Healing Joints From Within: The Promise of Regenerative Medicine

by Marlaina Donato

Someday, medical science will allow us to infuse damaged or aging organs with new cells, or to manufacture made-to-order organs on a 3-D printer. These emerging techniques to revitalize worn-out body parts are on the drawing board in the field of regenerative medicine. However, for the injured college athlete or the grandmother with compromised joint function, healing and pain relief can already be found in the form of prolotherapy and other non-invasive approaches that stimulate the body to heal itself.

Injection therapies using dextrose or the patient’s own platelets or stem cells are being used to naturally stimulate the body to produce collagen and rejuvenated tissue, offering hope to those with soft tissue injuries, osteoarthritis, degenerative disc disease and even pain syndromes like fibromyalgia. A recent review in the British Medical Bulletin of 10 high-quality studies of dextrose prolotherapy in adults with mild to moderate osteoarthritis of the knee showed patients experienced significantly less pain and improved range of motion in both the short term and long term without adverse effects. Eighty-two percent of patients were satisfied with the treatment.

Controlled Inflammation

A type of regenerative medicine innovated by osteopathic physician Earl Gedney in the 1930s, prolotherapy induces low-grade, temporary inflammation with the intention of triggering connective tissue cells called fibroblasts in and around the injection site. “If you cut your arm or twist your ankle, various immune cells rush to the area to begin the repair process. This is a very basic comparison of what prolotherapy does with injections directed to specific anatomical points,” says Ross A. Hauser, M.D., founder of Caring Medical Regenerative Medicine Clinics, in Fort Myers, Florida, and Chicago.

“Prolotherapy is used to treat osteoarthritis because it helps correct the underlying reason why it has occurred, which is joint instability. The body overgrows bone as a long-term response in an effort to stabilize an unstable joint,” Hauser says.

Naturopathic physician Brent Cameron, of Aurora Natural Medicine, in Gilbert, Arizona, suggests individualized treatment plans for best results. “My recommendations are very patient-specific, which is an important piece in prolotherapy.” Cameron says his patients are likely to start seeing relief in the first week. “In many instances, they experience complete relief and mobility after a series of treatments.”

While Cameron attests to the efficacy of dextrose prolotherapy, he is cautious with recommending it for people with systemic inflammatory conditions. “Someone with a history of joint-related autoimmune response tends to mount stronger inflammatory responses. Other forms of regenerative medicine can be helpful for rheumatoid arthritis [RA], but not in the inflammation-mediated way, like prolotherapy and platelet-rich plasma (PRP) injections.”

One option, according to the Institute of Regenerative Medicine, in Boca Raton, Florida, might be very small embryonic-like stem cells (VSELS), an emerging form of regenerative stem cell therapy. These have shown promise in dealing with RA and other autoimmune diseases. Meanwhile, the Mayo Clinic Center for Regenerative Medicine is ramping up its research into approaches that stimulate the body to repair itself, with numerous ongoing clinical trials utilizing different injection therapies for the treatment of osteoarthritis.

PRP injections are similar to prolotherapy, using platelets from the patient’s body instead of dextrose. “As blood flows through an injury site, the inflammatory chemicals trigger the platelets to release growth factors, which causes the torn fibers of the damaged structures to heal,” says Fort Worth osteopath Gerald Harris, of Texas Prolotherapy and Neural Therapy. PRP is sometimes used in conjunction with stem cell therapy, which is typically applied in cases in which something needs to be replaced, to help fill in gaps in ligaments or tendons, Harris says.

PRP injections have proven to be effective in easing chronic low back pain from damaged vertebral discs. An overview of research published in the Journal of Spine Surgery in 2018 found it to be safe, effective and feasible, with promising potential for the treatment of musculoskeletal disorders. Harris says that people that wish to avoid surgery or cortisone injections can benefit from PRP, which can also be applied topically to treat non-healing wounds like bedsores and diabetic ulcers.

Harris subscribes to the power of persistence. “Don’t give up. With proper treatment there is a strong likelihood that you can live a happy, healthy life free from chronic pain.”

Marlaina Donato is the author of several books and a composer.