Regenerative medicine in the field of pain medicine: Prolotherapy, platelet-rich plasma therapy, and stem cell therapy—Theory and evidence
Section snippets
Prolotherapy
The term “prolotherapy” first appeared in the medical literature during the mid-1950s and was described as a form of treatment for “incompetent structures through the generation of new cellular tissue.”5, 6 Introducing an irritating substance to induce healing has been used since the time of Hippocrates7; however, the modern use of prolotherapy in musculoskeletal injuries can be traced back to the 1930s.8, 9
Proliferant solutions used in this form of treatment are hypothesized to induce collagen
Platelet-rich plasma therapy
In the search for better modalities in the nonsurgical treatment of musculoskeletal injuries, platelet-rich plasma therapy (PRP) has recently been thrust to the forefront of public attention.45, 46 Initially used clinically in the fields of cardiothoracic and maxillofacial surgery in the late 1980s and early 1990s, PRP has since been adopted into the field of musculoskeletal medicine.47, 48, 49 The concept behind its use as a nonsurgical treatment modality is to place it directly into areas of
Stem cell therapy
Adult tissues often have the ability to repair and regenerate following injury. To date, the exact mechanism of repair is poorly understood; however, it is hypothesized to occur through the proliferation and differentiation of cells that ultimately restore tissue functionality. One possible explanation is found within nonhemopoietic progenitor cells found in pathologic tissue, as well as cell reservoirs at other locations, which may help to provide this reparative capability.89 These
Conclusions
Regenerative medicine is a new intriguing concept on the horizon in the field of pain medicine. Although continued research is greatly needed to determine efficacy and safety profiles, early evidence may foreshadow its future use in clinical practice.
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Cited by (56)
Prolotherapy: A Narrative Review of Mechanisms, Techniques, and Protocols, and Evidence for Common Musculoskeletal Conditions
2023, Physical Medicine and Rehabilitation Clinics of North AmericaNonoperative and Operative Soft-Tissue, Cartilage, and Bony Regeneration and Orthopaedic Biologics of the Shoulder: An Orthoregeneration Network (ON) Foundation Review
2021, Arthroscopy - Journal of Arthroscopic and Related SurgeryCitation Excerpt :Prolotherapy involves injecting a natural irritant, often hypertonic dextrose, into the soft tissues to stimulate an inflammatory response that can trigger healing in pathologic tissues. Although the mechanism has not been completely elucidated, it is suggested that certain irritants can trigger the local release of growth factors and chemokines that ultimately modulate inflammation and trigger the production of the appropriate connective tissues.30,31 Various Level I randomized controlled studies have been performed for the aforementioned treatments (Table 1).
Effects of platelet-rich plasma and prolotherapy on supraspinatus tendinopathy: a double blind randomized clinical trial
2023, Journal of Sports Medicine and Physical Fitness