Introduction
The human body is comprised of bones (two hundred six) and muscles (six hundred thirty-nine) for different functions present in the human body. Damage or injury to any of these can cause pain some of which lasts for a prolonged period.
What Is Musculoskeletal Pain?
Musculoskeletal pain is one of the most common conditions among humans which affects bones, joints, ligaments, tendons, or muscles causing pain in the respective areas alone (localized) or may cause pain overall in the body.
What Causes Musculoskeletal Pain?
Musculoskeletal pain can result from a variety of causes, some of which are mentioned below:
-
Injury - Fracture or dislocation of the bone, ligament tear, tendon tear, or muscle tear.
-
Health Conditions - Arthritis, fibromyalgia, gout, and osteoporosis.
-
Strenuous Activity - Excessive weight bearing, exercise in improper posture.
-
Developmental - Genetic disorders like osteogenesis imperfecta.
-
Deficiencies - Vitamin D deficiency.
What Are the Symptoms of Musculoskeletal Pain?
Musculoskeletal pain symptoms may be sudden in onset (acute) or continue to exist for a long period (chronic). Pain intensity also varies with the area involved. Some of the symptoms of musculoskeletal pain are as follows:
-
Sharp, stabbing, pulsating pain, or dull aching pain.
-
Mild to severe swelling that may cause difficulty in movements.
-
Stiffness and soreness cause pain in movement.
-
Redness of the skin on the affected side.
-
Tiredness and sleep disturbance due to pain.
How to Diagnose Musculoskeletal Pain?
A physical examination usually predicts the area affected and the cause of musculoskeletal pain. However, a computed tomography (CT) scan, magnetic resonance imaging (MRI), or an X-ray is usually used to confirm the diagnosis of musculoskeletal pain.
How to Treat Musculoskeletal Pain?
Treatment modalities vary depending on the cause of musculoskeletal pain. The prime focus is to relieve pain for the individual, find the causative factors, and to achieve long-term relief.
-
Medications - Pain management with non-steroidal anti-inflammatory drugs (NSAIDs such as ibuprofen) Acetaminophen, and Aspirin. Corticosteroid injections may also be given to provide immediate relief, for example, musculoskeletal pain after a slipped disc.
-
Therapy - Physiotherapy, and occupational therapy can help relieve pain. Treating reassure points by a trained acupuncturist or a chiropractor can also help.
-
Exercises - At-home yoga, exercises under the supervision of a trained instructor can help relieve pain in certain conditions. Applying heat in areas relieves muscle discomfort by improving blood circulation to the area. Applying cold areas affected by swelling and pain can give a sense of relief.
-
Surgery - Utmost severe cases, where nerve compression is the cause of pain or muscle tear that cannot heal will need a surgical intervention to relieve pain and improve the quality of life for the individual.
These treatment modalities do not give long-term pain relief in most musculoskeletal conditions as they cannot reverse any associated structural changes. Recent studies are doing multiple methods as trials to enhance healing and stimulate growth in injuries involving soft tissue and bone for long-term pain management. The use of platelet-rich plasma (PRP) is one such method.
What Is Platelet Rich Plasma?
In the human body, blood circulates with the help of a liquid medium called plasma, which contains suspended components such as platelets, red blood cells, and white blood cells.
Platelets help in the following:
-
Blood clot formation.
-
Platelets consist of cytokines and growth factors that help promote the healing and repair of the tissues
-
Exert anti-inflammatory effects (reduce swelling).
-
Exert analgesic effects (reduce pain).
Platelet-rich plasma is prepared in two phases. At first, anticoagulated blood from the individual is withdrawn from the individual and centrifuged at a particular speed to separate the blood components and get a concentrated form in the plasma. Platelets settle down slowly and red blood cells float to the top and white blood cells settle between the red blood cells and platelet concentrate. Another faster spin further separates the platelet-rich plasma from the platelet-poor plasma. Incorrectly performing the process can result in a plasma-rich concentrate that contains a lower concentration of platelets and a higher count of red and white blood cells than necessary.
How Does Platelet Rich Plasma Work?
The average of a normal individual’s platelet count is 250,0000 platelets per microliter (the normal range is 150,000 to 350,000 per millionth of a liter). The plasma concentrate is recommended to be five to six times the average count to have a beneficial effect.
In an adequate amount, the platelet-rich plasma has the potential to enhance cartilage repair, attenuate arthritis symptoms, and improve joint function.
Platelet-rich plasma promotes the healing process by delivering high concentrations of alpha-granules containing endothelial growth factor and transforming growth factor-β to areas of soft tissue damage. Platelet-rich plasma also stimulates cell proliferation and cartilaginous matrix production. Platelet-rich plasma also induces nearby healthy cells to synthesize greater amounts of growth factors.
How Is Platelet-Rich Plasma Used for Musculoskeletal Pain?
Various studies have shown that administration of platelet-rich plasma at the affected site can help conditions of musculoskeletal pain by the following:
-
Shorten recovery time.
-
Reduce pain.
-
Promote soft tissue healing.
-
Regenerating tendon.
-
Enhance bone strength.
-
Produce bone healing in a shorter time.
-
Decrease the wound infection rate.
-
Enhancement of osteoconduction (bone growth on the surface).
-
Reduce surgery-related swelling and pain.
-
Increasing the vascularity of tissue.
Approximately it takes about six to eight weeks to assess the benefits of platelet-rich plasma after administration.
What Are the Risks of Platelet Rich Plasma?
Risks are rarely reported from the use of platelet-rich plasma. Rarely, minimal pain, soreness, and discomfort at the injected site, which resolves on its own in a few days have been reported.
Allergic reaction from platelet-rich plasma is also not a concern since it is derived from one’s own blood. Further studies are needed to establish the effectiveness and indications for the use of platelet-rich plasma. Protocols also need to be set regarding the dosage, duration of use, and the way to administer platelet-rich plasma for maximum prolonged benefit.
Conclusion
Musculoskeletal pains are the most common cause of severe long-term pain and physical disability among humans. The severity of pain or the prolonged duration tends to have a major impact on the quality of life of individuals. Once platelet-rich plasma can be regarded as a mainstream treatment when conservative treatment modalities are ineffective, it will also help prevent the need for invasive surgeries in most cases.
