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Shoulder Pain

  • PRP Rotator Cuff Treatment Plans

    Published on February 20, 2014.

    Why are so many patients looking for surgical alternatives to rotator cuff tears? Results like these!

    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 one Platelet Rich Plasma injections at the site of the rotator cuff tear and surrounding tendon. The resultes? The single injection of PRP resulted in safe, significant, sustained improvement of pain, function, and MRI outcomes in the “difficult to treat” patients. 1

    Even after surgery, doctors are exploring a non-surgical repair in situations where the surgery was not as successful as hoped for. In a recent paper, researchers have noted that because rotator cuff tears can be caused by both traumatic and degenerative elements, surgical repair can be challenging. Even after surgical intervention, tendon residual defects or “retears” often develop. However Platelet-rich plasma therapy may be able to positively enhance rotator cuff tendon healing. 2

    Torn Rotator Cuff
    Research shows 57% failure rate in Large Rotator Cuff Repairs

    Being one of the few centers that offer Prolotherapy, PRP, and Stem Cell therapies in New Jersey, we see manyt patients following a failed surgical procedure who have decided not to seek a secondary “revision,” or “fix it” surgery.

    Many times we see patients with rotator cuff problems. There is a lot of medical research on the effectiveness or non-effectiveness of rotator cuff tear surgery. Numerous medical studies have shown that the re-tear rate of a surgically repaired shoulder could be anywhere from 20 – 90% depending on the patient circumstance. Recently Australian researchers, presenting at the American Academy of Orthopaedic Surgeons (AAOS) 2012 Annual Meeting (February 2012) say that the failure rate they measured in 500 patients was 57%

    Hi Dr. Greenberg
    I am one happy person since I found out about what you could do for me and my rotator cuff tear. I avoided surgery! Started treatment in May 2011 now it is October 4 and I can do what I want without pain – WOW! Thank you for being a caring doctor. Thanks again and see you in three weeks. Fondly, Arlene A.

    What is Torn Rotator Cuff?

    Rotator cuff tears are tears of one, or more, of the four tendons of the rotator cuff muscles. Most tears involve the supraspinatus (a relatively small muscle of the upper arm that runs from the scapula (shoulder blade) to the humerus). Furthermore, other ligaments and tendons in the shoulder (such as the biceps tendon) may become damaged when the rotator cuff is injured. A tear in the rotator cuff produces pain and also contributes to instability in the shoulder joint. If severe, there may be weakness or an inability to lift the arm. Torn rotator cuffs may happen either acutely – as a result of an injury – or may be degenerative from wear and tear over age.

    The most common symptoms of a rotator cuff tear include:

    * Pain at rest and at night, particularly if lying on the affected shoulder
    * Pain when lifting and lowering the arm or with specific movements
    * Weakness when lifting or rotating the arm
    * Crepitus or crackling sensation when moving your shoulder in certain positions

    Who is Affected?

    More than two million Americans seek treatment for a torn rotator cuff each year. Because most rotator cuff tears are largely caused by the normal wear and tear that goes along with aging, people over 40 are at greater risk, as are those who do repetitive lifting or overhead work. Athletes are especially vulnerable to overuse tears, particularly tennis players and baseball pitchers. Painters, carpenters and others who do overhead work also have a greater chance for tears. In young adults, most torn rotator cuffs are caused by a traumatic injury, like a fall.

    What are Options for Treatment?

    While it is commonly believed that MRI is the gold standard for determining injury, a careful physical examination will frequently reveal damage that may not show on an MRI. At the Magaziner Center for Wellness, we conduct a thorough physical evaluation to determine the nature and extent of an injury. When pain persists past conventional treatments – and provided the patient is otherwise in good health – we use regenerative orthopedic procedures such as prolotherapy and platelet rich plasma therapy (PRP) to naturally repair damage and eliminate related pain. Both treatments are natural and non-surgical.

    Prolotherapy consists of precise injections into injured areas to provoke the body’s cytokines and enable the immune system to naturally repair the damage. PRP uses the patient’s own platelets – which are spun to create a platelet-rich plasma that is injected into the area around the torn muscle to initiate the body’s natural healing response and help repair and strengthen the torn rotator cuff.

    We also use PRP and stem cell therapy to treat glenoid labral tears – or injuries to the cup of cartilage that the shoulder sits in. These tears typically do not heal themselves, as the shoulder labrum is avascular – it has a limited blood supply. By injecting the injured area with a patient’s own platelets and stem cells from their fat and bone marrow, vascularity is provided and the instinctive healing process is “jump started.” It is this type of non-surgical treatment that helped the New York Yankee’s Bartolo Colon return to the mound, even when it appeared his pitching days were over.

    Additionally, we use innovative manual therapies to realign the shoulder joint to help ensure proper shoulder motion, and also pay careful attention to ligament and joint capsule tissue that is often injured at the time of a rotator cuff tear.

    These safe, natural techniques – which have allowed the Magaziner Center for Wellness to help world-famous athletes return to the field, court or ice – continue to gain traction. In fact, combined, the doctors at the Magaziner Center perform thousands of these procedures each year.

    1 Scarpone M, Rabago D, Snell E, Demeo P, Ruppert K, Pritchard P, Arbogast G, Wilson JJ, Balzano JF. Effectiveness of Platelet-rich Plasma Injection for Rotator Cuff Tendinopathy: A Prospective Open-label Study. Glob Adv Health Med. 2013 Mar;2(2):26-31. doi: 10.7453/gahmj.2012.054.

    2. Barber FA. Platelet-rich plasma for rotator cuff repair. Sports Med Arthrosc. 2013 Dec;21(4):199-205. doi: 10.1097/JSA.0b013e31828a7c6a.

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