Research shows that cortisone injections or orthopedic surgery are not always the best option
Rotator cuff tears are one of the most common causes of shoulder malfunction and pain, which lead to a significant reduction in the quality of life. Playing sports requiring the arm to be moved over the head repeatedly as in tennis, baseball (particularly pitching), swimming, and lifting weights over the head can damage the rotator cuff.
In this latest study published in medical journal listed below, the researchers from Basel, Switzerland investigated the effects of subacromial platelet-rich plasma injections [i.e. autologous conditioned plasma (ACP) injections] as compared to standard subacromial cortisone injection therapy in 50 patients with partial rotator cuff tears.
They conclude that compared with cortisone injections, ACP injections show earlier benefit as compared to cortisone injections. Therefore, subacromial ACP injections are a good alternative to subacromial cortisone injections, especially in patients with contraindication to cortisone
In another study listed below - Doctors recruited patients from a sports medicine clinic who were not responding as positively to physical therapy and corticosteroid injections as hoped for. The patients received only one Platelet Rich Plasma injections at the site of the rotator cuff tear and surrounding tendon. Just one single injection of PRP resulted in safe and significant improvement of pain and function, as well as MRI outcomes in these “difficult to treat” patients.
Research shows 57% failure rate in Large Rotator Cuff Repairs. Even after surgery, doctors are exploring a non-surgical repair in situations where the surgery was not as successful as hoped for, especially for professional athletes. In a recent article, researchers noted that surgical repair can be challenging. Even after surgical intervention, residual defects or “retears” often develop in the tendon. But Platelet rich plasma therapy is able to enhance the rotator cuff tendon healing.
What is a rotator cuff?
Your rotator cuff is located in your shoulder area. It is made of muscles and tendons. It helps your shoulder to move and stay stable. Problems with the rotator cuff are common. They include tendinitis, bursitis, and injuries such as tears.
The rotator cuff is a group of muscles and tendons that attach to the bones of the shoulder joint, allowing the shoulder to move and keeping it stable.
Rotator cuff tendinitis refers to irritation of these tendons and inflammation of the bursa (a normally smooth layer) lining these tendons. A rotator cuff tear occurs when one of the tendons is torn from overuse or injury.
Rotator cuff tendons can become inflamed from frequent use or aging. Sometimes they are injured from a fall on an outstretched hand. Sports or jobs with repeated overhead motion can also damage the rotator cuff. Aging causes tendons to wear down, which can lead to a tear.
Playing sports requiring the arm to be moved over the head repeatedly as in tennis, baseball (particularly pitching), swimming, and lifting weights over the head can also damage the rotator cuff.
Rotator cuff tears:
The pain with a sudden tear after a fall or injury is usually intense. Weakness of the shoulder and arm is often present, along with a snapping sensation of movement.
Symptoms of a chronic rotator cuff tear include a gradual worsening of pain, weakness, and stiffness or loss of motion. The exact point when a rotator cuff tear begins in someone with chronic shoulder tendinitis may or may not be noticed.
Most people with rotator cuff tendon tears have pain at night. Pain that is worse at night may wake you up. During the day, the pain is more tolerable and hurts with certain movements.
Some tears are not painful, but others can be very painful. Treatment for a torn rotator cuff depends on age, health, how severe the injury is, and how long you've had the torn rotator cuff.
Over time, the symptoms become much worse and are not relieved by medicines, rest, or exercise.
There are two types of rotator cuff tears:
- A partial tear is when a tear does not completely sever the attachments to the bone.
- A complete or full thickness tear refers to a through and through tear. It may be as small as a pinpoint or all of the muscle tendon. Complete tears have detachment of the tendon from the attachment site and would not heal very well.
Traditional treatment for torn rotator cuff includes:
- Heat or cold to the sore area
- Medicines that reduce pain and swelling
- Electrical stimulation of muscles and nerves
- Cortisone injection
Source - NIH: National Institute on Arthritis and Musculoskeletal and Skin Disease
PRP and stem cell treatments can help:
While steroid injections may provide short-term relief, these injections do not “heal” rotator cuff injuries. In some cases, steroid injections could even contribute to tendon and joint degeneration – and that is not what an athlete needs.
Most times, athletes are told that they need surgery to fix their sports injuries. But surgery is not the best answer for most sports injuries, and may actually never help you regain your performance to the level you were prior to the injury.
At SmartChoice® Stem Cell Institute, we offer several non-surgical, office treatment options for your rotator cuff, including Adult Stem Cell and Platelet-Rich Plasma Injections.
Patients coping with sports injuries, tendon strains, sprained ligaments, muscle injuries, arthritis and more, will be comforted to know that surgery is not the only option of treatment available to them. Faster healing as well as improved functionality both are possible with innovative, cutting- edge ADULT stem cell and PRP procedures.
Also, we do have experience working with professional athletes like former number one PGA Tour Golfer, several NFL players, many Tennis and baseball athletes and athletes from various other sports.
And if you are considering surgery for your rotator cuff, knee, hip or other joint for your sports injury, you might want to learn about how the adult stem cells and PRP procedures stack up against these risky Orthopedic surgeries.
Call us today at 904-997-6100 and find out if these procedures are an option for you. Or visit us at SmartChoiceStemCell.comto learn more about our out-patient, non-surgical procedures to treat your sports injury or arthritis.
|Dr. Garg is an expert in these procedures and is one of the few physicians in this country helping patients with this exciting Regenerative medicine using your own stem cells and PRP. Non-surgical, office-based SmartChoice® Joint Procedures provide ALTERNATIVES to invasive and costly joint replacements and other orthopedic surgeries.|
- The effect of subacromial injections of autologous conditioned plasma versus cortisone for the treatment of symptomatic partial rotator cuff tears. von Wehren L1, Blanke F, Todorov A, Heisterbach P, Sailer J, Majewski M. , Knee Surg Sports Traumatol Arthrosc. 2015 May 28. [Epub ahead of print]
- Management of failed arthroscopic rotator cuff repair. Strauss EJ, McCormack RA, Onyekwelu I, Rokito AS. J Am Acad Orthop Surg. 2012 May;20(5):301-9.
- The role of platelet-rich plasma in rotator cuff repair. Mei-Dan O, Carmont MR. Sports Med Arthrosc. 2011 Sep;19(3):244-50.
- Effectiveness of Platelet-rich Plasma Injection for Rotator Cuff Tendinopathy: A Prospective Open-label Study. Scarpone M, Rabago D, Snell E, Demeo P, Ruppert K, Pritchard P, Arbogast G, Wilson JJ, Balzano JF. Glob Adv Health Med. 2013 Mar;2(2):26-31.
- Platelet-rich plasma for rotator cuff repair. Barber FA. Sports Med Arthrosc. 2013 Dec;21(4):199-205.
- Burbank KM, Stevenson JH, Czarnecki GR, Dorfman J. Chronic shoulder pain: part II. Treatment. Am Fam Physician. 2008;77:493-497.
- Burbank KM, Stevenson JH, Czarnecki GR, Dorfman J. Chronic shoulder pain: part I. Evaluation and diagnosis. Am Fam Physician. 2008;77:453-460.
- Greiwe RM, Ahmad CS. Management of the throwing shoulder: cuff, labrum and internal impingement. Orthop Clin North Am. 2010;41:309-323.
- Seida JC, LeBlanc C, Schouten JR, Mousavi SS, Hartling L, Vandermeer B, Tjosvold L, Sheps DM. Systematic review: nonoperative and operative treatments for rotator cuff tears. Ann Intern Med. 2010;153:246-255.