Monday, April 22, 2013

A Quick Insight Into Cortisone & PRP Injections

Before i start, i will give a brief description of what an injury is, and the stages involved. The first event during injury is bleeding followed by tissue regeneration.
There are three distinct stages of tissue regeneration. These include:
Inflammation
Proliferation (multiplication) of cells
Tissue remodelling

Plasma Rich Protein (PRP)
This is a relatively new treatment. It was made famous by Hines Ward, when he used to it to play in the Super Bowl. To break it down, PRP is an injection of protein. The uses of PRP are for soft tissue, tendon/ligaments, or bursas. Probably the most common injury that PRP is used for is Tennis Elbow. While the average platelet count in a normal human being is about 200,000/mm, the amount in a standard platelet concentrate used for PRP is about 1,000,000/mm or more.
PRP is collected by drawing a 20-60 cc volume of blood, then concentrating it. The total volume of fluid containing the platelets is approximately 5cc. In the following 7 days the plasma in the PRP start the growth factor.
During the process, a tenotomy (which is multiple holes) in the injured tendon or bursa (fluid filled sacs) needs to be done prior to introduction of the PRP.
20% of patients needs a repeated PRP treatment if there is no improvement after 4 weeks. Another important fact is any anti-inflammatory and immunosuppressive drugs should be avoided 4 weeks prior to PRP treatment as they reduce the affects.
The cost of a PRP treatment ranges in price, however i have noticed that you will need to pay a few hundred for a treatment.

Cortisone
Cortisone is a natural substance that is produced by the body. It is used when there is any inflammation accuring in the body. There is little side affects while admistrating cortisone. Even a small dose can get rid of the inflammation.
However, lab studies have shown that high concentrations of cortisone or repetitive use of the medication can lead to damage of the tissues in the body. This may lead to softening of the cartilage in joints or weakening of the tendons. There is also certain tendons that a prone to rupturing with the use of cortisone, like the achilles tendon.

So if it was a case of getting either of these injections? I would favour a PRP injection. Unless it was the night before an Olympic final, and it was a case of doing the race or not then I would use Cortisone.

Before either injection, you should explore other avenues as to why was the injury caused. Was it from a biomechanical difference, or an overuse injury that can be helped my proper manual treatments and a individualised strength and conditioning program.

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