Tennis elbow can be a chronic debilitating syndrome that is often refractory to conservative care that has a high quality-of-life and work impact. It is often caused by overuse, strain or injury to the tendon that attaches to the bone on the outside of the elbow (lateral epicondyle), often from painting, hammering, using a screwdriver or from playing tennis. There are billions of dollars of direct and indirect costs to the treatment of lateral epicondylitis. Conventional therapies such as anti-inflammatory meds, physiotherapy or steroid injections, do not treat the underlying pathology. Platelet-rich plasma is a new cutting edge injection technique for treatment of pain that treats the underlying pathology. It allows the body’s own platelets to do the work of healing tennis elbow naturally. The treatment does not just improve pain, it also heals the tissue so that there may be permanent recovery. Don’t just block the pain, repair the tissue and be pain free with PRP.
Studies have shown the effectiveness of PRP:

1. 140 patients with chronic severe lateral epicondylitis, all who were considering surgery, were treated with PRP or placebo. Eight weeks after the treatment, the platelet-rich plasma patients noted 60% improvement in their visual analog pain scores versus 16% improvement in control patients. At 6 months the PRP group noted an 81% improvement in their pain scores and 93% reduction in pain at 2 years.
2. In a 2003 study by Edwards after PRP therapy, 79% of patients in whom nonsurgical modalities (physical therapy, splinting, anti-inflammatory medication and prior steroid injections) had failed were completely relieved of pain.

Book an appointment for PRP treatment at The Centre For Natural Pain Solutions, 578 Broadway, Winnipeg, Manitoba. Phone # 775-4539.

Platelet-Rich Plasma (PRP) Therapy is a natural non-surgical injection technique for the treatment of pain that uses the body’s own platelets to not only decrease pain but also to heal and rapidly regenerate damaged joints and tissue. Yes, that’s right! Joints, ligaments, tendons, menisci and muscle tissue can be repaired with the use of PRP, meaning that permanent healing is possible and pain killers and aching joints may be a thing of the past. PRP is useful for treating many painful conditions including:

• Whiplash injuries
• Low back pain
• Neck pain
• Migraine headaches
• Sciatica
• Pain related to osteoarthritis
• Degenerative disc disease
• Temporomandibular joint dysfunction (TMJ Disorder)
• Knee arthritis and meniscal injury
• Carpel tunnel syndrome
• Tendonopathy, tendonosis
• Joint capsular laxity

Studies have shown PRP Therapy useful in treating:

Sports injuries:
PRP has been shown to diminish swelling, reduce pain and fully regenerate muscle tissue in athletic muscle injuries, allowing for restoration of functional capabilities in half the normal time of recovery. Hines Ward of the Pittsburgh Steelers received PRP treatment before the 2009 Superbowl and was able to play despite suffering from a sprained medial collateral ligament only two weeks before the Superbowl. Such an injury usually takes weeks to heal but Hines wasn’t going to let the injury keep him from playing. The Steelers’ medical staff chose PRP to quickly and safely allow their star wide receiver to play.

Plantar fasciitis:
After PRP therapy seven out of nine patients had complete resolution of their plantar fascial pain at one year and all the patients in the study had improvement that was noted on diagnostic ultrasound.

Shoulder injury/Rotator cuff tears:
All of the patients failed non-operative treatments such as NSAIDs, physical therapy, and corticosteroid injections and all were considering surgical options. After PRP treatment, 12 of 14 patients had statistically significant improvements in their pain scale and their strength and endurance at eight weeks. Of the 12 patients, six had radiographic evidence of healing of their tendinopathy on MRI at eight weeks.

Tennis elbow:
After PRP therapy, 79% of patients in whom nonsurgical modalities (physical therapy, splinting, anti-inflammatory medication, and prior steroid injections) had failed were relieved completely of pain even during strenuous activity.

Patellar Tendonitis:
After 1 to 2 treatments pain from palpation disappeared, ultrasound showed healing of the tendon, less inflammation and normal tendon striations.

What is involved in the treatment?
The method is to draw some of the patient’s own blood, spin it in a special centrifuge to harvest the platelets and plasma, combine the platelets with some of the plasma, and inject this blood tissue matrix autograft into the damaged ligament or tendon. In this way, platelets are concentrated 4 to 10 times the amount found in the blood. This platelet-rich plasma releases growth factors: transforming growth factor-beta (TGF-b), basic fibroblast growth factor (bFGF), platelet-derived growth factor (PDFa-b), epidermal Growth Factor (EGF), vascular endothelial growth factor (VEGF) and connective tissue growth factor (CTGF). These growth factors reconstruct the ligament or tendon damage and begin the process of pain relief and tissue repair. The entire treatment takes about an hour to perform.
https://treatingpain.com/diagnosis-and-treatments/vid_prp.html

How does it work?
PRP mimics the natural healing process that occurs after a wound. Conditions such as arthritis, sports injuries, tendonitis and ligament instability, for example, can remain beyond the recognition of the natural repair mechanisms of the body. Prolotherapy and PRP are ways in which the areas that need repair are finally recognized by the body as areas that require repair. Prolotherapy drops a signal into the tissue (with dextrose) that attracts platelets and white blood cells into the area to release growth factors. PRP is twice as effective as prolotherapy as it directly gives the area the components it needs for repair; platelets and white blood cells which directly and quickly bring about healing. Prolo acts like a beacon to attract the work crew. PRP brings the work crew right to the site.

What is the science behind PRP Therapy?
At the site of any trauma involving bone, a clot forms consisting of red blood cells, white blood cells, and platelets entrapped within a fibrin matrix. Platelet α-granules act as a reservoir of exogenous growth factors. The degranulation of the α-granules results in the release of platelet-derived growth factor (PDGF), insulinlike growth factor (IGF), vascular endothelial growth factor (VEGF), and transforming growth factor (TGF) among a host of other growth factors providing an ideal delivery system localized to the site of injury. Each of these factors plays a critical role in tissue healing. Platelet-derived growth factor enhances DNA synthesis, increases collagen deposition, and stimulates synthesis of extracellular matrix. In vitro, PDGF has been shown to stimulate type I collagen production and messenger RNA expression in osteoblasts and chondrocytes. Platelet-derived growth factor has enhanced hemotactic and proliferative effects and the ability to initiate differentiation of osteoprogenitor cells toward an osteoblastic lineage. Platelet-derived growth factor functions in a macrophage autocrine feedback loop stimulating production and release of growth factors or cytokines.

Platelet-Rich Plasma is a cutting-edge therapy available in Winnipeg at the Centre for Natural Pain Solutions. Please call (204) 775-4539 to book your appointment.

E. Anitua, I. Andia, B. Ardanza, P. Nurden, A. T. Nurden, “Autologous platelets as a source for healing and tissue regeneration”, Thromb Haemost 2004, 91: 4-15.
Barett S. Growth Factors for Chronic Plantar Fasciitis? Podiatry Today. 2004. 17: 36-42.
Scarpone MA, Davenport M, and Rauker N. PRP as a Treatment Alternative for Symptomatic Rotator Cuff Tendinopathy for Patients Failing ConservativeTreatment. 2005. HYPERLINK "http://www.treatingpain.com/pages/" http://www.treatingpain.com/pages/int_pain/ScarponeRotatorCuffstudy.pdf. Last accessed 1/2/08.
Edwards SG, Calandruccio JH. “Autologous blood injections for refractory lateral epicondylitis”, J Hand Surg Am. 2003 Mar;28(2):272-8.

Henry Stiene, M.D. “Non-Surgical Repair of Patellar Tendonitis with Autologous Platelet Concentrate Using Ultrasound Guidance: Two Case Reports”, Beacon Orthopedic & Sports Medicine, Cincinnati, OH.
John Koerner, BS, Peter Abdelmessieh, MSc, Vikrant Azad, MD, Karolynn Szczepanowski, MBS,
and Sheldon S. Lin, MD. “Platelet-Rich Plasma and Its Uses in Foot and Ankle Surgery”, Techniques in Foot & Ankle Surgery 7(2):72–78, 2008.