FEATURE PAIN RELIEF PLATELET RICH PLASMA What is it, and how it fits into multidisciplinary treatment plans N BY DR. CHRIS SPOONER, ND aturopathic doctors began using PRP for tendonosis and tendonitis in the late 1990s. In the early 2000s, PRP essentially became viewed as the logical next phase in regen-erative injection therapy and began to be adopted by practitioners previously trained in prolotherapy. Platelet rich plasma is being utilized in musculoskeletal medicine with increasing frequency and effectiveness by providers in multiple specialties. PRP has been success-fully used in various specialties such as maxillofacial, cosmetic, spine, orthopedic, podiatric and for general wound healing. 1,2 Soft tissue injuries treated with PRP include tendinopa-thy, tendonosis, acute and chronic muscle strain, muscle fibrosis, ligamentous sprains, and joint capsular laxity. PRP has also been utilized to treat intra-articular injuries. Ex-amples include arthritis, arthrofibrosis, articular cartilage defects, meniscal injury, and chronic synovitis or joint in-flammation. The logic behind PRP is that platelets are the first to arrive at the site of tissue injury, and thus have the potential to release growth factors that play a critical role in Platelets are the first to arrive at the site of tissue injury and have the potential to release growth factors that play a critical role in healing. mediating healing. PRP essentially alters cell ratios, by re-placing red blood cells which do not stimulate healing and replacing them with platelets to release growth factors that facilitate healing. Stages of healing DR. CHRIS SPOONER ND, B.SC. is a North Okanagan naturopathic doctor with 20 years of clinical experience. In his private practice, Paradigm Integrative Medicine, Dr. Spooner works with patients looking for a balanced approach to health care that combines conventional medicine with research informed integrative approaches. Dr. Spooner has advanced certifications through the College of Naturopathic Physicians of B.C., including prescriptive authority. He has been a board member and vice chair of the College of Naturopathic Physicians of British Columbia since 2008. 18 Chiropractic and Naturopathic Doctor September/October 2021 Wound healing is a well-orchestrated and complex series of events involving cell-cell and cell-matrix interactions, with growth factors serving as messengers to regulate the various processes involved. Normal platelet activation leads to four necessary stages of healing: Hemostasis, Inflammation, Proliferation, and Remodeling. If any of these stages are incomplete – or if they proceed unabated – tissue homeostasis is disrupted, and pain and loss of function may result. With wounds, and also after surgical incisions, repair begins with platelet clot formation, activation of the coagu-lation cascade, and platelet degranulation with release of growth factors. The inflammatory process is initiated by migration of neutrophils and subsequently macrophages to www.Cndoctor.ca Photo: © PAstudio / Adobe Stock
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