Does the use of asprin and nsaids interuppt prp treatment

 There was a time when the physicians used to recommend NSAIDs (Non-Steroidal Anti-Inflammatory Drugs), especially aspirin to reduce the risk of stroke or heart attack. However, the scientists in Montreal confirmed contrarily in 2017 that the current use of NSAIDs significantly increased the risk of a heart attack.1 Therefore, some questions arise. Is the use of NSAIDs a good idea, especially if you are planning a Platelet-rich plasma (PRP) therapy? Do NSAIDs affect the PRP function? Is there any downside? Several research studies report negative results. Let’s dig in.

WHAT IS PRP THERAPY?

Platelet-rich plasma therapy is used to treat varied conditions ranging from orthopaedic ailments to hair loss issues. It has emerged as an effective, promising alternative to surgery. PRP is prepared by concentrating the platelets rich in growth factors in your blood like platelet-derived growth factor (PDGF), transforming growth factor-beta (TGF), vascular endothelial growth factor (VEGF), epidermal growth factor (EGF), fibroblast growth factor (FGF), and connective tissue growth factors. Once the physician injects these concentrated platelets into the damaged tissues, they slowly release the growth factors to promote natural healing. However, what you take as far as daily medications may impact the efficacy and natural healing of the PRP.

WHAT ARE NSAIDS AND ASPIRIN?

NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) are a class of standard household medication used worldwide to reduce pain and inflammation. These can also reduce fever, hence, are recommended for short- and long-term diseases/conditions such as flu, arthritis, backpains, dental pains and other conditions. NSAIDs are available as over the counter medication and prescription. Among the NSAIDs, aspirin is the most well-known drug across the world. It has been widely used since just before the 20th century (1899). Aspirin alone stands out due to its increased blood-thinning ability. Hence, aspirin can effectively prevent blood clot formation. 

So is NSAIDs and aspirin use a good idea? Some studies suggest probably not if you are planning a PRP treatment. Let’s review.

WHAT IS THE ROLE OF NSAIDS IN THE PRP TREATMENT?

Even though NSAIDs are effective pain relievers, they hinder platelet activation and aggregation by inhibiting cyclooxygenase (COX) enzymes. This inhibition will consequently prolong the bleeding time and platelets will not be able to secrete the growth factors.2 Due to this impaired platelet function, patients consuming NSAIDs will not have any therapeutic effect when undergoing PRP treatment.

However, there is a difference between the effects of aspirin and non-aspirin NSAIDs upon the platelets. Aspirin irreversibly inhibits cyclooxygenase enzymes; therefore, its actions stay for the lifespan of the circulating platelets (about 8–10 days). Where non-aspirin NSAIDs reversibly block cyclooxygenase enzymes and, hence, the extent of their action depends on the relevant drug dose, half-life and serum level.3By discontinuing the consumption of NSAIDs, especially Naproxen for a minimum of one week before PRP treatment,it may improve the secretion of biological factors.4

So what does it mean if you are taking NSAIDs and are planning to undergo a PRP treatment? It means your NSAIDs use, especially aspirin, could sabotage your PRP treatment leading to less desirable outcomes than what they could be.

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Knee Replacement Alternatives You Can Consider

 Do you get a crunching sound while climbing the stairs? Are you experiencing chronic knee pain and swelling? Do you plan to opt for knee surgery? We can understand how terrible the pain can be and that you want to address it as soon as possible. However, don’t opt for surgery right away without exploring other alternatives. Remember going for a knee replacement is just one of the options available to you. Some people cannot go for knee replacement due to many reasons. Some might be too young for the surgery. A lengthy rehabilitation after the surgery with extended downtime is not feasible for others.

An artificial knee can last only for 15-20 years. After that, the person may require revision surgery. Hence, it is worth exploring several other nonsurgical options under medical guidance to delay the surgery as long as possible. Various knee replacement alternatives can provide lasting relief from knee pain. Here are our five recommendations:

Home-based treatment – R.I.C.E. formula

• Rest: Take rest and stop activities that can worsen your knee pain. Use crutches and don’t put excess weight on the knee.
• Ice: Ice therapy can reduce knee pain and swelling. Use cold packs like towels filled with ice cubes for 15-20 minutes every four to six hours. Follow this step within 24-48 hours of injury.
• Compression: Wear an elastic compression bandage to prevent inflammation and swelling.
• Elevation: Keep your leg higher than the heart level while taking rest to reduce swelling. You can even keep your legs on two pillows while sitting on a chair.

PHYSICAL THERAPY

Physical therapy can stabilize and support the knee joint. The therapists use stretching and strengthening exercises to increase the blood flow to the affected area. These exercises can strengthen the muscles around the knees and provide relief from pain and stiffness. It can also distribute the weight evenly around the knee.

NON-STEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDS)

Administration of NSAIDs can reduce both pain and inflammation. However, you cannot continue them for a long duration. You may experience side effects, including heart, gastrointestinal, and kidney problems.

Corticosteroids or hyaluronic acid injections

The physician may recommend corticosteroids or hyaluronic acid injections to reduce pain and enhance mobility. However, the effect will be only for a short duration. Prolonged administration, especially for elders, may cause potential side effects. Corticosteroids may deteriorate the injection region and the surrounding areas and make them more prone to rupture in the case of ligaments.

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PHYSIOTHERAPY

 

HOW CAN REGENERATIVE TREATMENT COMBINED WITH PHYSIOTHERAPY HELP YOU BECOME PAIN-FREE?

Regenerative therapy is a branch of medicine that helps repair, restore and regenerate damaged or injured cells to rebuild impaired function caused due to trauma, ageing and diseases. Physiotherapy, if started alongside regenerative treatment, can help patients recover to their optimal level. Regenerative rehabilitation therapy evolves as the combination of regenerative medicine and physiotherapy. While regenerative therapy targets the cause of the pain by triggering the healing process, physiotherapy enhances that recovery and give longer-lasting effects by strengthening. 

After undergoing regenerative therapy, your physiotherapist can recommend personalised exercise programmes to achieve your goals. By following recommended Regenerative rehabilitation therapy, patients can return to their everyday lives as quickly as possible.

WHAT IS PHYSIOTHERAPY?

Physiotherapy is the maintenance or improvement of mobility, physical abilities, fitness and quality of life using movement, exercise therapy and other physical methods. Both regenerative medicine and physiotherapy go hand in hand to reduce pain and increase the quality of life. As pain decreases, the ability to move and strengthen increases; this is where a physiotherapist plays a significant role to recommend the right strategy at the right time. The typical customised rehabilitation programme includes:

• Biomechanical assessment and goal setting
• Graded movement within pain levels
• Strengthening exercises
• Balance rehab
• Resistance training
• Functional rehab
• Electrical stimulation

WHAT PHYSIOTHERAPIST DOES?

The physiotherapist’s role is to help you recover optimally by evaluating your movement and prescribing the relevant exercise programme accordingly. However, it is you who must take active participation in the recovery procedure.

Throughout the sessions, the physiotherapist will monitor the progress of your recovery by carefully checking the strength and endurance as well as symptoms like pain or swelling, if any. Always inform your physiotherapist if you are having any difficulty adhering to your programme so that the physiotherapist can adjust the exercises to suit you. Eventually, by sticking to your exercise program, physiotherapy will help you in increasing your resistance level, improve mobility, function and wellbeing.

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Treat Shoulder Impingement With Regenerative Treatment

 

WHAT IS SHOULDER IMPINGEMENT?

The main cause of shoulder impingement is shoulder pain. When you lift the arm above the shoulder level, the subacromial space becomes narrow. Hence, the soft tissues, tendons, and muscles surrounding the area will become tired due to increased pressure. This extra pressure aggravates the rotator cuff, and this causes shoulder impingement. As shoulder impingement is common among swimmers, it is also called a swimmer’s shoulder. Shoulder impingement is also present among the racket players and the throwers as they frequently move their arms above shoulder level. It can also occur if someone falls by stretching the arms in the outer portion.

Suppose there is damage in the rotator cuff, the heaviness inside the tendon increases, which will lead to the compression of the blood capillaries. Hence, there is an inflammation in the tissues, and the pain slowly starts to aggravate. The pain will travel towards the backside, and you’ll have difficulty sleeping at night. This ailment, if not treated, may lead to the shoulder’s rotator cuff tear.

REASONS FOR SHOULDER IMPINGEMENT

There is no specific reason for getting shoulder impingement. However, the repeated usage of the shoulder may cause shoulder impingement. Excluding the sportspersons, many occupations involve lifting heavy things.  These activities can increase the risk of shoulder impingement. People having shoulder injuries like dislocation and elders can also have shoulder impingement.

SIGNS OF SHOULDER IMPINGEMENT

The signs that may appear when you have shoulder impingement include sudden pain in the shoulder when you lift your arms over your head and backwards. There are many other symptoms like weakness, restricted movements, and a nagging pain frequented from the front part of the sidearm. This nagging pain will worsen during the night time.

CONVENTIONAL TREATMENT METHOD OF SHOULDER IMPINGEMENT

There are many forms of conventional therapies like prescribing non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, RICE formula (Rest, Ice therapy, Compression, and Elevation), and corticosteroid injections.

Many side-effects are involved in the conventional shoulder impingement methods of treatment. Prolonged use of non-steroidal anti-inflammatory drugs can lead to heart problems, kidney-related problems, and gastrointestinal problems. Administering steroid injections can cause damage to the normal tissues that are around the damaged area.  Hence, usage of these steroidal injections for a prolonged period can lead to weakness. Some women also experience changes in their moods as well as the menstrual cycle.

As a last resort, your physician will suggest surgery to get rid of the symptoms. But shoulder surgeries may have many side effects like bleeding, stiffness of joints, infection, and the damage of nerves around the area of the surgery.

Treat Thumb Osteoarthritis With PRP Treatment

 Thumb osteoarthritis is a deteriorating condition, so many people are forced to opt for thumb joint replacement. However, many people are unaware of non-invasive alternate methods for delaying or avoiding thumb joint replacement surgeries.

In Medica Stem Cells Clinic, we offer treatment methods that may help you avoid the invasive method of thumb joint replacement with non-invasive therapies for thumb osteoarthritis.
Let us know first what thumb osteoarthritis is before we proceed with the non-invasive methods.

HOW THUMB OSTEOARTHRITIS OCCURS?

Compared to the other fingers, the thumb is distinctive because it can rotate more on its own at the carpometacarpal joint (CMC joint). CMC joint is situated at the bottom of the thumb, and it is commonly known as a basal joint. The thumb joint is held together inside a joint capsule that is filled with synovial fluid. This synovial fluid acts as a lubricant for the smooth movement of the thumb. Thumb osteoarthritis usually occurs in the CMC joint.
In the case of thumb osteoarthritis, the cartilage of the CMC joint deteriorates, and the easy movement of one bone over the other gets hampered. Hence, in this degenerative arthritis condition, the bones rub with one another, and a lot of friction is caused. Lastly, this friction leads to the damage of joints and bones. And the synovial membrane that produces synovial fluid and gets inflamed. In a severe condition, there will be a loss of the cushioning effect. Hence, it’ll lead to the grinding between the bones. Eventually, due to the prolonged grinding, there will be a change in the joint shape.
Women and elders above the age of 65 are at high risk of developing thumb osteoarthritis.

SIGNS OF THUMB OSTEOARTHRITIS

The most common sign of thumb arthritis is basal joint pain. The thumb gets worsened due to continuous movement, swelling, and stiffness around the region of the basal joint. Hence, there will be difficulty in gripping objects using the thumb.
Heal thumb osteoarthritis by conventional treatment
There are multiple forms of conventional therapies, like corticosteroid injections, RICE (Rest, Ice therapy, Compression, and Elevation) therapy, and prescribing NSAIDs (administration of non-steroidal anti-inflammatory drugs), e.g. ibuprofen. However, these can only provide momentary relief from inflammation and pain.
Also, consuming NSAIDs for an extended period can create many problems like damage to the kidney, gastrointestinal problems, and cardiovascular problems. Accordingly, prolonged usage of steroid injections can lead to a heart attack or stroke.
As a final solution to thumb osteoarthritis, the damaged thumb joint can be removed with the help of surgery. As a follow-up of surgery, a pad of tissue can be replaced. Therefore, it will aid in keeping the bones separated, and there won’t be any friction and damage. Hence, the bones will not rub with each other.
Undergoing surgery will create many complications. The thumb will look very prominently shorter after the surgery.

THUMB OSTEOARTHRITIS TREATMENT WITH REGENERATIVE THERAPY

Various regenerative therapies, including cell therapy and Platelet Rich Plasma (PRP) therapy, can help reduce your pain levels and offer faster recovery in a shorter time than conventional surgical treatment methods. These therapies aid in repairing the damaged tissues naturally and regenerating newer tissues in the damaged region. The platelets rich plasma containing active bio proteins and the regenerative cells used in Regenerative treatments are extracted from the patient’s own body. Therefore, there is no risk of any allergy or rejection.
Significant improvement may be seen in the patient as early as two weeks. Regenerative cell therapy helps in bringing the thumb joint to its normal mobility and function naturally. Hence, Regenerative therapy can be the best alternative to thumb joint replacement in some cases.

To learn more about Regenerative therapies and PRP treatment in UK, Ireland and India, please call Medica Stem Cells clinic in London on 020 8 168 2000, Dublin on 01 298 8000 or India on +91 9106092301

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Does Stem Cell Treatment Work For Osteoarthritis? What Do You Need To Know?

 Currently, researchers consider stem cells as the possible answer to many medical conditions, especially osteoarthritis. Their hope is that stem cell treatment can stop the progression caused by an ailment by repairing it. However, more research studies are ongoing to determine how stem cell therapy can be more effective and advanced to current protocols. Are you wondering what makes stem cell therapy so unique? Let’s read on.

How does stem cell therapy work?
Stem cell treatment uses the patient’s own cells to help restore the damaged tissues of your hip or knee joint. Unlike other treatments, stem cell therapy treats the underlying cause of knee pain and other joint pain. Hence, this therapy can reduce joint pain, increase movement, increase flexibility, speed up regeneration, improve blood flow, and treat ligament or tendon tears for a prolonged duration. Adult stem cell therapy is non-invasive and safe. Studies recommend that its side effects are very minimal with no adverse effects.

What are the stem cells used for knee osteoarthritis treatment?
Mesenchymal stem cells are used as they have the potential to differentiate into various types of cells. These mesenchymal stem cells can be administered as BMAC (bone marrow aspirate concentrate) and SVF (stromal vascular fraction).

How are BMAC and SVF collected?
BMAC
BMAC is collected as an aspirate from the bone marrow. This procedure is performed on the iliac crest under local anaesthesia. At the same time, this aspirate is concentrated with the help of a centrifuge to get the concentrate rich in beneficiary proteins. That’s bone marrow aspirate concentrate.
SVF
SVF collection involves the following steps:

• Collection of adipose (fat) tissue using liposuction procedure. The resultant is called lipoaspirate.
• Then centrifuged to separate and isolate the adipose-derived stem cells from blood and oil.
• Followed by a breakdown of fat by micronising the sample.

And the resultant SVF product can be readily injected into the affected joint area.

What happens during the BMAC or SVF procedure?
At first, a local anaesthetic is applied to the knee joint to numb any pain from the injection. Next, BMAC or SVF is injected intraarticular under ultrasound guidance for precision. Sterile dressings are applied to the affected area for up to three days to keep the injection area clean and prevent infection. Oral NSAIDs (non-steroidal anti-inflammatory drugs) should be avoided for four to six weeks before and after stem cell therapy as these negatively impact the healing process. However, always discuss with your doctor before stopping any medication!

How long does stem cell treatment last? What should you expect?
The effect of stem cell treatment for every joint region such as shoulder, knee, hip or ankle and foot fluctuates according to the severity and extent. However, several co-morbidities like kidney and heart issues, diabetes, body inflammation can also affect its success rate. Several research studies revealed that stem cell therapy had reported a long-lasting result anywhere between six months to a few years. The treatment can last up to 7 years or more depending on physiotherapy rehabilitation, active lifestyle, balanced diet and less stress post-treatment. Although no promises can be made about the exact duration of its long-lasting effect, stem cell therapy showed positive effects for a prolonged duration.

Is there any research update to back up the effect of stem cell therapy on knee osteoarthritis?
Yes.
A review article published in the year 2018 supports stem cells in the treatment of knee osteoarthritis. Stem cell therapy for knee pain appears to be very promising. A 2020 recent study conducted at Loughborough University in the United Kingdom recommended that the injection of bone marrow-derived mesenchymal stem cells in the affected knee could be safe, successful, and promising for cartilage repair and regeneration. This repair mechanism works due to the self-renewal, immunosuppressive, and differential potential of stem cells, especially bone marrow-derived stem cells. That’s why they bring significant improvement in your pain, functional outcomes, and overall quality of life. Michalek et al. published another 2015 large multi-national, multi-centre study on the journal Cell Transplant, proving that stem cell treatment works for a longer duration for arthritis. Nearly 63 per cent of patients had a minimum of 75 per cent improvement in pain and function. Similarly, 91 per cent of patients had a minimum of 50 per cent overall improvements. Of course, patients with obesity or severe arthritis took more time to respond. Anyhow, this is one of the most significant studies where all of them reported similar outcomes with a remarkable safety profile without any adverse side effects. According to the 2014 review article titled, ‘Mesenchymal Stem Cells in Regenerative Medicine for Musculoskeletal Diseases: Bench, Bedside, and Industry’ published in the Cell Transplantation journal, mesenchymal stem cells offered varied benefits such as spinal fusion, bone regeneration, tendon repair, cartilage defect restoration, disc degeneration, and osteoarthritis treatment.  

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5 Knee Pain Symptoms You Shouldn’t Overlook

 

The knee joint includes bones, ligaments, tendons, cartilage, and bursal sac. Hence, it is considered the most complex joint of the human body. All these parts should work together in a coordinated manner for various routine activities like walking, running, jumping, and bending.

The central part of the knee joint includes the thigh bone (femur), shinbone (tibia), and kneecap (patella). It is the connecting link between the shinbone and the thigh bone, where it helps many other body parts to work. The lubricant present in the bursa works as a cushioning agent between your knee bones to prevent the occurrence of any friction.

Any injury in this knee region causes pain. Knee pain either goes away on its own or aggravates. However, it would help if you never ignored several other symptoms along with the knee pain. Let us go through those five knee pain symptoms one by one:

5 SYMPTOMS OF COMMON KNEE AILMENTS

1. Consistent pain while walking or climbing stairs
Do you experience terrible pain in your knee while climbing stairs? The reason could be knee osteoarthritis. If you ignore this pain, it will aggravate more pain and discomfort. Additionally, your knee will degenerate since knee osteoarthritis is otherwise called a degenerative disease, causing stiffness and mobility issues.

Knee Osteoarthritis includes many other symptoms such as pain at night time that will wake you up from sleep, redness, swelling, stiffness, and warmth. These symptoms will take hours to wear off in the morning.

2. Something moving inside
Do you feel something is moving inside your knee joint? The knee joint should move. However, the things inside the knee joint should not move around. Sometimes, a piece of bone or cartilage might break or loosen and remain in and around the joint region. You feel that the foreign object remains in the knee joint, which does not prevent the joint from moving. At first, you may not experience any discomfort right away. However, it will eventually create a problem.

3. Noise in the knee
While cracking your knuckles, do you hear a popping sound? Are you wondering how this sound arises? It occurs due to the release of gas bubbles.
However, if there is knee pain or abnormal swelling, you will hear a popping, cracking, or snapping sound in the knee. Do not ignore this symptom. If you ignore it, you may experience permanent damage to your knee region.
If this popping sound is excruciating along with sharp pain, the reason could be an ACL Tear. In that case, you should consult the doctor right away.

4. Knee instability
The knee helps us to remain upright. If it becomes unstable, it will collapse, which shows that there are some severe issues in the knee joint.

5. Swelling in the knee
If the swelling in your knee is very mild, you generally don’t have to worry. However, if this swelling is extreme and sudden, it may be a tear in your knee joint. So, never ignore the swelling symptom.

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