscles to record their response to nerve stimulation.
  • Ultrasound imaging: In some cases, ultrasound imaging may be used to assess the structures within the wrist and identify any abnormalities. It allows visualization of the median nerve, tendons, and surrounding tissues, helping to confirm the diagnosis and rule out other conditions.

It is crucial to consult with a healthcare professional for an accurate diagnosis, as other conditions can exhibit symptoms similar to carpal tunnel syndrome. 

A comprehensive evaluation, incorporating medical history, physical examination, and relevant diagnostic tests, enables healthcare providers to formulate an appropriate treatment plan tailored to the individual’s specific needs. 

Once a diagnosis of carpal tunnel syndrome (CTS) is made, it is crucial to seek and obtain a personalized management plan that takes into account your specific needs and lifestyle preferences.

How Conventional Medicine Approaches Carpal Tunnel Syndrome

Conventional medical treatments for CTS aim to relieve symptoms, reduce inflammation, and alleviate pressure on the median nerve. The specific treatment options prescribed by healthcare professionals may vary depending on the severity of the condition and individual patient factors. Here are some common examples of conventional treatments for CTS:

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): Medications such as ibuprofen or naproxen are often recommended to reduce inflammation and alleviate pain associated with CTS.

Wrist Splints/Braces: Wearing a wrist splint or brace can help stabilize the wrist in a neutral position, relieving pressure on the median nerve and reducing symptoms. Splints are typically worn during activities that aggravate symptoms or at night.

Corticosteroid Injections: Injections of corticosteroids into the carpal tunnel can provide temporary relief by reducing inflammation and swelling around the median nerve. Repeat doses are often required overtime. 

Physical Therapy: Therapeutic exercises and techniques can improve wrist strength, flexibility, and posture, reducing symptoms and preventing further injury. Physical therapists may also employ techniques like ultrasound or laser therapy to promote healing.

Occupational Changes/Ergonomic Modifications: Making modifications to workstations or job tasks, such as using ergonomic keyboards or adjusting desk height, can help reduce strain on the wrists and minimize symptom exacerbation.

Lifestyle Modifications: Simple lifestyle changes like taking regular breaks from repetitive hand activities, practicing proper hand and wrist posture, and avoiding activities that aggravate symptoms can provide relief and prevent CTS progression.

Surgical Intervention

In cases where conservative treatments do not provide sufficient relief, surgical intervention may be considered. This surgery typically involves releasing the pressure on the median nerve by cutting the transverse carpal ligament, a procedure known as carpal tunnel release. 

However, it is important to note that surgery is typically reserved for severe or persistent cases of CTS that do not respond to more conservative measures. Individuals diagnosed with carpal tunnel syndrome (CTS) should seek professional medical advice to determine the most suitable treatment approach based on their specific symptoms and circumstances. 

While conservative treatments such as braces, physical therapy, and ergonomic changes may not always provide sufficient relief, relying on medications and steroid injections may not be preferred due to personal lifestyle choices. 

In the upcoming sections, we will explore the effectiveness of platelet-rich plasma (PRP) therapy for CTS and why it is favored as an innovative alternative for those who have not responded to conventional treatments and wish to avoid surgery.

Why Consider High-Dose PRP As A Treatment For Carpal Tunnel Syndrome?

One treatment that is safe and proven to be effective is high-dose platelet-rich plasma. In a small study examining the efficacy of PRP when applied to CTS, doctors Güven and Özçakar determined that “[p]latelet-rich plasma (PRP) treatment has the potential to become a part of the nonsurgical approach in carpal tunnel syndrome (CTS) as a regenerative method. 

PRP therapies aim to enhance the self-healing ability of [the] human body by exposing the injured tissue to a high concentration of autologous growth factors. Nerve tissues also seem to benefit from the regenerative effects of PRP concentrates” (2019).

The doctors explain their methods for determining PRP efficacy and explain that their purpose is “to investigate the possible beneficial effects of PRP injection in CTS. A total of 40 hands of 30 patients were included (20 hands per group) with mild to moderate idiopathic CTS. 

Patients with mild to moderate CTS were placed into either control or PRP groups. Activity modification and night-only wrist splints were suggested in both groups. 

Additionally, in the PRP group, a single perineural PRP injection into the carpal tunnel was applied under ultrasound guidance. Sensibility tests, Boston carpal tunnel questionnaire (BCTQ), and electrophysiological and ultrasonographical findings were measured initially and after four weeks. 

Groups were similar regarding demographics. BCTQ scores and ultrasonographical values were improved in both groups. Delta analyses revealed that the difference in BCTQ scores improved better in the PRP group. Electrophysiological values improved in the PRP group. 

Our study demonstrated that a single, perineural PRP injection into the carpal tunnel provided further improvements in CTS”. 

Study after study has concluded that PRP for carpal tunnel syndrome, if anything, supplements and improves pain management capability compared to other treatment options.

PRP And Nerve Regeneration

With nerve damage, the process of treatment is more complicated. However, the healing capability of our body works in much the same way. The application of high-dose platelet-rich plasma to CTS-affected areas is an assistance to the body’s natural healing process.  

Based on a comprehensive evaluation of studies conducted in 2017, doctors Sanchez and his associates concluded that there were six pieces of evidence supporting the effectiveness of high-dose platelet-rich plasma (PRP) treatment in promoting nerve regeneration.

 “1) neuroprotection and prevention of neuronal apoptosis, 

  2) stimulation of vascular regeneration, 

  3) promotion of axonal regeneration, 

  4) regulation of inflammatory response in the microenvironment, 

  5) alleviation of nerve collateral muscle atrophy, and 

  6) improvement of human nervous system parameters” (2017).

With the benefits of this natural application of healing platelets in mind, patients struggling with CTS pain and irritation are more and more likely to seek this type of treatment every day they have to live with the condition.

Common Patient Concerns About Platelet-Rich Plasma

We’ve all witnessed the human body’s incredible capability to heal injuries. A scraped back will bleed, scab, and scar in a number of days, and a broken bone will reset itself in a matter of weeks. These healing processes work through the cells in our body, activating and targeting the affected areas. 

High-dose platelet-rich plasma has the potential to heal and regrow damaged tissue around the median nerve and is often favored among those patients who have suffered from carpal tunnel syndrome. 

After hearing the results of these above studies, many might be jumping at the chance to treat their CTS with high-dose platelet-rich plasma, some might be more apprehensive due to their lack of understanding of what high-dose platelet-rich plasma is in the first place.

Let’s address some of the common reservations and basic concerns individuals may have regarding PRP Therapy:

Risks and Safety: Platelet-rich plasma treatment is considered safe since it utilizes the patient’s own blood components, reducing the risk of adverse reactions or complications. As with any medical procedure, there is a small risk of infection or allergic reaction. 

However, these risks can be minimized by choosing a reputable healthcare provider with experience in administering PRP therapy.

Recovery Time: The recovery time following a high-dose PRP treatment for CTS is significantly shorter compared to surgical intervention. However, it can vary depending on the individual and the severity of their condition. 

Side Effects: PRP treatment for CTS is generally well-tolerated, with rare temporary side effects at the injection site, such as pain, swelling, redness, or bruising. These typically resolve within a few days. Serious complications like infection or nerve damage are rare. At Orthagenex, we use specialized imaging to precisely guide PRP therapy, minimizing any potential risks.

By addressing these concerns, patients can make informed decisions about whether high-dose platelet-rich plasma treatment is the right option for their carpal tunnel syndrome. To gain further insight, it is helpful to compare PRP treatment to the more conventionally used cortisone injections.

Comparing PRP Treatment To Cortisone Injections

In a similar, albeit more extensive, study on the efficacy of high dose platelet rich plasma in comparison to corticosteroid injections, doctors Senna, Shaat, and Ali found that “[c]arpal tunnel syndrome (CTS) is the most common entrapment neuropathy in the upper extremity. 

Treatments for CTS alternate from conservative strategies to surgical decompression of the median nerve. Few studies have applied platelet-rich plasma (PRP) for treating idiopathic CTS, with acceptable success rates.” (2019). 

In great detail, the doctors continue to explain the process of their study and explain that it was “. . . a randomized controlled trial in a cohort of Egyptian patients [who] suffered from mild to moderate CTS. They were randomly divided into two groups. Group 1: patients received ultrasound-guided PRP injection, and group 2 patients received ultrasound-guided corticosteroid injection. 

The outcome measures were assessed via the Visual Analog Scale, the Boston Carpal Tunnel Syndrome Questionnaire, electrophysiological findings in sensory and motor functions of the median nerve, and morphological changes of median nerve detected by ultrasound . . . PRP injection was superior to the local steroid injection in the improvement of clinical manifestations . . . this superiority was observed in third-month follow-up suggesting better outcomes in a long-term follow-up”.

In the end, doctors Güven and Özçakar concluded that “Platelet-Rich Plasma could be an effective treatment of mild to moderate idiopathic CTS and superior to corticosteroid in improving pain, function, and distal sensory latency of [the] median nerve.”

Additionally, PRP therapy has a more favorable safety profile. As PRP is derived from a patient’s own blood, there is a reduced risk of adverse reactions or complications associated with foreign substances. Corticosteroid injections, on the other hand, carry potential side effects such as tissue atrophy, skin discoloration, and transient elevation of blood glucose levels.

Furthermore, PRP therapy has the potential for long-term benefits. The study mentioned above indicated that the superiority of PRP over corticosteroid injections was observed in the third-month follow-up, suggesting sustained improvement and better outcomes over a longer period. 

This long-lasting effect could be particularly advantageous for individuals with mild to moderate idiopathic CTS, providing sustained relief from symptoms and potentially reducing the need for the repeat interventions that cortisone injections typically require.

Now that we have gained a comprehensive understanding of CTS and the effectiveness of the treatment options available based on research studies let us shift our focus to how our professionals at Orthagenex have chosen to approach the management of the painful symptoms associated with CTS.

How Orthagenex Approaches Carpal Tunnel Syndrome

Orthagenex not only offers patients high-dose platelet-rich plasma as a treatment for CTS but consultation and educational tools to help them maintain and manage their condition with confidence. 

In the simplest explanation, from a patient’s own blood, we can take platelets in a concentrated form. 

When blood is taken from these patients and put in a centrifuge, it is spun around quickly to separate red blood cells from white blood cells as well as concentrate the number of platelets together. 

These concentrated platelets, once extracted and applied, act as a treatment that can be used to target nerve-damaged and nerve-irritated areas. These damaged areas include the median nerve damaged through carpal tunnel syndrome– regardless of its current pathogenesis.

Sessions with Orthagenex see patients not only going through the treatment process to reduce pain and increase flexibility but ensure patients have the tools they need to manage their conditions on a daily basis.

At Orthagenex, we offer personalized consultations and educational tools to empower patients to manage their condition proactively. These sessions aim to provide patients with a deeper understanding of CTS, its triggers, and practical strategies to alleviate symptoms and enhance overall well-being.Through a combination of PRP therapy and ongoing support, Orthagenex strives to reduce pain, improve flexibility, and enhance the quality of life for individuals with CTS. By equipping patients with the necessary means and knowledge, they can actively participate in self-care and implement strategies to manage their condition on a daily basis.

Orthagenex’s approach emphasizes a whole-person and patient-centered approach to CTS management, focusing not only on the treatment itself but also on empowering individuals to take control of their health and achieve long-term relief.

Seek A Regenerative Treatment For Carpal Tunnel Syndrome

In conclusion, Orthagenex’s high-dose platelet-rich plasma (PRP) treatment for carpal tunnel syndrome offers a breakthrough regenerative approach to managing this debilitating condition. Research studies have demonstrated the efficacy of PRP in reducing pain, improving functionality, and promoting nerve regeneration.

Unlike traditional treatments, such as cortisone injections or surgery, PRP therapy harnesses the body’s own healing capabilities to target the damaged tissue and enhance the self-healing process. Furthermore, PRP treatment has been shown to have superior long-term outcomes compared to corticosteroid injections.

Orthagenex’s approach to carpal tunnel syndrome combines high-dose PRP therapy with comprehensive patient consultations and educational resources. This whole-person approach empowers patients to actively manage their condition and achieve long-lasting pain relief and improved hand function.

If you are struggling with carpal tunnel syndrome, consider exploring high-dose PRP treatment at Orthagenex. Consult with a healthcare professional to determine if PRP therapy is the right choice for you and take the first step towards regaining control over your hand pain and restoring your quality of life.