Conditions

Offering hand or wrist PRP injections and physical therapy treatment

At Physicians Rehabilitation, our goal is to provide our patients with comprehensive care to eliminate their pain and dysfunction without surgery. Using state-of-the-art therapies like platelet – rich plasma we can treat your musculoskeletal conditions and get you back to the life you love as fast as possible. Platelet – rich plasma (PRP) has therapeutic benefits for many hand and wrist conditions.

Carpal tunnel syndrome (CTS)

50% of work – related injuries is due to CTS. CTS is entrapment of a nerve in the wrist that causes numbness, weakness and pain. Conservative treatment is rarely effective. Surgery to release the trapped nerve is effective when symptoms are severe. PRP treatment for mild to moderate CTS effectively relieves pain and improves function and symptom severity.

A randomized controlled clinical trial of patients with carpal tunnel found that PRP is a safe modality that effectively relieves pain and improves disability.

Osteoarthritis (OA)

OA is a degenerative joint disease that causes deterioration of articular cartilage, that lines the ends of bones. OA affects any of the finger joints, the wrist and the base of the thumb and is the most frequent cause of wrist pain.

PRP is recommended for mild to moderate OA. Studies have shown that when PRP is compared with cortisone injections, PRP was found to be superior at relieving symptoms, and improving function. Cortisone is a powerful drug that temporarily treats pain but can cause degeneration of the joint. There are no safety concerns with PRP therapy, and most people experience a permanent reduction or elimination of pain and inflammation.

The results of a 2018 study of PRP therapy for patients with osteoarthritis of the base of the thumb reported a 90% decrease in pain vs. those who received corticosteroid injection who showed an 8% increase in pain. The PRP group also had significantly better function.

A 2017 systematic review of the literature on PRP therapy for osteoarthritis reports that all the studies reviewed showed clinical improvement in pain, function and patient satisfaction.

Trigger finger

Trigger finger is a condition where one finger becomes stuck in a bend position due to inflammation and degeneration of the tendon in the affected finger. PRP injection can restore tendon structure, reduce pain and speed healing.

What is Platelet – rich Plasma?

Blood is primarily plasma, the liquid that contains red blood cells, white blood cells and platelets. Platelets are best known for their blood clotting ability, but platelets are a natural reservoir of hundreds of biologically active proteins called growth factors that play a key role in wound healing and tissue repair. When there is an injury or inflammation, platelets flood the area to stop bleeding, and heal damaged tissues.

PRP is a solution made by concentrating platelets, and growth factors to increase potency. Increased concentrations of platelets and growth factors boost the body’s repair mechanisms and shorten recovery. PRP harnesses the power of your body’s natural healing abilities to promote healing, and regenerate tissues that help you recover quickly.

How is PRP made?

A small amount of your blood is collected and prepared to separate the platelets from the other blood components. The concentrated platelets and growth factors are

combined with the remaining blood and local anesthetic, for your comfort.

The PRP Procedure

The PRP solution is injected in to the injured area, often under ultrasound guidance. The activated growth factors stimulate the release of repair cells to accelerate the healing process and provide symptom relief.

Side effects are minimal and may include pain at the site of injection that can last for a few hours or days and swelling that resolves within a few days. After treatment a patient will be advised to rest and avoid exercise for a time.

Generally, it can take up to a month to experience pain relief which will improve over the course of 3-6 months after treatment. However, the recovery period is determined by the type and severity of injury.

Is PRP therapy safe?

PRP therapy is very safe. It is not a drug. Because it is made from your own blood and injected into the site of your injury or degeneration, there is no risk of adverse reaction, or disease transmission.

How does PRP work?

PRP injections soak injured cells in the concentrated plasma and the numerous growth factors to enhance one or more phases of bone and soft tissue healing. PRP also enhances proliferation of stem cells and fibroblasts to boost healing and regeneration of damaged tissues. Studies show that the increased concentration of growth factors catalyze the body’s repair mechanisms and shorten recovery time.

Benefits of PRP Therapy

PRP therapy reduces inflammation, relieves pain, promotes repair, increases collagen production for firmer and more resilient cartilage, enhances blood flow to deliver nutrients that support healing, and recruits and supports stem cells to regenerate tissues. PRP restores normal healing mechanisms and accelerates repair of damaged tissues.

The result is improved pain relief without the risks of cortisone injections, surgery, anesthesia, and a long recovery. Most patients can resume their work and activities immediately after treatment. In some cases, PRP therapy is an alternative to surgery.

Because PRP is made from your own blood, there is no risk of adverse reaction, allergy or disease transmission. Side effects are minimal and may include pain at the site of injection that usually lasts for a few hours and swelling that resolves within a few days.

At Physicians Rehabilitation our physicians are specially trained in the procedures and preparation of PRP. Physicians rehabilitation has locations in Fort Myers, Lady Lake, Naples, Port Charlotte and Sun City Center for convenient, high-quality specialized sports-medicine and orthopedic services. Contact us to learn about how PRP therapy can benefit you.


References

  • Michael Alexander Malahias, Elizabeth O. Johnson, George C. Babis, and Vasileios S. Nikolaou, M.D., Ph.D. Single injection of platelet-rich plasma as a novel treatment of carpal tunnel syndrome
  • Neural Regen Res. 2015 Nov; 10(11): 1856–1859.
  • Wu YT, Ho TY, Chou YC, et al. Six-month efficacy of platelet-rich plasma for carpal tunnel syndrome: A prospective randomized, single-blind controlled trial. Sci Rep. 2017;7(1):94. doi:10.1038/s41598-017-00224-6
  • Ikumi A, Hara Y, Okano E, et al. Intraoperative Local Administration of Platelet-Rich Plasma (PRP) during Neurolysis Surgery for the Treatment of Digital Nerve Crush Injury. Case Rep Orthop. 2018;2018:1275713. Published 2018 Sep 20. doi:10.1155/2018/1275713
  • Malahias MA, Roumeliotis L, Nikolaou VS, Chronopoulos, Sourlas, Babis GC.Platelet-Rich Plasma versus Corticosteroid Intra-Articular Injections for the Treatment of Trapeziometacarpal Arthritis: A Prospective Randomized Controlled Clinical Trial.
  • Cartilage. 2018 Oct 20:1947603518805230. doi: 10.1177/1947603518805230.
  • Weilong J. Shi, Fotios P. Tjoumakaris, Mayan Lendner & Kevin B. Freedman (2017)Biologic injections for osteoarthritis and articular cartilage damage: can we modify disease?, The Physician and Sportsmedicine, 45:3, 203-223, DOI: 10.1080/00913847.2017.1357421
  • Garraud O, Hozzein WN, Badr G. Wound healing: time to look for intelligent, ‘natural’ immunological approaches?. BMC Immunol. 2017;18(Suppl 1):23. Published 2017 Jun 21. doi:10.1186/s12865-017-0207-y
  • Lubkowska A, Dolegowska B, Banfi G. Growth factor content in PRP and their applicability in medicine.
  • J Biol Regul Homeost Agents. 2012 Apr-Jun;26(2 Suppl 1):3S-22S.
  • Qian Y, Han Q, Chen W, et al. Platelet-Rich Plasma Derived Growth Factors Contribute to Stem Cell Differentiation in Musculoskeletal Regeneration. Front Chem. 2017;5:89. Published 2017 Oct 31. doi:10.3389/fchem.2017.00089
  • Moraes V. Y., Lenza M., Tamaoki M. J., Faloppa F., Belloti J. C. Platelet-rich therapies for musculoskeletal soft tissue injuries. Cochrane Database of Systematic Reviews. 2013;12CD010071
  • Qian Y, Han Q, Chen W, et al. Platelet-Rich Plasma Derived Growth Factors Contribute to Stem Cell Differentiation in Musculoskeletal Regeneration. Front Chem. 2017 ;5:89. Published 2017 Oct 31. doi:10.3389/fchem.2017.00089

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