Three Types of Regenerative Medicine Treatment and When to Consider Them
Our nationwide team of physical therapists and personal trainers always strives to stay on the cutting edge of movement health innovation.
That’s why we recently conversed with Dr. Noel Peterson, Dr. Kristian Flores, and Dr. Sam Oltman with Oregon Regenerative Medicine to talk more about regenerative medicine. Our physical therapists are proud to work alongside these three three practitioners to help people in the Lake Oswego and surrounding Portland area stay active, healthy, and pain-free.
Regenerative medicine involves treatment methods that regrow and repair damaged or diseased cells, organs, and tissues using your own body’s natural healing processes. In their previous article, the ORM team gave us a thorough introduction to regenerative medicine.
In this article, they cover three types of regenerative medicine treatments in greater detail, when to consider them, and how physical therapy is an important adjunct to an effective regenerative treatment plan.
What are some examples of regenerative medicine?
Prolotherapy
Written by Dr. Flores
Prolotherapy refers to “proliferative” or “regenerative” therapies using a high concentration dextrose injection that stimulates the release of growth factors to help heal the surrounding tissue. By creating inflammation to draw in the immune system to heal the area, we are essentially harnessing the innate ability of our body to heal itself. We often use prolotherapy in instances of acute tendonitis.
PRP
Written by Dr. Oltman
With PRP, or platelet rich plasma, we are creating an even stronger inflammatory reaction by injecting platelets and growth factors directly at the site of injury. The PRP is made from the patient’s own blood by extracting and concentrating the naturally occurring platelets found in the blood. The PRP begins working almost instantly to activate the inflammatory cascade, which generates a stronger regenerative and healing response. We often use PRP to treat more chronic tendinopathies or ligamentous issues.
Adipose Graft
Written by Dr. Flores
With an adipose graft, we inject a high concentration of stem cells from adipose tissue directly into joints, tendons, ligaments, and even skin to trigger an even stronger regenerative response. We reach for an adipose graft when we feel that only the strongest regenerative response would suffice, such as in the instances of severe tendinopathies, osteoarthritis, or other degenerative processes.
When is PRP preferred over prolotherapy?
Written by Dr. Oltman
For many conditions, PRP helps reduce pain and promote healing more quickly and with less treatments compared to prolotherapy. Prolotherapy’s specific virtue is in cases of laxity without advanced degenerative changes. This is commonly seen after ankle sprains, for example, or with spine pain in people who are generally hypermobile.
When should regenerative treatment be considered over surgery?
From Dr. Oltman and Dr. Flores
As physicians, we provide options and give our educated opinions. While each case should be taken on an individual basis, there are some overarching generalities.
In our minds, when you cut something, it is forever changed. The myofascial integrity of the tissue has been altered, and no matter how hard we try, we can never restore the tissue to its original architecture. We believe it is important to avoid surgery whenever possible, and our therapies often provide an alternative to surgery.
One example of using regenerative treatment as an alternative to surgery is when a patient has arthritis but is told they must wait in pain until they are eligible for a joint replacement. Often, this entails the patient becoming more and more sedentary due to increasing pain and experiencing years of decreased quality of life as they await surgery. Regenerative injections are an extremely important tool in this space for two reasons:
- If we begin regenerative treatment early enough, the patient may never need a joint replacement
- Even if the patient needs a joint replacement at some point in the future, regenerative medicine can provide an improved pain level and a much higher quality of life in the intervening years
The biomechanics, or how you move, governs the way in which stress and pressure are distributed within the joint. If we help regenerate the joint but don’t do anything to change the way in which that joint is stressed, then we will end up right back where we started in short order. Using the expertise of physical therapists in order to optimize biomechanics is the only way to get the supportive tissue to really change.
About the Author
Dr. Ashley Baker is a physical therapist with MovementX in Portland, OR who specializes in the treatment of patients with Ehlers Danlos Syndrome (EDS) and Hypermobility Spectrum Disorder (hEDS). She strongly believes in the “biopsychosocial” approach, assessing not only the physical implications of injury, but also the mental and social aspects involved with her patients’ health and recovery.
Regenerative treatment in conjunction with physical therapy can be beneficial in other situations as well, such as with small or partial ligament or tendon tears, mild or moderate osteoarthritis, or pain from excessive joint laxity. However, in cases of complete ligament or tendon tears or severe osteoarthritis, surgery is often the recommended choice of treatment.
Why is physical therapy important before or after regenerative medicine?
From Dr. Oltman and Dr. Flores
Physical therapy is essential to our treatment plans. Often, patients ask us if they are in pain because they are “old.” Absolutely not! Terms like “degenerative” imply that things have “worn out,” and in many ways, they have. But the culprit is not time alone—it is how you have used that joint over time that matters.
The biomechanics, or how you move, governs the way in which stress and pressure are distributed within the joint. If we help regenerate the joint but don’t do anything to change the way in which that joint is stressed, then we will end up right back where we started in short order. Using the expertise of physical therapists in order to optimize biomechanics is the only way to get the supportive tissue to really change.
About the Author
Dr. Ashley Baker is a physical therapist with MovementX in Portland, OR who specializes in the treatment of patients with Ehlers Danlos Syndrome (EDS) and Hypermobility Spectrum Disorder (hEDS). She strongly believes in the “biopsychosocial” approach, assessing not only the physical implications of injury, but also the mental and social aspects involved with her patients’ health and recovery.
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