Platelet Rich Plasma has been used for 30 plus years with widespread popularity in almost all medical fields. The rationale for PRP is that a concentrated number of platelets at a site of injury will release cytokines and growth factors that will initiate the healing of tissue. The advantage of PRP is the safety of the product with no side effects since it is autologous.
With many studies and articles written, the efficacy of PRP use for repair and regeneration of damaged tissue is no longer debated. However, PRP does more than repair and regenerate. PRP has analgesic effects that were first noted in 2008. The use of PRP as a pain modulator is an under-reported benefit especially in field of pain management after injury or surgery.
What is chronic pain?
Chronic pain is non-cancer pain that is not fleeting or minor and lasting greater than 6 months or, by another definition, chronic pain is pain that lasts past the normal time of healing, which may be less than 1 month or more than 3 months.
There is no universally accepted definition of chronic pain.
The total cost of pain yearly is $560-$635 billion in the United States alone.
- Healthcare cost is $261-300 billion
- Lost productivity is $299-$334 billion
100 million people in the US have chronic pain, 1-5 experience chronic pain over 50. A 2007 health survey $14.9 billion out of pocket expenses for chronic pain.
In 2016, $380 billion was spent on neck and back pain alone. Back pain alone in the UK caused 40% of all sickness absence from work as per the NHS agency. $10 billion for the UK economy.
94,053 articles and studies in PUBMED on all types of pain. In 2008, A Medical Expenditure Panel Survey 2-year study showed the adults with chronic pain increased by 64% between 2000-2007
Types of chronic pain reported from the Institute of Pain in the US
- Low Back Pain 1%
- Knee Pain. 19.5%
- Severe Headache or Migraine 16.1%
- Neck Pain. 15.1%
- Shoulder Pain. 9.0%
- Finger Pain. 7.6%
- Hip Pain. 7.1%
Risk for chronic pain is universal but some factors show increased vulnerability
- Sex
- Age
- Race
- Income and Education
- Geography
- Cognitive Impairments
Sex
The prevalence of chronic pain is higher in females than males. Several musculoskeletal conditions are much higher in women than men.
- Severe headaches 21.9% of women vs 12.6% men in a large study
- Neck pain 17.5% women vs 12.6% men
- Low back pain 30.1% women vs 26% men
Age
Chronic pain is much more common with each decade of life and advances with age.
Race
Racial and ethnic categories have inconclusive results, but African Americans had higher reported levels than non-Hispanic whites in one study. The review of 26 studies demonstrated lower pain tolerance in AA when compared with non-Hispanic whites.
Income and Education
In data from 2003 and 2004 (NHANES) they postulated that socioeconomic differences contribute to the apparent racial and ethnic disparities. Individuals with the highest socioeconomic positions tended to have less chronic pain compared with individuals in low socioeconomic positions.
Individuals without a high school education or general equivalency degree were 1.33 times more likely to experience chronic pain than an individual with some college education. An individual who was 100% below the poverty level was 1.76 times more likely to experience chronic pain than an individual who was 400% above the poverty level.
Geography
Geographic barriers may prevent patients from seeking help and adequate pain relief.
Cognitive impairments
Individuals who have cognitive impairments have a higher incidence of chronic pain as self- management by education is integral for prevention and reducing disease burden.
One in six people globally will be over the age of 60 in 2021.
Pain continues to be suffered by people all over the world and 85-95% of people claim to have suffered from body and head pain at some point in their lives. Body pain has been experienced weekly by more than half of the global population.
Self -diagnosis is the most common approach to understanding the cause of their pain.
Among body pain sufferers, half say they regularly work through their body pain
- 3 in 10 regularly struggle to concentrate at work due to pain
- 1 in 10 regularly leave work early because of body pain
- 2 in 10 say their body pain has had a negative impact on their career progression
Diagnosis of the cause of pain
94% of people claim to know the cause of their pain
Method used for diagnosis:
- 51% self-diagnosis
- 37% doctor
- 12% other health care professional
47% of body pain sufferers stay silent about their body pain.
Those who prefer non-prescription drugs as treatment state that they say they utilize this type of therapy due to quick access (43%.) For people who prefer prescription medication, strength is their key reason for preference (56%.)
In almost all cases of chronic pain, the patients realize medications will only treat the symptoms and not alleviate the root cause of the pain.
Platelet Rich Plasma and Pain
Platelet Rich Plasma has been studied for many years and the benefit of this autologous product for musculoskeletal applications is undeniable. Platelet Rich Plasma is based on the fact that growth factors and cytokines released from the alpha granules of activated granules support all three phases of wound and tissue healing; Inflammation, proliferation and remodeling. However, the granules also release serotonin (5-HT) which is key in pain killing.
Serotonin is well defined to be instrumental in critical roles in the central nervous system including pain control. 5-HT is made in the gastrointestinal system and then circulated in the bloodstream where it is taken up by the platelets and stored on the alpha granules. 5-HT has concentrated dependent metabolic effects on diverse cells including adipocytes, epithelial cells and leukocytes. Peripheral 5-HT is a powerful immune modulator that can stimulate and inhibit inflammation depending on the specific receptors.
During platelet degranulation, activated platelets release 5-HT that promotes vasoconstriction and stimulates activation of neighboring platelets and lymphocytes. This leads to the activation of a signaling cascade and upstream effectors that support the platelet activity.
Everts in 2008 was the first to report a randomized control study on the analgesic effects of PRP. He postulated on the mechanism of platelet released 5-HT. He found specifically when the dense granules release their contents, an abundance of pain modulation occurred. This was due to the 5-HT. In concentrated PRP, 5-8 times the baseline, the amount of 5-HT released was astronomical and the pain reported was significantly decreased.
In the peripheral tissues, as 5-HT is released, studies have confirmed 5-HT can interfere with nociceptive transmission at peripheral sites. Nociception is the sensory nervous system process of noxious stimuli to receive a painful stimulus.
Several studies indicated that PRP reduced or even eliminated pain in patients suffering from tendinosis, OA, plantar fasciitis and other musculoskeletal disorders. The final platelet concentration has been the key component identified in these analgesic effects.
In neuropathic pain due to degenerative nerve disease, the pain was found to decrease after PRP application. This was felt to be due to the result of PRP’s promotion of axonal regeneration and target reinnervation and the release of 5-HT in these tissues.
Pain is a world -wide medical problem. The economics are staggering. Platelet Rich Plasma treatments can repair damaged tissues and alleviate the pain associated with these diseases.
Juventix Regenerative Medical is an industry leader in the regenerative medical field. Our Platelet-Rich-Plasma Kits are FDA approved and designed for safety and effectiveness. They are cost effective and easy to use. Our kits provide consistency of concentrated product when obtained from the same source.
Juventix Regenerative Medical offers a patent pending LED Activator to activate the platelets and begin the regenerative process. The activation releases the serotonin from the alpha granules and will assist in the pain control of the damaged tissues while the repair takes place. The activation, a critical step in the release of cytokines, growth factors and 5-HT, is accomplished with light and not with the addition of other chemicals such as Calcium Chloride or Thrombin.
Juventix Regenerative Medical supplies a Bio-Incubator that transforms Platelet Rich Plasma into an Injectable Platelet Rich Fibrin. The PRF, commonly referred to as the “Second Generation of Platelet Products” has a broader range of clinical applications with different cytokines and anti-inflammatory properties that provide options for use in different disease states.
Juventix Regenerative Medical is proud to announce our newest regenerative device the Photo-biomodulator which offers disease treatments with three ranges of light therapy. The panel is oversized and is easy to use without having “hands on” attendance.
REPAIR, REVIVE, REGENERATE- JUVENTIX REGENERATIVE MEDICAL
Regenerative Regards,
Dr. Robert McGrath
References
Platelet Rich Plasma: Performance Understandings and Therapeutic Considerations in 2020
Int J Mol Sci 2020 Oct: 21(20) 7794 doi 10.3390/ijms21207794
Individual Differences in Pain: Understanding the Mosaic that Makes Pain Personal
Pain 2017 Apr:158(Supp 1); S11-S18 doi: 10.1097/j.pain. 000000000000775
Chronic Pain: An Update on Burden, Best Practices, and New Advances
Lancet 2021 May 29;397(10289) 2082-2097 PMID 34062143
GSK Global Pain Index 2017
Global Research Report
