Written by Dr. Payton Robertson

My Luck With Pain

It was 3 A.M. on a school night. Never before in my college career have I scrolled through Facebook so late. Sleep was important to me, even in college. The prior day’s weight lifting session with the soccer team, combined with a competitive spirit and poor technique, left my lower back in excruciating pain. No matter what sleeping position I tried, burning pain radiated from my back down to my heel. Within weeks, my search for help landed me in a surgical room with an X-ray guided needle carrying cortisone into small joints in my lower back. Fortunately, this powerful steroid reduced my pain and granted me sleep. Most importantly it gave me a chance to attend physical therapy so I could correct the weakened joints in my spine.

Current Chronic Pain Treatment Options

I was the perfect patient for a cortisone injection. However, not all patients with joint pain will be as lucky as I was with cortisone. Millions of Americans suffer chronic pain resulting in billions of dollars of  spending to combat not only the physical and mental repercussions, but also the loss of productivity due to pain. Most conventional treatments are aimed at symptom suppression which sounds great, but may do more harm than good. For example, symptom suppression with NSAIDS like ibuprofen can lead to gastric ulcers and opioids like hydrocodone can lead to addiction and sometimes overdose. Despite the potential risk neither treat the cause of pain. They only act to mask it while the underlying problem is allowed to worsen. The fortunate chronic pain patient will get a referral to physical therapy, which is the most likely conventional tool to address the cause of pain. Unfortunately, when all else fails, surgery is a last resort.

Cortisone Injections Decrease Pain at Cost of Compromised Tissue Integrity

Cortisone injections work spectacularly for treating the symptom of pain, but if the cause is not addressed, the pain will come back once the drug wears off. There is a time and place for cortisone injections, however patients are limited in the number of injections they can receive. This is because cortisone (a steroid) weakens tissues such as tendons, muscles, and ligaments, therefore jeopardizing the integrity of the joint. So with more cortisone injections the damage increases, often landing the patient with worsening pain and function until they, inevitably, are pointed to surgery. Surgery is always a last resort because it is not guaranteed to eliminate pain, and can require a lengthy and painful recovery period. A patient heading down the road of chronic pain needs a treatment designed to treat the root cause of pain. 

Causes of Chronic Pain

There are many contributing factors to chronic pain that range from older, improperly healed injuries to dietary influences. Connective tissue and muscles surround joints and coordinate the alignment and integrity of a joint. These tissues can become weak due to overstretching or fraying which puts the joint at increased risk of damage. Additionally, normal activities like running, lifting, prolonged sitting, or poor posture further weaken the joint. Eventually, some months or years later, the joint can feel very painful, often without a clear cause. 

Regenerative Injection Therapy (RIT): a Root Cause Approach to Pain Treatment

This class of treatment supports the body to heal the tissues that are at the root of many chronic pain diagnoses. With this therapy, different solutions such as dextrose or platelet-rich-plasma (PRP) can be injected into the joint to relieve pain and kick-start the healing process. RIT is not to be confused with cortisone injections, as RIT aims to heal the tissues, while cortisone only temporarily reduces pain.

Prolotherapy

Prolotherapy involves injecting dextrose (a natural sugar) into joints or ligaments that are  causing pain. The dextrose causes temporary local inflammation (opposite of cortisone injections), which stimulates the tissue to repair itself. The healing response results in improved tissue structure and increased stability of the joint.

Platelet Rich Plasma (PRP) Injections

With this therapy, platelets are taken from the patient’s own blood through a simple blood draw, and injected into joints, ligaments, and tendons. These platelets contain healing factors and cellular growth factors which stimulate a healing response at the location it is injected.

Which Conditions Can Prolotherapy and PRP Treat?

Below are conditions that may respond favorably to these injection techniques. Because these therapies rely on the healing potential of the patient, you and your doctor may work toward optimizing the benefits of treatment by first working to improve your overall health. 

  • Sprained ankles
  • Rotator cuff injuries
  • Labral tears (hips/shoulders)
  • Arthritis
  • Chronic joint pain
  • Acute joint injuries
  • Knee injuries

An evaluation by your doctor will help decide if you are a good candidate for RIT and which method is most likely to help you. 

Now through December, Natural Medicine of Seattle is offering 20% off injection therapies. Call 206-535-7527 to schedule a FREE phone consultation.

Dr. Payton Robertson 

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