As chronic pain specialists, our office sees many new patients looking for an alternative to a lifetime of pain killers and anti-inflammatories because of the risks associated with habitual use of these medications.
These risks including:
■ gastrointestinal distress,
■ liver and other major organ damage,
■ and overdose.
Patients also come to see us because they do not want to live their life in a drug induced “stupor.” Sometimes patients even become more sensitive to the pain and require higher doses of narcotics. Here is another risk: They don’t let you heal! A study in the American Journal of Bone and Joint Surgery said that not only does chronic use of opioid medications can lead to dependence but they can adversely affect perioperative and postoperative pain management, rehabilitation, and clinical outcomes after total knee arthroplasty. In patients they studied, a significantly higher prevalence of complications was seen in the opioid group. Patients who chronically use opioid medications prior to total knee arthroplasty may be at a substantially greater risk for complications and painful prolonged recoveries.
Most patients we see, visit us because they have already been given the surgical ultimatum – live with the pain or get the surgery. These patients want another choice to their knee replacement prognosis and diagnosis that include osteoarthritis (bone-on-bone caused by cartilage disintegration), weakness or tears in the meniscus and the ligaments. Supportive of this diagnosis will usually be a long history of MRI images, failed physical therapy and other conservative treatments. Many times they bring in a shopping bag filled with prescription pain-killers and anti-inflammatories and the long-list of over-the-counter remedies they take. Three options they have usually never tried or been informed of are Prolotherapy, Platelet Rich Plasma therapy, and Stem Cell Therapy. These treatments are injection therapies designed to rebuild cartilage, repair torn meniscus and ligaments, and reduce swelling and pain. They work similarly. First a proliferant, something in the injection that will cause tissue to regrow is introduced. The treatments work at growing new cells, Chondrocytes, the cells that comprise knee cartilage, and fibroblasts, the most common cells in the connective tissue (those that make up ligaments and tendons.)